Accreditation

This program fulfills the training requirements as defined by the American Board of Anesthesiology and is accredited by the Accreditation Council for Graduate Medical Education (ACGME).

Certification

Following successful completion of the fellowship program, trainees are eligible to take the Critical Care Medicine subspecialty exam offered by the American Board of Anesthesiology.

Program history

The Anesthesiology Critical Care Medicine Fellowship Program at Mayo Clinic in Arizona is a new program that will accept its first trainees in 2027-2028. The Mayo Clinic Arizona Department of Critical Care Medicine has successfully supported a Pulmonary Critical Care Medicine Fellowship since 2018. Additionally, our department has actively participated in the education of critical care medicine fellows from Mayo Clinic in Rochester, Minnesota, as well as Valleywise Medical Center in Phoenix, Arizona, for over fifteen years.

Positions

Two positions are available each year on a competitive basis in the Anesthesiology Critical Medicine Fellowship at Mayo Clinic’s campus in Phoenix, Arizona.

Qualifications

Applicants for the Anesthesiology Critical Medicine Fellowship program must be enrolled in or have completed an Accreditation Council for Graduate Medical Education (ACGME) four-year anesthesiology residency program or an ACGME accredited residency program in general surgery or a surgical subspecialty.

How to apply

Common Application Service by January 15th of the year prior to anticipated fellowship start date. In addition to the application materials required of all applicants to the Mayo Clinic School of Graduate Medical Education, please include the following:

• Three original letters of recommendation (it is strongly encouraged for one of these to be from your residency program director)
• Copies of USMLE Part I and II or COMLEX examination scores
• Copies of ITE examination scores
• A personal statement discussing your interest in critical care medicine as well as your career aspirations

Also see general admissions requirements.

You will be exposed to diverse patient populations and critical illness states spanning the spectrum of adult critical care medicine, with emphasis on cardiovascular and surgical critical care. Core ICU rotations include the cardiovascular ICU (with a distinct rotation at Mayo Clinic in Rochester, Minnesota, in an ICU that focuses on patients requiring mechanical circulatory support), medical ICU, and surgical ICU.

Additionally, there are elective rotations in burn/trauma ICU at Valleywise Medical Center as well as neurocritical care at Mayo Clinic in Jacksonville, Florida. 24/7 in-house consultant presence in the Mayo Clinic ICUs ensures that you are always supported. Cumulatively, this results in a deep and broad-based training experience with progressive autonomy that lays the foundation for a successful and rewarding career in critical care medicine.

The one-year Anesthesiology Critical Care Medicine Fellowship at Mayo Clinic in Phoenix, Arizona, is divided into thirteen four-week blocks.

As per ACGME requirements, there are nine ICU blocks, which are supplemented by ten weeks of elective time, two weeks of orientation and bootcamp, and four weeks of vacation.

The nine ICU blocks consist of three rotations in the cardiovascular ICU, two rotations in the medical ICU, three rotations in the surgical ICU, and one rotation in the cardiovascular device ICU at Mayo Clinic in Rochester, Minnesota.

Additionally, you may elect to complete a four-week burn/trauma ICU rotation at Valleywise Medical Center and/or a neurologic ICU rotation at Mayo Clinic in Jacksonville, Florida, in place of core ICU rotations at Mayo Clinic in Phoenix, Arizona.

Prior to commencing fellowship, you will meet with the program director and associate program director to discuss optimal individual fellowship schedule structure based on self assessment, previous experiences, and future aspirations.

Cardiovascular and thoracic ICU at Mayo Clinic in Arizona: The CVICU admits patients with cardiovascular critical illness including post-operative cardiothoracic surgery patients, cardiogenic shock including patients requiring temporary or durable mechanical circulatory support, and other critical illness states affecting cardiac and thoracic patients. We have active heart and lung transplant programs, are a referral center for combined heart-liver and heart-liver-kidney transplant, and are also an ECMO referral center.

