Residents gain experience in Critical Care Medicine during both the PL-2 and PL-3 years. All PL-2 residents complete a four-week rotation in the 30-bed Medical-Surgical Intensive Care Unit (MSICU) at Boston Children’s Hospital. In the PL-3 year senior residents rotate in the 22-bed Medical ICU (MICU) at Boston Children’s Hospital and as the sole resident in the 6-bed pediatric ICU (PICU) at Boston Medical Center. The BCH MICU is split into two teams composed of two residents (who rotate in two week or one month blocks) or nurse practitioners, one critical care fellow and one critical care attending physicians. The BMC PICU has two residents per month, who work directly with the critical care attending.
In the Children’s MSICU, junior residents serve as primary providers for medical and select surgical patients and participate in daily rounds and family meetings. They attend morning conference as part of a comprehensive didactic curriculum that includes formal mock code sessions delivered in the sophisticated simulator suite. Attendings conduct formal debriefings after mock codes using video footage to enhance feedback. There are also weekly sessions focused focused on procedures and emergency scenarios, with the assistance of simulation.
These experiences help residents develop crucial decision-making skills. Building on concepts introduced in the PL-2 year, residents gain proficiency in the management of severe status asthmaticus, mechanically ventilated patients, hemodynamically unstable patients, patients with dangerous ingestions or toxic exposures, and patients in status epilepticus. Residents also participate in advanced vascular access, airway management, and delivery of emergency medications. Faculty didactics complement the experiential learning on each unit.