Required Rotations

The CICU  is a mix of cardiac and cardiac surgery patients requiring critical care and is a closed model with cardiac intensivists providing all care. The heart failure service occasionally is primary on patients in the 4A ICU; however, if they are intubated for greater than 48 hours, they require complication by the CICU team for critical care management. See CTICU rotation description for details on cardiac surgery patients.

The patient population consists of those with cardiogenic shock with or without VA ECMO including cardiac arrest, massive PE, and general cardiology patients requiring ICU level of care. In addition, the CICU team provides complicated services for the pulmonary embolus response team (PERT), general ICU consultations for the heart failure team and other ICU-level patients with cardiology complicated needs, and any patients requiring peripheral VA ECMO.

The MICU is a mostly closed unit meaning trainees are the primary physicians and are responsible for, under the direction of the teaching Attending physician, all aspects of their patients’ medical care. Discussion about diagnostic testing, pathophysiology, medication selection, and patient disposition is facilitated by the teaching physician with the expectation that Fellowship trainees can defend their decisions at a scientific level appropriate to their experience. The unit consists of two teams each with 1 resident and 1 intern. There is an APP assigned to the MICU who works with both teams and there may be medical students and/or a Family Medicine resident.

The Medical ICU admits patients with a wide variety of multi-system illnesses although respiratory failure, sepsis, acute neurological disease and liver failure predominate. Patients will encompass all age groups over 18 years of age, including geriatric patients, and both genders. Minnesota Health is a tertiary referral center and most patients are admitted from within the hospital, transferred from other medical centers for specialized care or, less frequently, admitted from the Emergency Department. Fellows’ interactions with patients and families is broad as patients admitted to the University of Minnesota Medical Center range from sophisticated, high-expectation medical consumers to disadvantaged, non-English-speaking immigrants. Fellows are exposed to patients with advanced forms of common diseases such as emphysema and liver cirrhosis as well as patients who require specialized therapies such as lung, heart and blood transplantation, mechanical cardiac support devices and extracorporeal membrane oxygenation. In addition, patients with acute severe illness refractory to standard therapies are seen requiring specialized ventilatory strategies, novel medications or immunologic therapies, or advanced Interventional Radiology or Gastrointestinal procedures. Severity of illness is higher than community intensive care units with 30 day mortality rates averaging 12% over the last three years. Fellows gain valuable experience in treatment-limitation decision-making, family conferences and the process of support withdrawal.

M Health Fairview Southdale is a 23 mixed medical, surgical, cardiovascular, and neurological intensive care. It is an open ICU model with high-intensity ICU provider staffing with a mix of medical, surgical, and anesthesiology trained intensivists. The intensivist service is the primary provider on all patients requiring mechanical ventilation, pharmacological and/or mechanical hemodynamic support, and otherwise acts in a consultant role for ICU patients not meeting the above criteria. ICU additionally employs a co-management model with cardiovascular surgery and sees all postoperative patients.

All adult patients requiring ICU level intervention or monitoring including medical, surgical, neurological, cardiac and cardiac surgery patients