Medical ICU at Mayo Clinic in Arizona: The MICU is a high acuity and high volume service with common referral sources including the emergency department, hospital internal medicine, hematology-oncology, and other hospitals, reflective of Arizona’s significant rural and medically underserved patient population. Additionally, this service responds to code blue events in much of the hospital.

Surgical ICU at Mayo Clinic in Arizona: This ICU admits critically ill patients from various surgical disciplines, particularly liver transplant for which Mayo Clinic in Arizona is a high volume center. Additionally, this ICU also focuses on neurocritical care.

Cardiovascular Device ICU at Mayo Clinic in Minnesota: The cardiovascular device ICU admits critically ill patients requiring mechanical circulatory support. The intent of this rotation is for fellows to build on previous cardiac ICU rotations by refining and mastering hemodynamic interpretation and optimization, understanding of ECMO physiology, and management of patients requiring mechanical support.

Electives

There are ten weeks of elective rotations in the one-year fellowship. In order to balance breadth and depth of elective experiences, elective rotations will typically be two weeks in length, with notable exceptions including ICU electives, which are four weeks in length.

Available elective rotations include abdominal transplant, burn/trauma ICU, cardiothoracic surgery, congestive heart failure, infectious disease, international medicine, nephrology, neurocritical care, nutrition, pleural service, research, stroke neurology, and transfusion medicine. Alternative elective experiences may be arranged on an individual basis.

Didactic training

Formal didactics are offered in conjunction with the Pulmonary Critical Care Medicine Fellowship and consist of bi-weekly critical care medicine core curriculum lectures, weekly fellow led complex patient rounds, weekly ECMO rounds, as well as monthly departmental grand rounds, journal clubs, research, and quality improvement meetings.

Additionally, you will receive regular point of care ultrasound, ventilation waveform interpretation, and simulation training. Fellows are encouraged to achieve National Board of Echocardiography CCEeXAM certification, which entails submitting a log of 150 performed and interpreted scans as well as passing an exam.

Procedures

You will have ample opportunities to develop and refine a wide array of procedural skills that span the gamut of adult critical care and are also encouraged to develop supervision skills by mentoring junior trainees.

You may attend one conference of your choice for up to five days, for which Mayo Clinic will pay for registration, travel, lodging, and food up to $2,550. This includes conferences and board review courses. Fellows may also attend up to five additional conferences, with $2,550 available for each conference if presenting a poster, a case, or participating in a committee at the conference.

Research opportunities

You may complete a research elective following a discussion of your interests and identification of a suitable research mentor and project. Active areas of investigation within our department include: artificial intelligence, bioinformatics, critical care education, clinical trials, and retrospective analyses.

Teaching opportunities

Consistent with our mission to develop future leaders in critical care medicine, you are actively encouraged to participate in teaching other members of the critical care team via formal and informal teaching sessions. Additionally, there are ample intramural opportunities for you to serve as faculty for department-sponsored courses.

International opportunities

If you're interested, you may participate in a one week international medicine elective opportunity involving perioperative care in a remote environment. Faculty and trainees from Mayo Clinic in Arizona regularly participate in an international medicine opportunity in Honduras and other sites are under consideration.

• Critical care fellow bootcamp: A foundational component of fellow orientation intended to provide introductory exposure to procedures less frequently emphasized during anesthesiology training, including bronchoscopy and tube thoracostomy. Additionally, fellows participate in one day “micro-rotations” with ICU nursing, rapid response nursing, respiratory therapy, and vascular access intended to foster interprofessional relationships and enhanced comprehension of systems based practice.
• Emergency Neurologic Life Support (ENLS): An interprofessional and multidisciplinary course sponsored in conjunction with the departments of neurology and neurosurgery with lecture, hands-on, and simulation components to emphasize identification and management of incipient neurologic critical illness as well as systems based practice.
• Fundamental Critical Care Support (FCCS): An interprofessional and multidisciplinary course with lecture, hands-on, and simulation components to emphasize identification and management of incipient critical illness as well as systems based practice.
• High acuity procedure course: An innovative annual department course with significant multidisciplinary support utilizing cadaver and other high-fidelity models focused on teaching high risk, low volume procedures such as cricothyrotomy, cryoprobe use, emergency re-sternotomy, Minnesota tube insertion, and pericardiocentesis.
• Interprofessional Code Blue simulation: Each fellow will have the opportunity to function as the code team leader during these monthly exercises intended to hone resuscitation management.

