Overview

The Critical Care Fellowship is a 1-year, advanced training program designed exclusively for trainees who have completed the 3-year ACGME-accredited Cardiovascular Disease Fellowship at our institution. This track provides comprehensive training in the management of critically ill patients with complex cardiovascular and multi-organ conditions and offers and offers dual board eligibility in Cardiovascular Disease and Critical Care Medicine. Fellows gain experience through rotations in medical, cardiac, and surgical intensive care units, working alongside multidisciplinary teams.

Efforts in critical care-cardiology align closely with the fundamental educational mission of Johns Hopkins Hospital to lead nationally in preparing the next generation of clinical pioneers. These initiatives represent an opportunity to develop robust educational innovation with national interest. The program fosters meaningful academic opportunities and scholarly work, while also enhancing clinical care provided to critically ill cardiovascular patients.

Program Structure

This 1-year Critical Care Fellowship track is offered specifically to one internal Johns Hopkins Cardiology fellow every other year, in alignment with ACGME requirements for Pulmonary-Critical Care programs accepting non-Pulmonary trainees.

The fellowship is designed to meet the ACGME requirement of 12 months of clinical critical care training when combined with another ACGME-accredited internal medicine subspecialty fellowship. Fellows may apply up to 3 months of prior CCU experience from their Cardiovascular Disease Fellowship toward this requirement.

We offer training within a multidisciplinary environment that brings together board-certified intensivists, cardiologists, anesthesiologists, surgeons, and other specialists committed to exceptional clinical education and mentorship. 

Clinical Training Requirements

Per ACGME guidelines, clinical training must include:

• At least 6 months in a medical or cardiac ICU (with up to 3 months fulfilled during cardiology fellowship).
• A minimum of 3 months caring for non-medical ICU patients (e.g., surgical, trauma).
• Up to 3 months of additional critical care clinical experiences (with 4 weeks of vacation).

Our program is structured to fully meet these standards while providing broad, high-acuity exposure across multiple intensive care settings.

Rotation Breakdown

During the dedicated critical care year, fellows complete the following rotations:

• 3 months in medical ICUs
• JHH Medical ICU
• JHH Oncology ICU
• JHBMC Medical ICU
• 6 months in cardiac surgical intensive care
• JHH Cardiovascular Surgical ICU (CVSICU)
• 5 month in the JHH Surgical ICU (SICU)
• 5 month in the JHH Neurocritical Care Unit
• 1 month in Interventional Pulmonary
• 5 month in Cardiac Anesthesia

Program Highlights

Specialized Training for Cardiovascular Disease-Trained Fellows

Focused preparation in the evaluation and management of critically ill cardiovascular patients, including shock states, advanced heart failure, acute valvular disease, mechanical complications of myocardial infarction, and complex postoperative presentations.

Extensive Procedural and Technical Experience

Hands-on training in arterial, central venous, and pulmonary artery catheterization; temporary and epicardial pacing; mechanical circulatory support (IABP, VADs, ECMO); noninvasive and invasive hemodynamic monitoring; airway management; and advanced ventilator and oxygenation strategies.

Robust Medical Knowledge Development

Comprehensive education in hemodynamics, cardiovascular pharmacology (including vasoactive, anticoagulant, antiplatelet, antiarrhythmic, and pulmonary hypertension therapies), differential diagnosis of shock and organ dysfunction, perioperative risk stratification, transplant-specific considerations, and evidence-based ICU prophylaxis practices.

High-Acuity Clinical Exposure Across Diverse ICU Settings

Immersive, supervised management of unstable cardiac patients, post-cardiac surgery cases, mechanical support patients, and individuals with complex arrhythmias, advanced pulmonary hypertension, aortic pathology, and multisystem organ failure.

Interdisciplinary Care and Collaboration

Daily engagement with cardiology subspecialties (heart failure, electrophysiology, interventional cardiology), surgery, pulmonary/critical care, anesthesia, nephrology, neurology, pharmacy, and other essential ICU team members to deliver coordinated, patient-centered care.

Competency Development in Communication and Professionalism

Training in effective communication with multidisciplinary teams, coordinated perioperative and ICU management, transitions of care, and family counseling, including end-of-life discussions, while cultivating the skills required to serve as an emerging leader in the critical care setting

Strong Emphasis on Evidence-Based Practice, QI, and Patient Safety

Integration of guideline-based management, appropriate use criteria, risk-benefit analysis, and cost-conscious decision-making; active participation in ICU quality and safety initiatives; and development of continuous improvement skills through identification of knowledge gaps and engagement in performance enhancement activities.

Systems-Based and Practice-Based Learning

Experience navigating interdisciplinary ICU systems, understanding patient preferences and values, practicing within defined scope of expertise, and utilizing real-time decision-support and scholarly resources to guide clinical care.

Procedures and Competencies:

Fellows develop proficiency in a broad range of critical care skills, including:

• Central venous access
• Airway management
• Advanced mechanical ventilation
• Bronchoscopy
• Critical care ultrasound and bedside echocardiography
• Thoracentesis
• Chest tube insertion and management
• Advanced hemodynamic monitoring and support
• Renal replacement therapy
• ECMO and other mechanical circulatory support modalities
• Post-surgical critical care

Educational Curriculum

The curriculum includes:

• Weekly didactics and case conferences
• Morbidity & mortality reviews
• Education in quality improvement and patient safety
• Simulation-based procedural training
• ICU interdisciplinary rounds

Research & Scholarly Activity

The program offers avenues for fellows to participate in clinical research, pursue quality improvement projects, present at national conferences, and prepare scholarly work including abstracts and manuscripts.

Application Process

The Critical Care Fellowship is integrated into our broader Cardiovascular Disease Fellowship Program and is not offered as a stand-alone fellowship. The candidate will be chosen following a committee review and formal request for applications. For specific inquiries or additional information, please contact our Fellowship Manager Kelly Choi at [email protected].