…… A Unique Educa t ional Experience in America’s F inest Ci t y……….

1. Anesthesiology Critical Care Medicine Fellowship at the University of California, San Diego …… A Unique Educational Experience in America’s Finest City……….

2. 4 Educational Sites UCSDThornton Hospital UCSD Medical Center, Hillcrest Sulpizio Cardiovascular Center Jacobs Medical Center (Opening 2016)

3. Clinical ICU Training • Thornton Hospital: 12 Bed Medical/Surgical ICU • Sulpizio Cardiovascular Center: 12 Bed CCU/Thoracic-Cardiovascular Post Op Unit • UCSD Medical Center, Hillcrest: 20 Bed Surgical Trauma ICU, 8 Bed Burn ICU, and a dedicated Neurosciences Critical Care Unit • Additional Opportunities for expansion include: Jacobs Medical Center (2016,) VA-ICU, Rady Children’s PICU

4. Critical Care Faculty Erik Kistler, MD, PhD – Director of Research MedicalSchool:GeorgeWashington University, AnesthesiologyResidency:UCSD, CCMFellowship:MGH Interests: SepsisandShock(Mechanisms,Diagnosis,andTreatment) Brian Lemkuil, MD MedicalSchool:Loma Linda, Anesthesiology Residency: UCSD, CCMFellowship:UCSD/Cambridge Interests: Cerebral Blood Flow, Subarachnoid Hemorrhage, Cerebral Vasospasm Zeb McMillan, MD MedicalSchool:University of Iowa, AnesthesiologyResidency:Advocate Illinois Masonic Medical Center (Chicago) CCMFellowship:UCSF Interests: Venous Blood Gas Analysis, Ventilator Synchrony, Pain and Sedation in ICU, RBC transfusion Angela Meier, MD, PhD MedicalSchool:Ludwig Maximlans University (Munich), AnesthesiologyResidency:MGH, CCMFellowship:MGH Interests: Sepsis, Trauma, Immunologic Impact of Anesthesia

5. Critical Care Faculty AnushrivanMinokadeh, MD – Division Chief MedicalSchool:LSU, AnesthesiologyResidency:SUNYDownstate Hospital, CCMFellowship:JohnsHopkins Interests: Neurocritical Care, Liver Transplantation, Resuscitation Science, Quality and Performance Improvement Beverly Newhouse, MD – Education Director MedicalSchool:University of NorthCarolina, AnesthesiologyResidency:UCSD, CCMFellowship:MGH Interests: MedicalEducation,Mechanical Ventilation &Weaning,ResuscitationPhysiology Albert Nguyen, MD MedicalSchool:University of Colorado, Anesthesiology Residency: UT Southwestern, CCMFellowship:UCSD Interests: Coagulopathy and Coagulation Monitoring E. Orestes O’Brien, MD – Clinical Chief MedicalSchool:Harvard, AnesthesiologyResidency:UCSF, CCMFellowship:MGH Interests: Monitoringandhemodynamic optimization

6. Critical Care Faculty Kimberly Robbins, MD-Fellowship Director MedicalSchool:University of Virginia, AnesthesiologyResidency:UCSD, CCMFellowship:UCSD Interests: Obstetric Critical Care, Echocardiography, Education Ulrich Schmidt, MD, PhD, MBA MedicalSchool:University of Munich, Anesthesiology Residency: MGH, CCMFellowship:MGH Interests: Care of the Critically Ill patient in OR and in the ICU, Optimization of high risk interventions in the ICU Christopher “Kit” Tainter, MD, RDMS MedicalSchool:University of Washington, Emergency MedicineResidency:Mount Sinai NY, CCMFellowship:MGH Interests: Point of Care Ultrasound, Resuscitation, Cardiac Arrest, Education

7. Educational Overview: CoreandElectiveRotations • The ACGME requires all fellows in Anesthesiology Critical Care Medicine to complete 9 months of adult critical care. • Each fellow will spend approximately 7 months in the Thornton & Sulpizio CVC ICU. The patient population consists of complex Cardiovascular, Thoracic, Neurosurgical, General Surgical, Urologic, Gynecologic, & Orthopedic Patients. • Fellows may complete their additional critical care requirement in the neuro, medical, burn, or surgical/ trauma ICUs.

