Massachusetts General Hospital’s Accreditation Council for Graduate Medical Education (ACGME)-accredited Critical Care Anesthesia Fellowship offers extensive clinical training and educational experiences designed to provide each fellow with the opportunity to fulfill the requirements of the American Board of Anesthesiology (ABA) for subspecialty certification in critical care and to achieve competence in the specialty. Mass General is currently accredited for eight, 12-month fellowship positions.
Fellows spend at least nine months providing care to patients in an Intensive Care Unit (ICU) and supervising residents and medical students under the direction of the critical care attending staff. The fellowship in critical care medicine is based in the multidisciplinary Surgical Intensive Care Units (SICUs) at Mass General. The Ellison 4 SICU is a 20-bed ICU that admits a wide variety of surgical patients. The Blake 12 ICU is an 18-bed mutidisciplinary ICU.
During the three months of fellowship not spent in the ICUs, the fellows have a range of elective choices. Fellows care for a variety of patients including:
- Postoperative vascular patients
- Thoracic patients
- Orthopedic patients
- General surgery and trauma patients
- Complex surgical patients transferred from other hospitals
- Medically and critically ill obstetric patients
- Trauma and liver transplant patients
The ACGME-accredited Critical Care Anesthesia Fellowship is a 12-month program begun after successful completion of an ACGME-accredited anesthesiology or surgical residency program.
The Department of Anesthesia, Critical Care and Pain Medicine follows all minimum selection criteria as delineated in the Institutional Policy on Selection (PDF). As a prerequisite for entry, all applicants for the fellowship must be a graduate of one of the following:
- Liaison Committee on Medical Education (LCME)-accredited medical school
- American Osteopathic Association (AOA)-accredited medical school
- Medical school listed in the World Health Organization Directory of Medical Schools
- USMLE completion requirement for clinical trainees
Applicants must have also completed one of the following:
- An Accreditation Council for Graduate Medical Education (ACGME)-accredited residency in anesthesiology or emergency medicine, or in an RCPSC-accredited or CFPC-accredited residency program located in Canada
- At least three clinical years in an ACGME-accredited residency in neurological surgery, obstetrics and gynecology, orthopaedic surgery, otolaryngology, surgery, thoracic surgery, vascular surgery or urology
All residents, clinical fellows, research fellows and staff who are not United States citizens and do not have a green card must have the appropriate visa in order to receive a Mass General appointment.
For questions regarding a J-1 visa, please call the Mass General Registrar/Credentialing Office at 617-726-5316. Questions on all other types of visas should be directed to the Partners International Office at 617-726-9211.
Massachusetts General Hospital's Critical Care Anesthesia Fellowship is a 12-month training program that provides core experience in two multidisciplinary surgical intensive care units (SICUs) and offers a wide variety of clinical electives, didactics and research opportunities. All fellows complete the requirements for certification by the American Board of Anesthesiology (ABA). Our graduates have been successful in securing staff positions in critical care medicine.
A diverse group of guest lecturers are invited each year to speak to fellows on core topics that are important in managing critical care patients in the intensive care unit (ICU). The Fellows' Lecture Series aligns with the recommendations of the ACGME, Society of Critical Care Medicine and the ABA for critical care medicine education. The ICU Morbidity and Mortality (M&M) meetings actively involve fellows’ participation in quality assurance and quality improvement initiatives. The program director also offers a series of lectures to prepare fellows for the critical care board certification exams.
