All fellow educational activities (lectures, journal clubs, M&M conference, guideline reviews) occur from 10:00-11:00 AM on weekdays (Monday-Friday), unless otherwise noted.

Didactic Lecture Series

Fellows attend fellow-specific didactic lectures several times a week throughout the year. These lectures are presented by faculty from within the intensive care division as well as experts from other departments in the institution. The topics covered during this series provide a comprehensive knowledge of critical care medicine and are selected based on ACGME-published guidelines as well as fellow feedback.

Point of Care Ultrasound and Critical Care Echocardiography

Basic transthoracic cardiac and pulmonary ultrasonography is rapidly becoming a standard of care for intensivitists, because it allows for rapid noninvasive assessment of pulmonary status, hemodynamics, cardiac function, and volume status. 

Critical care fellows at Iowa will have access to a state-of-the-art, high-fidelity transthoracic and transesophageal echocardiography (TTE/TEE) simulator as part of their training. The formal critical care echocardiography curriculum at Iowa includes supervised and independent sessions on the TTE/TEE simulator, supervised exams of volunteer model patients, formal instruction on the use of ultrasound equipment currently available for bedside use in our ICUs, didactic lectures, directed readings, informal bedside teaching from faculty in the course of routine patient care, and an expectation that fellows dedicate significant independent time to ultrasonography study. Fellows will be routinely tested on their knowledge of terminology, anatomy, and recognition of pathology, and will be expected to demonstrate proficiency of transducer manipulation and image acquisition on the TTE/TEE simulator. 

An additional elective rotation in clinical echocardiography, that can include hands-on exposure to intra-operative and medical in- or out-patient transesophageal echocardiography as well as proctored interpretation of echocardiographic studies, is available.

By the end of their fellowship, trainees will be expected to able to:

• Recognize the basic physical principles of Ultrasound image formation and imaging planes;
• Define terminology involved in probe and transducer manipulation and orientation;
• Identify common steps required to improve poor image quality;
• Consistently obtain high-quality standard echocardiograpy views on patients; and save and interpret still- and cine-images from these views;
• Identify normal and abnormal cardiac, thoracic, abdominal, and vascular anatomy;
• And apply all these skills to use focused ultrasonography for monitoring patients (for example, to assess intravascular volume status and volume responsiveness) and for diagnosing emergent conditions (such as pneumothorax, significant pulmonary edema, pulmonary embolus or other cause of acute right heart failure, pericardial effusion, a significant decrease in left ventricular function, deep venous thrombosis, and certain intra-abdominal pathology).

Journal Clubs

Journal clubs are held once a month and are attended by fellows and faculty. During each journal club, three fellows will present one article each. Two of these articles will be selected by the fellows from recent literature. The third will be selected from a list of landmark studies that have greatly affected the practice of critical care medicine. In addition to the presentation and an open discussion of the articles, the fellows will also discuss a statistical concept relevant to the chosen article. On a quarterly basis, instead of the standard format, a Pro-Con debate is presented. For this presentation, two fellows will pick a controversial topic related to critical care and present an evidence-based pro-con debate.

Morbidity and Mortality Conference

Once a month a divisional Morbidity and Mortality Conference is held in which three fellows present one case each to the other fellows and faculty with open discussion following the presentations. Approximately every two months, the critical care fellows presents their cases at the Department of Anesthesia’s departmental Morbidity and Mortality Conference, which is held on Wednesdays from 5:00-6:00 PM.

Critical Care Reading Program

A critical care reading program is available to guide fellows self-study. Each week, one chapter from a leading critical care text and 2 influential journal articles are assigned, and fellows meet with faculty every 2 weeks to discuss.  This program effectively covers the breadth of critical care over the one-year fellowship period.

Core Intensive Care Unit Rotations

Nine months of the year-long fellowship are spent in the Surgical and Neurosciences Intensive Care Unit (SNICU) and Cardiovascular Intensive Care Unit (CVICU). The SNICU has four bays with a total of 30 beds and the CVICU (which is a mixed medical and surgical unit) will usually have 6-8 covered beds, depending on surgical census. Four teams cover the SNICU/CVICU (three based in the SNICU, one based in the CVICU). Fellows will rotate on an equal basis among the four teams, generally spending 2-4 weeks at a time with each team.

