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Rotations

Even though the fellow is based at the Duke University Hospital SICU, it is important that he/she gains a broad experience in all aspects of critical care. The fellow spends eight months in the SICU, one month in the Medical Intensive Care Unit, and one month in the Neuroscience Intensive Care Unit. Two months are allowed for elective rotations, which may include:

  • SICU at the Durham VA Medical Center, which is situated directly across the street from Duke University Hospital.  The VA SICU sees patients who have undergone complex cardiac, general surgery, vascular, orthopaedic, and urology procedures.
  • Hyperbaric medicine
  • OR Anesthesia, including transesophageal echocardiography
  • Pediatric Intensive Care Unit
  • Neonatal Intensive Care Unit
  • Coronary Care Unit
  • Cardio-thoracic Intensive Care Unit

Rotations spent in the SICU also include committee time and meetings with hospital administration to meet the requirements of systems-based practice experience and to gain expertise in the administration, financial planning, and staffing of intensive care units. The SICU rotation will also provide the fellow with time to conduct scholarly activities or to implement a Quality Improvement project.

One example of a fellow’s schedule is depicted below:

  • July: SICU
  • August: SICU
  • September: SICU
  • October: SICU
  • November: SICU
  • December: SICU
  • January: MICU
  • February: Neuro
  • March: Anes
  • April: PICU
  • May: SICU
  • June: SICU

Fellow Duty Hours

Duty hours are defined as all clinical and academic activities related to the fellowship training program. This includes patient care, administrative activities relative to patient care, the provision for transfer of patient care, time spent in-house during call activities, and scheduled activities such as conferences. Duty hours do not include reading and preparation time spent away from the duty site.

Duty hours must be limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house call activities. Duty hours each week must be accurately logged on the on-line tracking system, E-value.net.

Fellows will be provided with one day in seven free from all educational and clinical responsibilities, averaged over a four-week period, inclusive of call. One day is defined as one continuous 24-hour period free from all clinical, educational, and administrative duties.

Adequate time for rest and personal activities are provided. This consists of at least a 10-hour time period between all daily duty periods and after in-house call.

If the fellow is on a rotation that requires in-house call, this must occur no more frequently than every third night, averaged over a four-week period. Continuous in-house call will not exceed 24 consecutive hours. Fellows may remain on duty for up to six additional hours to participate in didactic activities, transfer care of patients, and maintain continuity of medical and surgical care.

The Surgical Critical Care fellow may be afforded the opportunity to moonlight, as long as the moonlighting activity does not interfere with the ability of the Fellow to achieve the goals and objectives of the educational training program. Any hours a fellow works for compensation at the sponsoring institution or any of the sponsor’s primary clinical sites (internal moonlighting) must be considered part of the 80-hour weekly limit on duty hours.