Faculty
The Program Director of the Anesthesiology Critical Care Medicine (ACCM) Fellowship is Dr. Robert N. Sladen, who is Medical Director of the Cardiothoracic and Surgical Intensive Care Units and Medical Director of Respiratory Therapy at Columbia University Medical Center. Dr. Sladen is a Fellow of the American College of Critical Care Medicine (FCCM) and a Past-President of the Society of Critical Care Anesthesiologists (SOCCA).
The Critical Care Division consists of a group of dedicated critical care anesthesiology faculty, including Dr. Sladen (Chief), and Drs. Tricia Brentjens, Matthew Coleman, Brigid Flynn, Sumeet Goswami, Desmond Jordan, Steven Miller, Vivek Moitra, Joseph Rumley, Peter Salgo, Julia Sobol, Gebhard Wagener, Staffan Wahlander, Brian Woods and Hannah Wunsch.
Clinical Experience
Each year up to nine positions are available in this 12-month ACGME-accredited program. It is designed to take the Fellows through increasing levels of experience and responsibility and prepare them for Board Certification in Anesthesiology Critical Care Medicine (ACCM). The Fellows supervise and teach anesthesiology and surgery junior house staff and medical students under the direction and guidance of the ICU Faculty.
The Fellows rotation is organized into 13 four-week blocks. About 50% of the year is spent as a key member of the ICU team on the Milstein and Heart Center Cardiothoracic Intensive Care Units (CTICU, 27 beds) and Surgical Intensive Care Unit (SICU, 16 beds). Combined, the two units average about 2200 admissions per year. Together they provide postoperative care for patients undergoing transplantation (heart, lung, liver, pancreas), ventricular assist device insertion, CABG and valvular surgery, major thoracic surgery, major vascular surgery and a wide variety of general and subspecialty surgical procedures. The ICU Fellows have an office with computer support and sleeping facilities directly adjacent to the CTICU and SICU.
About 25% of the year is spent providing consultation outside the ICU, and about 25% of the year on elective rotations tailored to the individual Fellow’s interests. Choices for electives include Medical ICU, Coronary Care Unit, Neuroscience ICU, Ethics, Palliative Care and Pediatric ICU, as well as preceptorships with specialists in infectious disease, nutritional support, dialysis and liver transplantation. In addition there is instruction and hands-on experience in transesophageal and transthoracic echocardiography throughout the year.
Our goal is to give our Fellows exposure to a wide variety of ICU problems and approaches. Each Fellow takes ICU Call one night in six or seven in the two "home units" (CTICU and SICU) throughout the year, with day off after call. In addition there is a night float week (8 pm – 8 am) every seventh week. As the year progresses the ICU Fellow takes increasing responsibility for the conduct of rounds and decision-making, while the ICU Attending remains available for backup and support as appropriate.
Academic and Administrative Activities
Twice weekly the ICU Fellow leads multidisciplinary bedside rounds attended by the ICU Nurse Manager, Social Worker, Respiratory Therapist, Physical Therapist and representative of Ethics Committee. The goal is to formulate joint strategies for family support and discharge planning of long-term ICU patients. Every ICU Fellow is a full member of the CT-SICU Multidisciplinary Quality Improvement Committee, which meets monthly and includes the ICU Faculty, Nurse Managers and senior nursing staff, and representatives from Respiratory Therapy, Pharmacy, Social Services, Nutritional Support, Laboratory and Hospital Quality Assurance.
The Fellows, together with the Faculty, give lectures at the ICU Teaching Conference (ICU 101) for medical students, residents, physician assistants and nurse practitioners, as well as their own Fellowship seminars (see below). They are responsible for coordinating our monthly Morbidity and Mortality Rounds. During the year Fellows, together with an ICU Faculty mentor, provide presentations at Department of Anesthesiology Grand Rounds and at Critical Care Grand Rounds.
Our Fellows are encouraged to attend major critical care meetings such as the Society of Critical Care Anesthesiologists (SOCCA) or the Society of Critical Care Medicine (SCCM). The Department of Anesthesiology provides $1,600 each year toward academic support and activities for each Fellow.