Elective Rotations

Up to three months may be spent in elective rotations relevant to critical care medicine. The two most popular electives are Echocardiography and Bronchoscopy. Other possible electives include, but are not limited to, Infectious Disease, Neurology, Nephrology, Medical Intensive Care, Pediatric Intensive Care, OR Anesthesia, Burn Surgery, and Research. Novel electives based on a fellow’s particular interests can be arranged with prior notification and approval. Electives are generally two or four weeks in length, depending on the rotation sponsor’s and fellow’s preferences.

Rotation Goals and Objectives

Goals and objectives are established for each rotation and can be reviewed here (note: UIowa/Internal access only)

Call responsibilities are shared equally amongst all critical care fellows.

On weekdays (Monday through Friday), fellows take 24 hour, in-house call, with one fellow being on call each night.

On weekends (Saturday and Sunday), one fellow will cover both days (48 hours) on home call.

How are the applicants chosen for interviews?

Applications are reviewed by a group of faculty. Based on the strength of the candidate and their application materials, an interview is offered.

Can you describe a typical clinic day for your fellows?

Fellows generally show up at around 7:00am. Morning rounds start at 7:30 and are most often done by 9:30-10:00. Fellow lectures, journal clubs, morbidity and mortality conferences, etc. are from 10:00-11:00 several days per week. Afternoon/checkout rounds occur at 2:00pm and generally last one hour. After checkout rounds, the non-call fellows make sure any outstanding issues are taken care of and generally leave by 5:00pm.

Do you have an electronic record?

Yes, since November 2010 the University uses Epic for medical records, including documentation and orders.

Do fellows have an educational fund?

Yes. Fellows are allotted a fund of $2,400 to provide support for specific needs during the course of their training, including attendance at one national meeting (attendance at the Society of Critical Care Medicine’s annual meeting is highly encouraged).

What are your average duty hours?

Fellows average less than 60 hrs per week. Duty hours are tracked by MedHub.

Can you give me an overview of your clinical activities?

The fellowship is based in the Surgical and Neurosciences Intensive Care Unit (SNICU) and the Cardiovascular Intensive Care Unit (CVICU). Fellows actively participate in the care of all patients in these units and are exposed to a broad and comprehensive patient base encompassing all aspects of critical care medicine. Experiences include, but are not limited to, complicated post-operative patients (solid organ transplant, heart and lung transplant, ventricular assist devices and total artificial heart, major vascular, etc.), neurological disease (stroke, intracranial bleed, neoplasm), trauma, respiratory failure/ARDS, cardiac failure and ischemia, liver and kidney dysfunction, and sepsis. The critical care service is responsible for all ventilator management, invasive monitoring, and coordination of care among the participating services. There is a particular emphasis on non-invasive cardiac output monitoring and procedural and diagnostic ultrasound.

How is fellow performance evaluated?

Faculty evaluate fellows quarterly using MedHub and the director meets semiannually, and as needed, with each fellow to review these evaluations and develop corrective strategies if indicated. The evaluations are based on the six ACGME core competencies. Nursing and other support staff also evaluate the fellows quarterly. These evaluations are also reviewed with the fellow during their semiannual meeting with the director.

Do fellows educate other trainees?

Yes. Residents of all training levels from multiple services rotate through the SNICU. In addition, the SNICU rotation is a popular elective among third and fourth year medical students. Fellows are encouraged to be active in both the clinical/bedside education of these learners as well as participating in didactic lectures to residents and medical students.

