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The Department offers a one month subinternship in Cardiothoracic and Surgical Intensive Care (AS03P). The rotation is offered throughout the year (July through June) for up to a maximum of six students per month. Students spend half of the month in the Cardiothoracic Intensive Care Unit (CTICU) and the other half in the Surgical Intensive Care Unit (SICU). In the CTICU students care for patients recovering from major cardiothoracic surgery, including heart and lung transplantation, coronary revascularization and ventricular assist device (VAD) placement. In the SICU the patient mix consists of thoracic, liver transplant, vascular, abdominal, orthopedic, ENT, urologic and gynecologic patients requiring postoperative critical care. Under the supervision of the ICU Attendings and Fellows from the Department of Anesthesiology, students participate day-to-day patient care. Rounds are held twice daily with ICU Attendings during which patients and their laboratory and x-ray findings are carefully analyzed and plans are made to clarify and resolve management problems. Three days each week an hour-long seminar is given by ICU Attendings and Fellows. Each Thursday students attend Critical Care Grand Rounds, a conference representing all staff involved in Critical Care at CUMC. Consultants in Infectious Disease, Cardiology, Renal Disease, Neurology, and Pulmonary Medicine make daily rounds within the Unit and review problems relevant to their special fields with the house staff and sub-interns. Students take evening call during the week but there is no call on weekends or holidays. Students will develop a working understanding of: resuscitation and endotracheal intubation; mechanical ventilation; hemodynamic monitoring using arterial, central venous pressure and pulmonary artery catheters; nutritional support including total parenteral nutrition and monitoring; interpretation of blood gas and other monitoring data; management of major postoperative problems such as bleeding and sepsis, and an understanding of organ system failure and shock. Students will have an opportunity to develop the skills of analysis and judgment important in the optimal management of complex critically ill patients. Please submit applications through the Dean's Office (212-305-1642) before making contact with the Course Director, Dr. Robert Sladen (rs543@columbia.edu) or the Division Administrative Assistant, Ms Randi Ditman (rd2005@columbia.edu) for permission to take the course. Robert N. Sladen, M.D.
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