Fellows benefit from a robust, multidisciplinary didactic schedule that includes:
- Fellows' Lecture Series
- SICU Fellows’ Journal Club
- Combined Critical Care Center Lecture Series
- M&M Rounds
- Ethics Rounds
- Trauma Conference and Trauma Rounds
- Respiratory Rounds
- Echo Rounds
- Anesthesia Grand Rounds
The core curriculum of the fellowship covers all of the major aspects of the art and science of critical care. Fellows encounter the entire spectrum of critical care patients, working in multiple Intensive Care Units (ICUs) with a wealth of clinical material. Fellows gain experience and training in the following areas:
- Cardio-respiratory resuscitation
- Respiratory failure
- Trauma, thermal, electrical and radiation injury
- Neurological impairment
- Infectious diseases
- Pharmacokinetics and dynamics of drug metabolism and excretion in critical illness
- Ethical and legal aspects of critical care
- Renal failure
- Gastrointestinal disorders
- Hematologic and coagulation disorders
- Critical obstetric and gynecologic disorders
- Monitoring and medical instrumentation
- Principles and techniques of administration and management
- Biostatistics and experimental design
Specific electives may be structured by the fellow, under the supervision of the fellowship director, to suit the fellow's particular academic interests and needs. Examples of common elective choices are:
- Medical ICU
- Coronary Care Unit
- Neuroscience intensive care
- Pediatric intensive care medicine
- Blood bank/laboratory medicine
- Infectious disease
- Hyperbaric medicine
- Burn ICU
- Pulmonary Critical Care Unit
- Respiratory ICU
- Neonatal ICU
- Research and academic projects
Fellows take an active role in teaching, conducting rounds and participating in research projects. Fellows supervise the residents in all aspects of the care of intensive care unit (ICU) patients, and are in turn supervised by ICU attendings. Each morning, the fellow coordinates activities and plans with the surgical teams and consultants and conducts morning ICU work and teaching rounds together with the staff physician. The balance of the fellows’ workday is spent providing care to the patients in the unit, supervising all procedures, meeting with primary care physicians, resident teams and consultants, and doing his/her own reading and research.
Each fellows participates in a night shift system scheduled in one-week blocks throughout the year, supervising the care provided by the ICU resident who spends the night in the unit, and returns to the hospital for any issues that require his/her physical presence. The fellow is on duty for the unit an average of one weekend per month.
The fellow is also leader of the Emergency Airway Consult Service team, which provides urgent overnight airway management for patients throughout the hospital. The team leader also performs elective intubations, invasive procedures and consultations.
Basic and clinical research is an important ongoing activity and an integral component of the mission at Massachusetts General Hospital. More than 80% of fellows choose to pursue an academic career at the conclusion of their fellowship. Examples of recent research projects conducted by our faculty include:
- Clinical prediction model for early detection of ventilator-assisted pneumonia
- Effects of a systematic team approach to guide early mobilization in surgical intensive care unit (SICU) patients
- Determining predictors of adequate upper airway function in long-term ventilated patients
- Midodrine for the treatment of refractory hypotension in patients otherwise ready for discharge from the intensive care unit (ICU)
- Coenzyme Q10 in critically ill patients
- Heart rate variability during discovery phase of trauma resuscitation
- The MIND-USA Study: Modifying the impact of ICU-induced neurologic dysfunction
- Evaluation of a new protocol of enteral nutrition for surgical critical care
- A randomized controlled trial of a video decision-making aid to obtain informed consent in the SICU
Selection to the fellowship is highly competitive. Only completed applications are reviewed.
Please submit the following documents electronically to: firstname.lastname@example.org:
- Personal statement describing your interest in the Critical Care Anesthesia Fellowship and your plans after completion of the fellowship
- A current curriculum vitae in MM/YYYY format, except for medical and residency should be in MM/DD/YYYY format
- Three letters of recommendation. One letter must be from your residency program director or chief of service. Letters should be addressed to Edward Bittner, MD, PhD, and should be sent from the letter writer’s email or his/her assistant’s email
- A copy of your medical school transcript
- A copy of your USMLE scores
All documents should be submitted electronically to email@example.com to the attention of:
Edward A. Bittner, MD, PhD, fellowship director
c/o Tina Toland, program manager
Department of Anesthesia, Critical Care and Pain Medicine
Massachusetts General Hospital
Applicants should use the following naming convention (first five letters of last name, first initial, document type):
The deadline for completed applications is March 31. Interviews will be conducted from December through May.
The Mass General Critical Care Anesthesia Fellowship is participating in the SF Match. Registration for the 2017-2018 academic year opens on November 2, 2015. Match Day is May 26, 2016.
Critical Care Anesthesia Fellowship
Edward A. Bittner, MD, PhD, fellowship director