There will be only one off service rotation during the 3 years of the Fellowship. This rotation is the first block of the second year, during which time the fellow will be assigned to the SICU at the Johns Hopkins Hospital. This rotation is an intense 24 hours on, 24 hours off, in-unit rotation, which is jointly administered by the Departments of Anesthesia and Surgery. Every day (Monday to Monday) there is 1.5 hours of bedside group teaching by the SICU Faculty. The fellow's sole responsibility during this four-week block is his/her obligation to the SICU. The fellow is immune from "call back" or vacation coverage.