West Virginia University Charleston Division Internal Medicine Residency Curriculum

Medicine Critical Care
Preamble	The intensity of a block ICU experience complements a continuity experience especially in the areas of procedural competence and ventilatory management.
Goal & Educational Purpose	Residents to be prepared to assess and care for critically ill patients requiring admission to and care in the ICU areas at CAMC.
Objectives	Experience and knowledge should be gained in the areas of: Multi-system failure and management Ventilatory management Nutritional assessment and management Invasive monitoring and techniques Nosocomial infections Ethical, moral, and legal issues in the ICU Outcome predictions Team management of severely ill patients Family counseling for patients with a poor prognosis All types of shock Sedation of critically ill patients Assessment for benefit and futility of ICU care Efficient utilization of multiple consultants Satisfactory evaluations for rotation by attendings and supervisory residents Satisfactory or better scores on in-training and certifying examinations Brain death determination APACHE assessment
Educational Content	Block ICU MICU Memorial Division Senior Residents One month A senior medicine resident will be based in the unit from 9:00 AM to 4:00 PM or 4:00 pm to Midnight {if 2 residents are on the same month} for five weekdays and remain at Memorial Division during these hours. The resident will evaluate and care for all MICU patients unless the attending is not a clinical faculty member. Every other weekend the resident will be present from 8:00 AM to 12:00 N. The resident will be responsible for all MICU patients (unless the attending does not agree). The resident will also present the case to consultant and discuss their recommendations. Attending and consultants will conduct management and teaching rounds with the ICU resident. The attending of record remains the responsible attending. Identified attendings will provide formal recurring organized teaching sessions for residents. When a resident is on this rotation, M-4 students may elect this rotation and act as a subintern under the direction of the resident and attendings. Review with radiology the radiographs of ICU patients. All medical service patients will have the ICU resident involved as will all the patients that are seen by the attendings involved in the critical care rotation. Consultants will not write orders on medical service patients. Attend Medical Ethics Advisory Group meeting on second Wednesday of each month.
Evaluation	The nurses will provide a consensus evaluation of the resident/students emphasizing humanistic qualities and relationships with family. The residents/students will evaluate the rotation and the attending with whom there was significant contact. The same attendings will evaluate the residents/students. The resident must complete the pulmonary/critical care quiz on the web at the end of the rotation. The residents/students will record their patient care activities with patient name, DOB, important diagnosis, procedures, outcomes, attending, consultations. Such accumulated data will be used to evaluate and improve the rotation. Residents' meetings Residency Evaluation Committee. Score on Hospital Medicine/Critical Care WebCT quiz
Reading List	Pulmonary and Critical Care Unit of MKSAP Pulmonary section of Standard Medicine textbook Consult specialty text UpToDate®