The critical care fellowship has established a series of optional longitudinal electives as part of the curriculum.  While these are not required, these curriculum tracks offer the fellow more in-depth experience for developing additional qualification, certification, or competence during the critical care fellowship.  These longitudinal electives will consist of dedicated month(s) of elective, in addition to a sustained exposure to the topic of interest during a 6-month period of the fellowship.  The currently available tracks are listed below:

Extracorporeal life support

This elective consists of a 1-week course in extracorporeal life support management, followed by 2 weeks of dedicated time learning from the ECMO physicians and specialists. Following the dedicated 3-week elective, the fellow will take call with the ECMO team and round on ECMO patients in the cardiovascular ICU (venoarterial ECMO) and the medical ICU (venovenous ECMO).

Transthoracic echocardiography

This elective consists of an introduction to cardiac echo, followed by 2 months of dedicated  rotations in the echocardiography laboratory. During these rotations, fellows will be performing formal echocardiograms (in both critically ill and non-critically ill patients and interpreting echocardiograms with cardiologists specializing in echo interpretation. After the elective time, fellows will spend some afternoons on other rotations performing and interpreting echocardiograms, with the goal of 300 echo interpretations and 150 supervised echocardiograms. At the conclusion of this 6-month experience, the fellow will have sufficient training and experience to sit for the American Board of Echocardiography Transthoracic Echocardiography Board exam, and would qualify for Testamur status on successfully passing the examination.

Percutaneous dilatational tracheostomy

This elective consists of a dedicated 2-day course in percutaneous tracheostomy placement, followed by structured meetings with the acute care surgeons who perform bedside percutaneous tracheostomy at the University of Iowa. After the didactic portion of this rotation, fellows will observe 5 tracheostomy procedures, then will perform 15 percutaneous tracheostomy procedures with graded levels of responsibility (consistent with training requirements recommended by American College of Chest Physicians and American Thoracic Society).

Inter-hospital transfer

This elective starts with a one-month EMS experience incorporating air transport, ground transport, EMS education, and EMS administration components. Fellows will fly on AirCare, the University of Iowa helicopter aeromedical transport service.  They will provide direct clinical care during their shifts, and they will have a didactic and reading program focused on the administration of EMS services, especially for critically ill patients undergoing interfacility transfer. Over the remainder of a one-year experience, they will be scheduled for AirCare shifts and providing continuing prehospital provider education as well.