Larry Field, MD Assistant Professor and Chief, Division of Critical Care Leslie Fowler, M.Ed Program Coordinator Dawn Leberknight Program Assistant

The Critical Care Fellowship at the Medical University of South Carolina is ACGME - accredited for two fellows per year.  The fellowship program provides an in depth ICU experience producing well qualified critical care anesthesiologists.   The program is designed to allow fellows to gain the experience and knowledge needed to prepare for Board Certification in Anesthesiology Critical Care Medicine.  The fellows participate in the Medical/Surgical ICU, Surgical/Trauma ICU, Neurosurgical ICU, Cardiothoracic ICU, and elective rotations at the MUSC hospital.   In these units, fellows gain additional experience and instruction in the postoperative management of patients undergoing complicated gastrointestinal surgeries, trauma, transplants (liver, heart, lung, kidney and pancreas), major vascular, neurosurgical, cardiac and thoracic surgeries. During each rotation, fellows are appropriately supervised and mentored by well-trained faculty.  They will also participate in supervising and teaching medical students, interns, and residents from all medical disciplines.  The clinical volume is sufficient to gain a broad experience, but not so onerous as to limit potential research involvement and writing. The institution is committed to providing the necessary support to allow the achievement of all educational goals.

Department and Faculty
The critical care faculty members are recognized leaders in the field with peer reviewed publications and book chapters, in addition to speaking at national conferences such as the American Society of Anesthesiologists  and Society of Critical Care Anesthesiologists yearly meetings.  Our critical care faculty members are board certified in both anesthesiology and critical care medicine.  The Department of Anesthesia and Perioperative Medicine at MUSC is a highly integrated, collaborative group of adult and pediatric anesthesiologists. The department is comprised of >50 staff anesthesiologists, 36 residents in clinical anesthesia training and more than 50 nurse anesthetists who are all committed to providing optimal care to adult and pediatric patients requiring anesthesia. Members of the department also conduct basic and clinical research and teach postgraduate and continuing education programs. MUSC anesthesiologists supervise over >35,000 annual cases requiring anesthesia. This large number of cases, integrated with ongoing research and education, results in wide-ranging expertise in anesthetic and critical care management.  The critical care division of our department maintains an outstanding working relationship with our surgical critical care, pulmonary critical care, neurocritical care, and cardiothoracic colleagues; creating a multidisciplinary environment that benefits our fellows’ educational experience.

Lecture Series
Information is presented in many different formats to accommodate different learning styles. In addition to the clinical experience gained in the various intensive care units, there is a weekly critical care educational conference held with all fellows and division staff as well as a monthly multidisciplinary Critical Care Grand Rounds. Information is delivered in pure didactic sessions, group discussions and journal clubs.  In addition, fellows will participate in the Anesthesia Departmental Grand Rounds conferences and the multidisciplinary Morbidity and Mortality conferences.

Research Opportunities
There are many opportunities to become involved in ongoing bench, clinical or translational research within MUSC.  Current projects within critical care include:

• Telemedicine implementation to improve care in sepsis and trauma: Impact on rural hospitals and patient care (RC1)
• Improving Clinician Communication Skills study (RO1)
• Simulation in ACLS training with and without ACLS card (FAER Grant)
• Evaluation of vasopressin for the treatment of cardiopulmonary-induced hypotension
• Ventilator Associated Pneumonia Rates in Trauma Patients: A Multi-Institutional Study
• Stems cells in ARDS (quantity and specific type of stem cells in patients with ARDS; cytokine profile associated with stem cell recruitment and outcomes)
• Retrospective analysis of subarachnoid hemorrhage patients designed to analyze features predicting development of symptomatic vasospasm.
• Retrospective analysis of intracranial hemorrhage patients designed to better describe the incidence, time course, and complications of edema in African American patients.
• Impact of a Hospital–Acquired/Ventilator–Associated Pneumonia Practice Guideline on Outcomes in Surgical Trauma Patients.
• Incidence of Ventilator-Associated Pneumonia (VAP) After Percutaneous Tracheostomy vs Open Tracheostomy
• Comparison of Tight vs Liberal Blood Glucose Target Ranges in Surgical Trauma ICU Patients
• Caspofungin in patients at high-risk for fungal infections in the ICU
• Impact of telemedicine technology on ICU care within an institution
• Measuring the financial impact of Evidence Based Data on ICU care
• Impact of Elevated Percent Carbohydrate - Deficient Tranferrin at Hospital Admission on Outcomes in Trauma Patients                          
• Evaluation of Routine Use of the Beach Chair Position in ICU Patients
• Multiple quality improvement projects, especially related to rapid response/ emergency teams

Moonlighting Policy
For those who have a permanent South Carolina license and are in good academic standing, a couple interal moonlighting opportunities exist. Moonlighting should not compromise the educational experience, but rather enhance it.

Application Process
We are currently accepting applications for the 2013-2014 academic year.  Two ACGME accredited positions are available. To apply, please complete the online form. In addition, please send three letters of recommendation to the attention of Larry Field MD, care of Leslie Fowler either by email or mail. Your application will be considered complete when all three letters of recommendation have been received. We look forward to reviewing your application. Click here for application!

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Program Contacts
For more information about the Critical Care Fellowship Program at MUSC please contact:

Larry Field, MD
Assistant Professor
Chief, Division of Critical Care
Office: (843) 876-5744
Fax: (843) 876-5746
field@musc.ed

Leslie Fowler
167 Ashley Avenue, STE 301
MSC 912
Charleston, SC 29425
Office: (843) 792-4316
Fax: (843) 792-9314
fowlerl@musc.edu