Research Activities
Fellows are encouraged to participate in ongoing research projects and are given all available assistance in setting up their own research projects. Funding is obtained through grants approved by the Department of Anesthesiology and outside funding agencies. Through the Columbia University Office of Clinical Trials, Fellows obtain certification in Good Clinical Practice and attend an annual course at the Irving Center for Clinical Research on clinical research protocol design and statistics.
Current areas of research interest include:
- ICU outcome studies – validation of predictive models
- Sedative and analgesic regimens and delirium in the ICU
- Renal protective strategies in the ICU
- Perioperative outcome of liver transplantation
ICU Research Meeting: 2:30 p.m. – 3:30 p.m., twice per month
Venue: SICU Conference Room, Milstein Hospital 4th Floor
This Meeting is organized by the ICU Clinical Research Coordinator, and is open to all ICU Fellows as well as Faculty and research coordinators. We review and discuss all ongoing and developing research projects in the Division. It is an opportunity for ICU Fellows to learn about projects that they may be interested in joining, or to present their own ideas.
Teaching Conferences
ICU Teaching Conference (ICU 101): Every Monday, Tuesday, Friday 1:30 - 2:30 p.m.
Venue: SICU Conference Room, Milstein Hospital 4th Floor
This Conference is coordinated by Dr. Brian Woods. Three days a week a one-hour tutorial is presented to the ICU residents, medical students, physician assistants and nurse practitioners. It provides didactic coverage of the ICU Core Curriculum to supplement rounds and bedside teaching by the ICU Faculty, pharmacists and nutritionists. In the second half of the year the ACCM Fellows take over many of the lectures themselves and so have the opportunity to hone their didactic teaching skills.
Transesophageal Echo (TEE) Fellows’ Lecture: Every Wednesday 1:00 - 2:00 p.m.
Venue: SICU Conference Room, Milstein Hospital 4th Floor
Dr. Jack Shanewise (Chief, Division of Cardiothoracic Anesthesiology) gives a weekly lecture on TEE to the combined group of ACCM and ACTA (Adult Cardiothoracic Anesthesiology) Fellows. This is a unique opportunity to receive what is essentially a one-year course on TEE delivered by an acknowledged expert.
Critical Care Fellows’ Journal Club: Every Wednesday 2:00 - 3:00 p.m.
Venue: SICU Conference Room, Milstein Hospital 4th Floor
Dr. Hannah Wunsch coordinates this weekly Fellows’ Journal Club. Presentation assignments are rotated among the ICU Fellows. The goal is to stimulate interactive discussion on a wide range of topics in critical care medicine between Fellows and Faculty. These include “classic” critical care papers, recent therapeutic advances, evidence based medicine, ethics, medico-legal issues, and other issues pertinent to organization and medical direction of an ICU
On the last Wednesday of each month we host a Multidisciplinary CCM Journal Club that combines Faculty and Fellows from CTICU, SICU, Medical ICU and Neurosciences ICU. Our Fellows alternate presentations of journal articles with the Pulmonary Medicine Fellows and Neurointensive Care ICU Fellows. Discussion is led by the joint ICU Faculty.
Critical Care Fellows’ Conference: Every Thursday 1:00 - 2:00 p.m.
Venue: SICU Conference Room, Milstein Hospital 4th Floor
This is a formal lecture to the ICU Fellows given by ICU Faculty and non-ICU Faculty (surgeons, pulmonologists, cardiologists, ID specialists, nephrologists etc.), and Visiting Professors.
In July and August each year, these conferences take the form of multidisciplinary introductory lectures for our own AACM Fellows together with the Pulmonary Medicine and Neurointensive Care Fellows.
Palliative Care Conference: Every Other Thursday 2:00 - 3:00 p.m.
Venue: SICU Conference Room, Milstein Hospital 4th Floor
Dr. Craig Blinderman, Director of the CUMC Palliative Care Service, gives a tutorial on palliative care every other Thursday. This is an interactive, case-oriented session that enhances the Fellows’ appreciation of the role of palliative care in the ICU.
Anesthesiology Grand Rounds: Every Thursday 7:00 - 8:00 a.m
Venue: Alumni Auditorium, Black Building
ACCM Fellows attend our weekly departmental Grand Rounds and have the opportunity to present cases 2-3 times per year.
