Duke University Hospital Program

Faculty within the Critical Care Medicine Division at Duke University Hospital provide expert care for patients suffering from a broad range of critical illness and injuries. The division is known for delivering world-class care across multiple intensive care units, including Duke University Hospital, Durham VA Medical Center, Duke Regional Hospital, and Duke Raleigh Hospital. The program has achieved national and international recognition as a leader in critical care through innovative education programs and cutting-edge research.

The Critical Care Medicine (CCM) Division offers clinical services and training in six intensive care units distributed across the health system. These units include:

• Surgical Intensive Care Unit (SICU): A 24-bed Level 1 trauma unit focused on multidisciplinary care for trauma and postoperative patients, co-directed by faculty from anesthesiology, surgery, and medicine.
• Cardiothoracic Critical Care Unit (CTICU): A 32-bed unit dedicated to patients undergoing cardiac or thoracic surgical procedures.
• Neurological Intensive Care Unit (NICU): Specializes in the care of patients with critical neurologic problems, including strokes and spinal cord injuries.
• Surgical Intensive Care Unit (VA SICU): A 12-bed unit serving critically ill surgical patients at the Durham VA Medical Center.
• Critical Care Unit (DRH ICU): A 22-bed unit providing comprehensive care for critically ill patients at Duke Regional Hospital.
• Intensive Care Unit (DRaH ICU): A 28-bed unit at Duke Raleigh Hospital managing a variety of critically ill patients.

The fellowship in critical care medicine at Duke has been ACGME-accredited since 1994. It is designed to provide comprehensive training in critical care, and fellows have access to additional training in transesophageal echocardiography (TEE). First-year residents in anesthesiology are introduced to critical care at the VAMC SICU, where they develop skills essential for managing critically ill patients. The program emphasizes a robust clinical and educational experience, with a multidisciplinary approach that fosters diverse perspectives in treatment.

Duke offers two main training tracks for residents: a core rotation in the 24-bed SICU at DUMC and a unique experience with attendings from various departments, which enhances the educational value and clinical exposure. CA-3 residents can opt for extended training in the SICU to acquire enhanced responsibilities and skills in managing complex cases.

Medical students can participate in a dedicated rotation focused on critical care medicine, offering hands-on experiences in the SICU, complemented by interactive learning sessions on advanced technologies such as invasive hemodynamic monitoring and mechanical ventilation.

The nursing and administrative leadership in the department comprises distinguished faculty, including numerous assistant and associate professors across different specialties, ensuring that the fellowship program is backed by experienced practitioners committed to education and research.

The Competitiveness of the program is notably high, attracting strong applicants from other institutions. The program is also friendly toward international medical graduates (IMGs) and offers comprehensive visa support, including H-1B and J-1 visas, for eligible fellows.

Application requirements include completion of an accredited residency program and a maximum of two failed USMLE Step exams.

In terms of research, the division has ongoing projects that encompass population health to basic science studies, supported by various funding sources. The Critical Care and Perioperative Population Health Research (CAPER) Unit is dedicated to improving patient outcomes through methodologically rigorous research.

Collaboration is a hallmark of the program, engaging in partnerships with multiple divisions and departments within Duke University, as well as national and international organizations focused on critical care and anesthesiology.