Leading The Way In Fellowship Education Training

Rotations

Rotations include thirteen 4-week blocks during the academic year for a total of 52 weeks of fellowship instruction. 4 weeks of vacation will be assigned during elective rotations.

Critical Care Ultrasonography (CCUS)

Stanford Critical Care Medicine has a long and extensive history in training fellows and residents in bedside echocardiography and ultrasound for critically ill patients.  In 2009, Dr. Anne-Sophie Beraud enhanced the training through implementation of bedside training, simulation training, focused individual feedback for acquired images, and online resources.  Dr. Beraud and Dr. Sara Nikravan developed a self-directed online training course for Anesthesia, Internal Medicine, and Emergency Medicine trainees.  This course is now available through Stanford EdX.  The course will lead you through the core concepts of ultrasound physics, transthoracic echocardiography, lung ultrasound, and measurement techniques.

The Critical Care Ultrasound (CCUS) training for our fellows is currently run by 3 Co-Directors Dr. James McAvoy (ACCM), Dr. Natalie Htet (EM-CCM), and Dr. Daniel Gerber (Cards-CCM).  The CCUS training encompasses formal training in TTE, non-cardiac applications (FAST exam, lung, abdominal, DVT, and ocular ultrasound) of ultrasound in the ICU, as well as ultrasound-guided vascular access.

Training in transthoracic echocardiography (TTE) for critically ill patients takes place over the entirety of the fellowship program in order to provide a longitudinal learning experience. All fellows are assigned one of the 3 Co-Directors of CCUS who provide 1:1 hands-on scanning sessions and are available for image review and feedback as the year goes on. Fellows are encouraged to record all studies and document all studies throughout fellowship training.  All fellows are trained to reach competency at the advanced level by the end of their training.  The recommended studies for competency in critical care ultrasound training are listed below and are adapted from SCCM, SOCCA, and Stanford CCM guidelines.

Airway Management Training

The Stanford Advanced Airway Management Program (SAAMP) of the Department of Anesthesiology offers comprehensive, multidisciplinary airway training to a national and international audience. The course is ideally suited for anesthesiologists, critical care, emergency medicine, and ENT physicians.  Critical care fellows will attend this course during their fellowship training to advance their airway management skills.  Many of our current and former faculty in addition to current and former fellows are highlighted in this video showcasing the course.


Non-anesthesia fellows receive hands-on training in basic airway management with all routine intubations using an outstanding video laryngoscopy system, so that subtleties of direct laryngoscopy can be learned, in the realtime ICU environment.

An Advanced Airway Workshop in all areas of airway management is held in conjunction with the Anesthesia department to train fellows in basic/advanced Fiberoptic intubation techniques, as well as many other advanced techniques (LMA, Fastrach LMA, Trachlight, Double lumen endotracheal intubation, Retrograde guidewire, classical and percutaneous Cricothyrotomy)..

Critical Care Simulation

Stanford is well known for being one of the pioneers of simulation in Anesthesia. The Simulation Center is now being used  to help improve physician response in highly stressful, life-threatening situations.

Fellows serve as instructors in a critical care simulation course for medical students and participate in simulation-based team training activities at both the VA and Stanford hospitals. There are also routine unannounced in-situ mock codes at the VA and Stanford hospitals to simulate multidisciplinary crisis management. Facilities include high capability simulation centers at both adult hospitals and Packard Children’s hospital, and use of workplace-based (in situ) simulations throughout these facilities. Stanford has a long-standing tradition in using patient simulation to research human performance in the operating room and ICU.

Fellows can use research time to develop a scholarly concentration in simulation activities by participating as an instructor in existing programs and potentially developing their own curricula. Fellows are welcome in simulation instructor courses, debriefing workshops as well other medical education programs throughout the medical school.