Welcome to the University of Iowa Emergency Medicine Critical Care Multidisciplinary Track of the Anesthesia Critical Care Fellowship. Critical care is one of the fastest growing subspecialties in emergency medicine, and the University of Iowa is offering a 2-year comprehensive, interdisciplinary fellowship to train the next generation of emergency medicine critical care leaders. Our program is based in the Department of Anesthesia with clinical rotations throughout the 811-bed University of Iowa Hospitals & Clinics, and with cooperation from the Department of Emergency Medicine, the Department of Surgery, and the Division of Pulmonary, Critical Care, and Occupational Medicine. Fellows will be training alongside fellows in other critical care fellowship programs, offering a rich environment for interdisciplinary training. Graduates will be eligible for certification through the American Board of Emergency Medicine Anesthesia Critical Care Medicine Pathway.

The Emergency Medicine Critical Care Track is a distinct track of the Anesthesia Critical Care Fellowship that prepares emergency medicine graduates for a broad-based multispecialty critical care practice.

Our fundamental philosophy is:

• To train excellent critical care clinicians with a broad multi-specialty critical care experience to manage diverse critical care patient populations in both academic and community settings,
• To advance the specialty of emergency medicine-critical care through scientific discovery, medical education, and quality improvement through ICU administration, and
• To develop leaders in emergency medicine to advocate for continuity of critical care from the prehospital environment through the emergency department, the intensive care unit, and recovery from critical illness.

With four pathways to board-certification now available to emergency physicians, we are excited to be on the forefront of training emergency medicine intensivists. We are looking for applicants who want to shape this movement through teaching, research, practice, and advocacy. You are joining a select group of emergency medicine intensivists, and we are excited that you are interested in joining us.

Quick Facts

• Multispecialty training in surgical, medical and subspecialty critical care
• 811-bed hospital with 103 adult critical care beds
• Rotations in 4 adult critical care units
• The University of Iowa Hospitals & Clinics Emergency Treatment Center is a new facility (opened in 2009) that sees approximately 60,000 patients annually
• ACGME-accredited critical care fellowships in anesthesia critical care, surgical critical care, pulmonary and medical critical care
• ACGME-accredited emergency medicine residency with 27 current residents
• Located in a progressive Midwestern university community with excellent schools, recreation, and ranked as one of the top 5 Most Livable Cities in America (Livability 2018)

Program Certification

The University of Iowa has had an Anesthesia Critical Care Fellowship continuously accredited since 1994. The American Board of Anesthesia has approved the emergency medicine track curriculum, and graduates will be eligible for Anesthesiology Critical Care Medicine board certification through the American Board of Emergency Medicine.

Archit Sharma, MD MBA
Fellowship Director
Department of Anesthesia
200 Hawkins Drive, 6512 JCP
Iowa City, IA 52242-1079
Phone: 1-319-384-7911
Fax: 319-356-2940
archit-sharma@uiowa.edu

Nick Mohr, MD
Assistant Fellowship Director, EMCC Track
Departments of Emergency Medicine and Anesthesia
200 Hawkins Drive, 1008 RCP
Iowa City, IA 52242-1009
Phone: 1-319-384-6511
nicholas-mohr@uiowa.edu

Tammi Steffen, BS
Critical Care Fellowship Coordinator
Department of Anesthesia
University of Iowa Hospitals & Clinics
200 Hawkins Drive, 6546 JCP
Iowa City, Iowa 52242-1079
Phone: 1-319-356-7205
tammi-steffen@uiowa.edu

Program Accreditation

The anesthesiology critical care medicine fellowship at the University of Iowa Hospitals & Clinics is a one-year Accreditation Council for Graduate Medical Education accredited program. The program is approved for 4 total fellow positions.

Information specific to program requirements for an anesthesiology critical care medicine training program and milestones for fellow performance may be found at the ACGME’s Anesthesiology Review Committee (RC).

Board Certification

The ABA-American Board of Anesthesiology-certifies physicians in critical care medicine by administering the Critical Care Medicine examination. Our fellowship program expects fellows to become certified in Critical Care Medicine.

The critical care medicine physician is a specialist whose knowledge is of necessity broad, involving all aspects of management of the critically ill patient, and whose primary base of operation is the intensive care unit (ICU). This physician has completed training in a primary specialty and has received additional training in critical care medicine aspects of many disciplines. This background enables the physician to work in concert with the various specialists on the patient care team in the ICU; to utilize recognized techniques for vital support; to teach other physicians, nurses and health professionals the practice of intensive care; and to foster research.