Critical Care Grand Rounds (CCGR): Every Thursday 3:00 - 4:00 p.m., September through June.
Venue: Heart Center, 1st Floor, Conference Rooms 1 & 2
Critical Care Grand Rounds is a conference open to all staff at Columbia University Medical Center with an interest in critical care medicine. The audience includes faculty and house staff, nursing staff, therapists, pharmacists and medical students. Columbia University Faculty and Visiting Professors who are experts in critical care and related fields, present lectures. Our Fellows participate in giving ICU case presentations at Critical Care Grand Rounds 2-3 times each year.
In July and August CCGR gives way to the multidisciplinary introductory lectures for our own AACM Fellows together with the Pulmonary Medicine and Neurointensive Care Fellows (see above).
Patient Care / Quality Improvement Conferences
Cardiac Surgery QI Meeting: Every Wednesday 8:00-8:45 am.
Venue: Conference Room, Milstein 5 Hudson South
This is a multidisciplinary QI Meeting attended by the cardiac surgeons, ICU Faculty and Fellows, ACTA Faculty, nursing and many ancillary services. QI Indicators are reviewed, and our ACCM Fellows summarize goals for the long stay (> 1 wk) cardiac surgical patients in CTICU. There is an M&M discussion of all CTICU mortalities and re-admissions.
There is also a case review meeting with the Liver Transplant team every Friday morning and also a monthly M&M meeting with the Lung Transplant Team.
ICU Morbidity and Mortality (M&M) Conference: Second Wednesday of each month, 2:00 – 3:00 p.m.
Venue: Ikea Lounge, Milstein Hospital 4th Floor
The ICU M&M Conference is coordinated by Drs. Gebhard Wagener and Hannah Wunsch. They select one or two cases representing sentinel events or major morbidity for presentation by the ACCM Fellows and discussion with the Faculty.
Multidisciplinary Meeting for SICU and CTICU: One Wednesday each month, 1:30 – 2:30 p.m.
Venue: Heart Center Conference Room 3
This monthly multidisciplinary QI meeting is led by Dr. Sladen and addresses issues common to both ICUs. Members include ICU Faculty and Fellows, and senior leadership of nursing, pharmacy, physical therapy, nutrition, palliative care, respiratory therapy, physician assistants and nurse practitioners in SICU and CTICU. It is the most important venue for formulating and updating ICU policies, procedures and guidelines for our two units.
Faculty
Tricia Brentjens, MD
Matthew Coleman, MD
Brigid Flynn, MD
Sumeet Goswami, MD
Desmond Jordan, MD
Steven E. Miller, MD
Vivek Moitra, MD
Joseph Rumley, MD
Peter Salgo, MD
Robert Sladen, MD, FCCM (Chief of Division)
Julia Sobol, MD
Gebhard Wagener, MD
Staffan Wahlander, MD
Brian Woods, MD
Hannah Wunsch, MD, M.Sc.
Critical Care Fellows 2010-2011
Insung Chung, MD
Adam Evans, MD
May Hua, MD
Navraj Kahlon, MD
Shreyajit Kumar, MD
Lloyd Meeks, MD
Katherine Palmieri, MD
Jennifer Sandadi, MD
Critical Care Fellows 2011-2012
Martin Chen, MD
Nishant Gandhi, DO
Elrond Teo, MBBS
Mabel Chung, MD
Julia Weinkauf, MD
Elaine Yang, MD
Olof Viktorsdottir, MD
Horia Rus, MD
Fellows Alumni List
Critical Care Administration
Ms Anke Freude
Division Administrative Assistant
212-305-8633 / af2409@columbia.edu
Fellowship Application Checklist
Fellowship Application
Fellowship Applications
For more detailed information on the Fellowship and to initiate the application process, please e-mail Ms. Freude at af2409@columbia.edu, or call her at 212-305-8633. Our fax number is 212-305-8287, and our mailing address is:
Robert N. Sladen, M.D., FCCM
Program Director, ACCM Fellowship
Department of Anesthesiology, PH 527-B
College of Physicians & Surgeons of Columbia University
630 West 168th St, New York, NY 10032
