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Critical Care Medicine Fellowship

Position Identification: Fellow

Position Summary: fellow position for training in critical care via the American Board of Internal Medicine certification pathway

For the purpose of this document, the term “Resident” or “Fellow” includes medical and dental residents and fellows, including those in ACGME, CODA and non-ACGME accredited programs.

General Overview of the Fellow Role

A fellow’s responsibilities include patient care responsibilities within the scope of their clinical privileges commensurate with level of training and other responsibilities required of all members of the medical staff. Under the supervision of attendings, general responsibilities of the fellow may include:

  • Initial and ongoing assessment of patients’ medical, physical and psychosocial status
  • Performing history and physical examinations
  • Developing diagnostic and treatment plans
  • Conducting patient rounds
  • Documentation, including progress notes, admission notes, procedure notes and discharge summaries
  • Ordering tests, examinations, medications and therapies
  • Arranging discharge, referral and after care
  • Patient education and counseling about health status, test results, disease processes and transition of care planning
  • Performing procedures
  • Teaching and evaluating junior learners, such as residents and medical students
  • Teaching and collaborating with advance practice providers
  • Case review for educational or QA/QI purposes
  • Professional development activities for career and personal growth

UW GME Expectations for Professional Behavior

Essential Functions

Essential functions are the fundamental job duties of the position that cannot be eliminated or substantially modified without changing the nature of the position.

A fellow must perform the position’s essential job functions with or without an approved reasonable accommodation. Reasonable accommodation means modifying or adjusting practices, procedures, policies, job duties, or the work or application environment so that a qualified individual with a disability can still perform a position’s essential functions. Approved reasonable accommodations are determined via an interactive process involving the fellow, DSO/HR/GME and the program.

Essential functions ensure the safe and smooth delivery of education and patient care and are identified in alignment with program aims to facilitate trainee readiness for independent practice across an appropriate range of clinical settings for that specialty. Transparent documentation of a program’s essential functions is also an important resource for applicants evaluating the training program during recruitment.

Essential Program Administrative Functions

Onboarding

The fellow must:

  • comply with all program and institutional tasks required for credentialing and onboarding by the requested deadlines

Program Tasks and Documentation

The fellow must:

  • participate in all requests for schedule preferences, requests for absence or schedule changes of requests for clinical coverage on the requested timelines or deadlines.
  • complete all evaluations requested for medical students, peer residents, faculty or other members of the team in a timely manner
  • complete MedHub clinical and educational hour logs
  • complete case or procedure logs
  • complete the annual ACGME Fellow Program Survey
  • complete the program’s annual confidential internal survey
  • complete testing requirements, including in-training examinations and program-specific guidelines for national board certification
  • attend all required program meetings, including semiannual meetings, mentorship meetings, program retreats, etc.

Essential Program Core Educational Functions

Didactics

The fellow must:

  • Comply with all standards for attendance at didactics or other core educational activities
  • Adhere to the preferred mode of attendance (in-person, virtual, hybrid)
  • Prepare didactic presentations as required by the fellowship including but not limited to Seattle Area Chest Grand Rounds case presentations and didactic presentations for trainees in various core rotations

Scholarship

The fellow must:

  • Comply with all program or specialty requirements for research or scholarship, quality improvement, national or regional conference presentation, publication or scholarly writing or teaching and presentations internal to the program (e.g. journal club, didactics, case conference, M&M, etc.)

Essential Patient Care Functions

Presence and preparedness

The fellow must

  • present to work as physically, mentally and emotionally fit for duty
  • arrive at the patient care setting on schedule
  • arrive at work in attire appropriate for the professional and safe delivery of patient care
  • meet expectations for chart review or pre-rounding
  • satisfy expectations that precede sign-out and/or departure from the clinical setting, including an appropriate handoff and follow up on all patient assessments/data/studies that will alter care in the near term
  • immediately alert fellowship leadership if extenuating circumstances prevent their presence and preparedness for clinical duties

Administrative

The fellow must:

  • complete patient health record documentation on the schedule prescribed by the program or medical center. (Examples include but are not limited to progress notes/visit summaries, discharge summaries, operative or procedure notes, perioperative records)
  • comply with expectations for EHR inbox management, including timely responses to messages from patients, medical staff and tracking and patient follow up of expected results

Patient Care Communication

The fellow must:

  • respond in a timely manner to pages, phone calls and Epic Secure Chat
  • remain within the program-prescribed geographic range while on call or eligible for coverage

Patient Care Volumes

The fellow must:

  • work toward (with supervision) or meet benchmarks for patient care volumes in all clinical settings
  • appropriately request and utilize supervision
  • work toward or ultimately meet procedure certification standards
  • be prepared to alter their clinical schedule when acuity, census, or other circumstances require such assistance

Consultation

The fellow must:

  • appropriately respond to, triage, and staff consultations in a timely manner
  • document findings and recommendations in a timely manner
  • communicate with the requesting service directly (e.g. in-person, phone) in advance of and following the assessment
  • ensure that consultations are staffed and finalized with a faculty member in a timely manner

Essential Shift and Schedule Functions

Settings

The fellow must:

  • complete assigned shifts in settings deemed essential by the program, including multiple intensive care units
  • complete assigned away rotations or prehospital/transport responsibilities deemed essential by the program

Shift length and timing

The fellow must:

  • complete shifts of all lengths deemed essential by the program, which may include daytime, swing, nights, weekends, and holidays
    • Shifts must not exceed ACGME limits of up to 28 hours per shift, and up to 80 hours per week averaged over a 4 week period
  • where appropriate, comply with designated break lengths (to meet personal needs and not impact patient care)

Call Responsibilities

The fellow must:

  • complete assigned shifts of overnight call, as deemed essential by the program
  • remain within the prescribed geographic range while on call or eligible for coverage

Essential Cognitive Functions

The fellow must:

  • make time sensitive decisions in the absence of complete information for critically ill patients
  • acquire, interpret, and synthesize clinical information to devise and implement patient care plans.
  • balance the needs of concurrent critically ill and/or decompensating patients

Essential Communication Functions

The fellow must:

  • effectively communicate clinical information, plans of care, and medical recommendations verbally and in writing to patients, their families and their other social support, and to other medical providers/staff
  • convey complex clinical information in language that can be easily interpreted and understood by individuals without medical training or experience
  • express empathy and compassion to patients, their families and other social support, and to other medical providers/staff

Essential physical functions

The fellow must:

  • have technical skills and ability to position themselves to perform basic physical exam skills to gather patient information at the bedside
  • have technical skills to perform bedside procedures including but not limited to tube thoracostomy, vascular access, airway management, lumbar puncture, thoracentesis, paracentesis and fiberoptic bronchoscopy
  • be able to traverse the entire hospital to respond to emergent situations including cardiac arrest

Statement Of Nondiscrimination

The University of Washington prohibits discrimination, harassment and sexual misconduct in any education program or activity that it operates. Individuals may report concerns, make complaints, or direct inquiries to the Civil Rights Compliance Office. View the Statement of Nondiscrimination.

This document reflects requirements, established practices, policies, procedures, and resources as of the date of publication; however, parts of this document may be updated from time to time in accordance with changes in the law and applicable requirements, established practices, policies, procedures, and resources. Continued participation by a resident or fellow in the program will demonstrate agreement by the resident or fellow to adhere to the updates. The program will communicate such changes either via electronic communication or direct meeting.