Subspecialty certification is detailed in the ABA's BOI (Booklet of Information).

Eligibility criteria for applicants:

1.  Graduate from one of the following:

• United States or Canadian medical school accredited by the Liaison Committee on Medical Education (LCME)
• United States college of osteopathic medicine accredited by the American Osteopathic Association (AOA)
• Medical school outside the United States or Canada with:
  • A valid certificate from the Educational Commission for Foreign Medical Graduates (ECFMG) and have a passing score for Step 1 and Step 2 of the USMLE
  • Be a U.S. citizen, a legal permanent resident, or hold a visa which provides eligibility to work in the U.S. Typical visas are J-1 (requires Steps 1 and 2 of USMLE and ECFMG certification) and H1-B (requires departmental approval, and Steps 1, 2 and 3 of USMLE, and an Iowa medical license)

2.  Meet Iowa Board of Medicine licensure requirements.

3.  All applicants must also meet program eligibility requirements as defined by the ACGME’s respective RRC.

Contact our Fellowship Coordinator if you have any eligibility questions.

The Department of Anesthesia at Roy J. and Lucille A. Carver College of Medicine and UI Health Care shares the University of Iowa’s commitment to equal access and, consistent with its academic mission and standards, strives to achieve excellence through the advancement of diversity, equity, and inclusion. In the Department of Anesthesia, we are mindful of all aspects of human difference and define diversity in the broadest sense to mean inclusion of all persons. This means we do a holistic review of applications, with particular interest in recruiting applicants who have shown grit and resilience in their path to medicine, as well as potential to lead anesthesiology in the future.

The Interview

To minimize health risks associated with travel during the COVID-19 pandemic, and in compliance with institutional, state, and national recommendations, we will conduct all interviews will be conducted online only. We will not offer any in-person interviews or site visits during this cycle. The online-only interview requirement applies to all candidates, internal or external, so that we may provide an equitable experience to all applicants.

We plan to interview candidates beginning in December and ending in February. Match Day for the Critical Care Fellowship is generally in May for the following July 1 start.

Invitations to interview

Interview invitations from our program will be extended via SF Match. You will be able to see available times and dates and self-schedule your interview.

What should I expect on the interview day?

We plan to conduct interviews on the Zoom platform. The interview day includes an overview of the program, a virtual tour, and interviews with the program director, current fellows, and Anesthesia Critical Care faculty.

Current Fellows (2023-2024)

Emergency Medicine Track, First Year

Joseph Crum, DO

Steven Ilko, MD

Marc Toofan, MD

Emergency Medicine Track, Second Year

Jordan Miller, DO

Graduates

Erin Evans, MD (2021-2023)

Jenna Lizzo, MD (2021-2023)

Rachel Posey, DO (2021-2023)

Erik Campbell, MD (2020-2022)

Alysa Davis, DO (2019-2021)

Benjamin Rezny, DO (2019-2021)

Brad Johnson, MD (2018-2020)

Aaron Tyagi, MD (2018-2020)

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Graduates (2018-2019)

• Alex Suginaka, DO, Critical Care Medicine Fellow
• Bharathram Vasudevan, MD, Critical Care Medicine Fellow

Graduates (2017-2018)

• Michael Hicks, DO, University of Iowa
• Luke Linz, DO, University of Iowa
• Anna Riessen, MD, University of Iowa
• Adrienne Samar, MD, University of Iowa

Graduates (2016-2017)

• Anita Chazhikattu, MBBS, University of Iowa
• Alexandra Chludzinski, MD, University of Iowa
• Sara Herrera, MD (Surgery), St. John Hospital, Detroit
• Jennifer Shanklin, MD (Surgery), University of Iowa

Graduates (2015-2017)

• Emergency Medicine Track
  • Ryan Dick-Perez, DO, Summa Akron City Hospital
  • Robert Plambeck, MD, Eastern Virginia Medical School