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Medical Intensive Care Unit Rotation

This is a four-week rotation in the medical intensive care unit under the supervision of Dr. Bhagat S. Aulakh. You will be an integrated member of the MICU team providing intensive treatment on a concentrated and continuous basis.


Principal Goals and Objectives (Relevant Competencies) Heading link

  1. Develop the ability to initiate a rapid evaluation, diagnostic evaluation, and stabilization of critically ill adult patients. (MK, PC)
  2. Demonstrate skill in the initial resuscitation of patients with unstable vital signs. (PC)
  3. Demonstrate the ability to manage various types of shock, including hypovolemic, hemorrhagic, septic, anaphylactic, and neurogenic shock. (MK, PC)
  4. Demonstrate appropriate history and physical examination skills of the critically ill patient. (PC)
  5. Demonstrate proficiency performing diagnostic and therapeutic procedures for critically ill patients such as: central venous access, Swan-Ganz catheter placement, arterial line placement, tube thoracostomy, endotracheal intubation, etc. (PC)
  6. Demonstrate competence with the management of ventilator patients. (PC, SBP)
  7. Demonstrate effective use and interpretation of laboratory, radiographic and other diagnostic tests in the management of critically ill patients. (MK, PC, SBP)
  8. Demonstrate proficiency in the use of invasive hemodynamic monitoring for critically ill patients. (MK, PC, PBL & I)
  9. Demonstrate knowledge regarding pharmacologic agents of choice (including their indications, contraindications and complications) for the use in patients with shock, sepsis, dysrhythmias, respiratory failure, congestive heart failure, hepatic failure, and renal failure. (MK)
  10. Function effectively as an integrated team member of the ICU team with nurses, respiratory technicians, residents, fellows, staff, etc. (ISC, P, SBP)
  11. Develop skills handling social, psychological, and ethical issues affecting critically ill patients and their families. (SBP, ISC, P)
  12. Learn the indications for withholding and terminating resuscitation or aggressive medical treatment. (ISC, P, MK, PC)

Additional Optional/Aspirational Educational Objectives by Competency Heading link

Expectations Heading link

During the four-week rotation, the ICU patient population offers the residents exposure to a wide variety of critical illnesses, experiences, and procedures. At all times there will be a senior IM resident, critical care fellow, or attending available to provide supervision, consultation, and assistance. Residents are expected to be actively involved with ICU admissions and to be first call for many medical issues that arise on their patients.

Expectations include:

  • A comprehensive history and physical examination
  • Differential diagnosis of chief complaint or presenting illness
  • Assimilation and interpretation of data
  • Development of a problem list
  • differential diagnosis, and plan of care.

The resident is also responsible for daily notes and orders, communication with patients’ families, coordination of consultations, procedures, interventions, and discharge summaries.

In addition, a brief tutorial on a specific diagnostic or intervention technique commonly needed by ICU patients and provided by the IR service will be given by the IR/DR resident to the MICU team at the end of the rotation. Topic selection will be decided by a consensus of the IR/DR resident, MICU rotation director, and IR/DR Program Director.

Evaluation Process Heading link

Residents will receive concurrent feedback from the faculty, fellows, and senior IM residents while on the MICU rotation. At the end of the rotation, the resident is evaluated by the MICU rotation director utilizing the E-value system and will include a competency-based assessment of the principal goals and objectives of the rotation and the tutorial presentation. These evaluations are available to the resident after their receipt. The IR/DR Program Director reviews all evaluations with the resident at least semiannually.