All fellows complete a hypothesis driven QI project during fellowship with concomitant goals of achieving Mayo Quality Academy certification and presenting this work at a national or international conference.

All fellows participate in additional formal development opportunities including a one day course regarding conducting challenging conversations.

Call frequency

• When rotating on an ICU service at Mayo Clinic in Arizona, you are typically present from morning sign-out at 6 a.m. until following evening sign-out at approximately 6:30 p.m., Monday through Thursday and take call on Friday nights from 6 p.m. until approximately 6:30 a.m. the following morning.
• You are post-night on Saturday and off on Sunday, with the intent of balancing continuity, experiencing the longitudinal arc of critical illness, reducing day-night transitions, and promoting balance.
• This results in an anticipated average of 62.5 hours of clinical hours per week when rotating on an ICU service at Mayo Clinic in Arizona.
• In the rare event, which we will do our utmost to avoid, where two fellows are assigned to the same ICU during a given rotation block, they will be scheduled for alternating day float and night float blocks to optimize fellow education by minimizing overlap.
• Work hours are significantly less during elective rotations.
• Away ICU rotations follow each site’s call schedule.

Moonlighting

Moonlighting is permitted for trainees in good standing as per department and institutional policies. There are moonlighting opportunities in the operating rooms; time spent in this fashion falls within ACGME work hour regulations.

Mentorship

Mentorship is a cornerstone of our program. Each fellow is paired with a faculty mentor who provides individualized guidance in clinical development, research, and career planning. Faculty are highly accessible and actively involved in bedside teaching, simulation training, and scholarly collaboration. Many have contributed to landmark studies and lead ongoing research in areas such as extracorporeal life support, perioperative outcomes, and medical education. Their collective expertise, enthusiasm for teaching, and genuine investment in trainee success fosters an environment where fellows are supported to reach their highest professional and academic potential.

Evaluation

To ensure that you acquire adequate knowledge and develop the appropriate technical skills to meet program expectations, your performance is monitored carefully during the program. You are evaluated formally by the supervising faculty member after each clinical rotation, and you will meet with the program director to review these evaluations. In addition, you will also regularly evaluate the faculty to ensure that your educational needs are being met.

• The ICUs at Mayo Clinic in Phoenix, Arizona, have dedicated, recently remodeled workrooms and fellow call rooms.
• Hospital infrastructure is modern and up-to-date.
• Recently completed expansion of the medical center such that 28 of the 48 ICU rooms are new.
• Anticipated expansion of an additional 12 ICU beds within the next few years.

Department

Our department is somewhat unique in that it is a multidisciplinary Department of Critical Care Medicine comprising faculty from various training backgrounds, including anesthesiology, emergency medicine, internal medicine, and surgery.

Our faculty are experienced clinicians and enthusiastic educators who have trained at renowned institutions and maintain deep expertise. This results in a fertile training environment where you are exposed to multiple approaches and thought processes, as well as contemporary guideline-based care contextualized within the history of our field.

Faculty

The Department of Critical Care Medicine at Mayo Clinic in Arizona, comprises a diverse group of twenty-four faculty members from various training backgrounds including four anesthesiologist-intensivists, providing fellows with a truly multidisciplinary learning environment.

Our faculty members have won numerous awards for clinical care and education and are involved at the highest levels of institutional leadership. Above all, our faculty are deeply committed to our shared success: of our patients, trainees, department, and institution.