Residents gain experience in Critical Care Medicine during both the PL-2 and PL-3 years. In the Children’s MSICU, junior residents serve as primary providers for medical and select surgical patients They attend morning conferences and radiology rounds 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 on procedures and emergency scenarios, with the assistance of simulation.
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 additionally rotate in the 22-bed Medical ICU (MICU) at Boston Children’s Hospital and/or as the sole resident in the 4-bed pediatric ICU (PICU) at Boston Medical Center. The BMC PICU additionally allows for a valued experience of increased autonomy during the senior year, as there is no fellow or attending in-house overnight.
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 or severe diabetic ketoacidosis. Residents also participate in advanced vascular access, airway management, and delivery of emergency medications. Faculty didactics complement the experiential learning on each unit.