Twice a week, our fellows have a lecture from a subject matter expert on one of 160+ curated topics. These topics have been refined over the years to reflect the content outlines of various critical care board exams with additional topics requested by fellows. The lectures are given by over 100 staff who speak on these topics at various conferences and are respected thought leaders. Your education does not depend on co-fellows hastily throwing together lectures the day before.

The lectures are during lunch, with protected time away from the ICU and catered food. (Don’t hesitate to share with us what you think of the food.) We change vendors regularly depending on our fellows' preferences.

The lectures are also recorded and stored on an internal server which you can access off campus from any mobile device. In essence, our didactics are turned into a podcast that you can listen to at your convenience. So, you can listen to a great lecture you missed because of a night shift the next time you have a free moment during the day.

The core ICU unit directors and critical care program directors have coordinated a series of 65 topics that are divided among and specific to the various ICUs: DKA management in the MICU, LV Venting Strategies in the Mechanical Circulatory Support unit, OB Emergencies in the Med-Surg unit, etc.

Each week, the Sub-C fellow (see our Unit Schedules section) is required to lead the ICU team through two case vignettes with questions and essential readings developed by our staff. These teaching sessions are 20-30 minutes long and are tracked to ensure fellows teach on a variety of topics and don’t just default to repeating topics they’re comfortable with. By the end of the fellowship year, all fellows deliver numerous high-value talks on various subjects, reflecting their broad training and the diverse patient populations they care for.

To minimize the burden on fellows, essential resources are already curated for each Teaching Topic and fellows are free to teach however best suits them, like a whiteboard “chalk talk” or a verbal round-table discussion. You do not have to create new presentations or slide decks de novo for each session. Nor do you have to use somebody else’s teaching material. You are free to do so, but we try to minimize the constraints on how you teach.

Learn more in this example of a teaching topic.

Every Friday, there is an Ultrasound review. As with our iCCC lectures, these sessions are an hour of protected time at lunch with catered food. In general, the sessions alternate between presentations by staff on various ultrasound topics and fellow “show and tell” sessions. During show and tell, you review your ICU scanning in a group setting with sonographic experts. By doing so, you develop a mastery over critical care ultrasound and greater confidence and competence than if you were just scanning independently.

All fellows are encouraged to achieve the National Board of Echocardiography (NBE) CCEeXAM certification. This entails collecting 150 scans and passing the NBE exam in January.

Unlike most programs that simply give their fellows a probe and tell them to start scanning, we systematically work our fellows through a three-staged scanning structure that progresses through basic to intermediate to advanced image sets. At the beginning of the year, fellows obtain only the basic image set. Once they have mastered this, they are expected to start obtaining intermediate image sets. Each four-week ICU block, fellows are expected to obtain at least ten scans that they can present on a Friday show and tell and include in their 150 exam portfolio for CCEeXAM certification.

One unique aspect of our training is that we heavily emphasize assessing the image quality. It’s not sufficient to determine if there is a pathology; one also has to determine if the image is reliable enough to make a determination. For example: one cannot simply say that the left ventricle has a reduced ejection fraction if the image is terribly foreshortened. By training at Mayo, you’ll not only learn how to interpret scans, but how to do so reliably with an appropriate understanding of the limitations to your scan.

Critical Care Grand Rounds is held every Thursday. Like our noon iCCC lectures, you are given protected time to attend and food is provided. In addition, all ACCM fellows are expected to give a formal grand rounds of their own. Numerous resources are available to aid in developing the presentation, including a free subscription to BioRender, and access to Mayo’s Media Assist Management, a curated repository of over 2 million photographs, visual assets, videos, presentations, medical illustrations, and animations. You can even submit your slide set to our media support services to have a professional designer review your slides and help redesign them into a more aesthetically pleasing, clear, and effective presentation. And, of course, there are abundant mentors and subject matter experts on various topics who are always eager to support you in presenting cutting-edge lectures.

Six times a year, the various critical care fellowships gather off campus in the evening for an interdisciplinary journal club. Topics usually center around a theme, and we invite other departments to participate. For example, when discussing ECMO and OB, we held our journal club in concert with the OB Anesthesiology Fellowship and the Maternal Fetal Medicine Fellowship. When we discussed the ACORN and AMIKINHAL trials, we partnered with the Infectious Disease fellows and their staff. We rent out a room at a local restaurant and food and drink are free.

These journal clubs also serve as a nice venue for fellows and staff to socialize outside the hospital and grab a beverage of choice in a relaxed atmosphere.

All fellows are required to present one Journal article at some point in the year. To help, we teach all fellows how to rigorously analyze primary literature and provide a framework for presenting articles to a larger audience.

It’s not enough to talk about subjects in critical care. We engage you in various hands-on workshops, too. Workshops include:

• Introduction to ECMO
• Three days of hands-on POCUS training
• Basic mechanical ventilation
• Advanced mechanical ventilation
• Effective communication
• Rapid response team training
• Bronchoscopy training
• Thoracentesis and drainage systems
• Advanced vascular access
• Neuro emergencies