Critical Care Introductory Course

In recent years, there has been a shift in IR from being technical proceduralists to comprehensive disease specialists. Multiple studies have suggested that previous IR training has not offered enough practical clinical experience (1, 2). Institutions are attempting to compensate for this, but there is not yet a nationwide consensus on how best to address this gap in IR training (3, 4).

Current training pathways require at least 1 critical care rotation, but this tends to occur near the end of residency. Thus, the purpose of this course is to reinforce clinical knowledge, prevent loss of clinical reasoning during predominantly DR years of residency, and better prepare IR trainees to be comprehensive disease specialists. The curriculum consists of 16 topics covered in 1-month units. Each unit contains approximately 4-5 hours of high-yield material with additional "bonus" materials and a post-unit self-assessment.

Topics:

1.   Hemorrhagic Shock & Blood Transfusion 2.   Fluids, Electrolytes & Acid-Base
3.   Anti-coagulation 4.   Arrhythmias
5.   Vasopressors 6.   Overview of Shock, Intro to Sepsis
7.   Septic Shock & Antimicrobials 8.   Respiratory Failure & Non-Invasive Ventilation
9.   Mechanical Ventilation 10.   Trauma
11.   Vascular Emergencies 12.   Cardiac Emergencies
13.   Renal Failure 14.   Liver Failure
15.   Nutrition & GI Prophylaxis 16.   CNS Emergencies

Materials:

  • Podcasts: Each module will feature several podcasts, which are easily played back at 1.5-2x speed if desired. Examples include EMCrit, EMCases, ICU Rounds, iCritical Care, and Louisville Lectures.
  • Marino’s ICU Book. The quintessential resource for everything critical care. Selected readings will be assigned with most modules.
  • Online videos: MedCram and other ‘chalk talk’ presentations are favored for being practical and succinct.
  • Society of Critical Care: Comprehensive online course designed for residents and fellows, featuring simulated cases and self-assessments. This is the only resource with a paid subscription and costs only $60 for lifetime access. Best accessed via Google Chrome.
  • Selected Journal Articles, Summary Documents, and Online Tutorials

Please contact RFSICUCurriculum@gmail.com for any assistance in accessing course materials.

Participating Residencies:

Participating residencies

Contributors: 

John Braun, Shantanu Warhadpande, Nico Cardenas, Thaddeus Maguire, Suraj Prakash, Nick Shaheen, and Brad White

References:

(1) Meek, M. & Deloney, L.A. Development of a ‘Call Attending” Simulation Scenario to Improve Resident Education in IR.

(2) Messina et al. Integrated Fellowship in Vascular Surgery and Interventional Radiology. Iii.) Requarth, J.A. Thinking Very Outside the Box: Providing Improved Clinical Care.

(3) Nassim, L. & Kupinski, E. Vascular and IR/DR and IR Enhanced Clinical Training Pathway: Survey of Graduates and Trainees from this IR Training Pilot Program.

(4) Siragusa et. al. Requirements for Training in Interventional Radiology.