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 Children’s Hospital. In the PL-3 year, senior residents rotate as the sole resident in the 6-bed pediatric ICU (PICU) at Boston Medical Center and in the 16-bed Medical ICU (MICU) at Children’s Hospital. The MICU is split into two teams composed of 2 residents or nurse practitioners, 1 critical care fellow and 1 critical care attending physician.
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.
Senior residents also have at least one ICU experience in either the BCH MICU or BMC PICU. During these rotations, the senior resident works directly with the supervising critical care attending or fellow. 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.