WELCOME TO THE ICU
Before your ICU rotation, or on day 1, please take a moment to review this orientation video.
During your PGY1 rotation you need to learn the foundational material of critical care; the basics of mechanical ventilation, pressors and inotropes, sedation, etc. You will build on this if/when you come back for additional rotations. At this level you should not be making changes to machines or vasoactive medications without discussing the situation with your attending/fellow, but you should have a plan in mind before you talk with them.
During your PGY2 rotation you will build on the information you learned during your first rotation. Now you will learn to troubleshoot complications with your therapies, manage more complex machine/medication interactions, and have an active role in the acute setting. At this level you are expected to be able to intervene on acute patient decompensations while the attending/fellow are enroute, and be able to defend the thought process of your plan of care.
This is the critical year (so to speak) if your goal is to become an intensivist. You should make every attending you work with aware that CCM is your goal. Talk with Dr. Bob so you can get a mentor within the department and to talk about the application process.
During your PGY3 rotation you should be fine-tuning your knowledge of vents, drips, and regular ICU problems. If you were in an isolated ICU and you were the only doctor within 100 miles, would you be able to care for them until an intensivist arrived or you were able to transfer the patient (by the end of this rotation the answer should be yes). You should have operational knowledge of all of the patients in the ICU and should be supervising and teaching the PGY1 residents.
Certainly by this point you should know what you plan to do after residency. If your goal is to be an intensivist the ICU team should already be aware. If you're coming to the realization that this is what you want to do with the rest of your life, it's never too late, but be aware that you are significantly behind your peers. Talk with Dr. Bob ASAP.
During your PGY2 rotation you will build on the information you learned during your first rotation. Now you will learn to troubleshoot complications with your therapies, manage more complex machine/medication interactions, and have an active role in the acute setting. At this level you are expected to be able to intervene on acute patient decompensations while the attending/fellow are enroute, and be able to defend the thought process of your plan of care.
This is the critical year (so to speak) if your goal is to become an intensivist. You should make every attending you work with aware that CCM is your goal. Talk with Dr. Bob so you can get a mentor within the department and to talk about the application process.
During your PGY3 rotation you should be fine-tuning your knowledge of vents, drips, and regular ICU problems. If you were in an isolated ICU and you were the only doctor within 100 miles, would you be able to care for them until an intensivist arrived or you were able to transfer the patient (by the end of this rotation the answer should be yes). You should have operational knowledge of all of the patients in the ICU and should be supervising and teaching the PGY1 residents.
Certainly by this point you should know what you plan to do after residency. If your goal is to be an intensivist the ICU team should already be aware. If you're coming to the realization that this is what you want to do with the rest of your life, it's never too late, but be aware that you are significantly behind your peers. Talk with Dr. Bob ASAP.