8. Educational Overview: CoreandElectiveRotations • Fellows spend a total of 3 monthsofelective time eitheron corollary serviceswithrelevanceto critical care(e.g.InfectiousDisease,Cardiology, Palliative Care,) or completing original research • Individualized electives may also be developed by the fellow • Fellows are expected to complete both an academic project and a quality improvement project during the year

9. Educational Overview (cont.). Expectations & Goals • Theprimary goalof thecorefellowshiptraining is toprovidethe fellowwithclinicalexperienceinthemanagement of critically illsurgicaland medical patients. • Fellows will gain extensive experience managing heart and lung transplant patients, ventricular assist devices, total artificial heart, and extracorporeal circulation. • Our fellowsalsodevelopexpertisein coordinatingamultidisciplinary team, andinallof thecommonprocedures usedinCCM. • TraininginEchocardiography& Bronchoscopy willbe specifically emphasized& providedtoallfellows.

10. Echocardiography Training • Our flourishing cardiovascular program provides our fellows with opportunities to become proficient in both TTE and TEE. • Bedside teaching as well as electives in both modalities are available. • Fellows will attend the 3 day UCSD Perioperative TEE Review Course/Conference • at no charge

11. Fiberoptic Bronchoscopy (FOB) Training • FOBTrainingandexperience is one of theCoreCCMProceduresthat will bemasteredbyACCMFellows. • All Facultyareproficient in FOBuse andteaching. • Inaddition,Dr.JonathanBenumof, “originatoroftheASADifficult Airway Algorithm”,will teachFOB techniques in hisDifficult AirwayLab. • AnAirwaySimulator is available. • All Fellows will becomeexpert bronchoscopists.

12. Research Opportunities • All Fellows will participate in clinical research including planning of a project, production of IRB proposal, and eventual presentation of research findings. • Research topics explored by previous fellows include: • Effect of positive pressure ventilation on diastole as measured by echocardiography • Effect of blood transfusion on SVO2 in post-cardiac surgery patients • Long-term outcomes following SICU • Admission • CCM Faculty will closely assist the fellows in all aspects of research.

13. Current Research Projects • Dr. Kistler– Analysis of the changes in hemodynamics and oxygen delivery in response to blood transfusions in the ICU. Shock and inflammation, with particular focus on the bowel. • Dr Meier - Investigations on how sedatives and pain • medications modify the immune response. • Dr. Nguyen – Long Term Outcomes Following Surgical ICU Stay. • Dr. O’Brien - Investigating the effects of neuraxial • sympathectomyon cardiac function in term parturients. • Dr. Schmidt – Investigating the value of high intensity interventions in the critical care setting.

14. Eligibility Criteria and Application Process • The EligibilityCriteria ForACCMFellowshipareasfollows: • Board certification (or eligibility) in Anesthesiology by the ABA (or equivalent ifnon-American trained.) • Possess (or be eligible for) a California medical license (must have current license in State of Residence at time of application.) • Havecertification in ACLS (or equivalent.) ATLSis also advised. • ApplicationProcess • U • UCSD currently has 3 fellowship positions available beginning July 1. • We participate in the SF Matching Program: www.sfmatch.org • Applications typically open in November, with the match occurring in May one year prior to start date. • Applicants interested in a combined experience in CCM and Adult Cardiothoracic Anesthesia should apply to both programs individually and alert both program directors of your intent.

15. ACCM Fellowship Contact Information JulieNguyen,ACCM FellowshipCoordinator Department ofAnesthesiology and Critical Care University of California, SanDiego 200WestArbor Drive, #8770 San Diego, CA92103-8770 Phone (619) 543-6240 Fax: (619) 543-6476 JUNguyen@UCSD.edu