Residents interested in Critical Care Medicine should seek out elective and procedure experiences that build skills in acute resuscitation, complex physiology, and interdisciplinary care of critically ill children. Key rotations include the Pediatric and Cardiac Intensive Care Units, where residents manage high-acuity patients and participate in medical emergency and code teams. Electives in anesthesiology and transport medicine offer hands-on exposure to airway management, vascular access, and the stabilization of decompensating patients in dynamic settings. Complementary experiences in palliative care, simulation, and relevant subspecialties such as cardiology, nephrology, and pulmonology help deepen clinical knowledge and procedural confidence. Residents are encouraged to engage with faculty mentors in the PICU and CICU, and consider scholarly work or quality improvement projects related to critical care.
Contact
Matt Zackoff – matthew.zackoff@cchmc.org (Rotation & Fellowship Director)
Daniel Loeb – daniel.loeb@cchmc.org (Rotation Director)
Steve Standage – steve.standage@cchmc.org (Elective Director)
Kama King – kama.king@cchmc.org (Administrative Support)
Essential Electives
PICU Elective
This full-block elective allows for deeper exposure to the processes and care environment of the PICU and allows for additional experience in the care of critically ill children, including the evaluation of sick versus not sick, acute resuscitation, and contingency planning for clinical deterioration. Residents participate in the Medical Response and Code Teams, manage transport of decompensating patients, and observe and participate in critical care procedures such as airway management, vascular access, and central line placement.
Cardiac Intensive Care Unit
This half-block elective exposes residents to the management of children with congenital and acquired heart disease, focusing on pre- and post-operative cardiac critical care as well as cardiomyopathy, heart failure, ECMO, and other critically ill patients. Residents learn about cardiac physiology, hemodynamic monitoring, and the specific needs of patients with mechanical circulatory support devices. Exposure to postoperative management of complex surgical repairs and congenital anomalies is a key component.
Recommended Electives
Anesthesiology
This half block elective offers hands-on experience with airway management techniques including bag-valve-mask ventilation, anesthesia induction, intubation, and peripheral IV placement. Residents work alongside anesthesiologists in same-day surgery, ENT, and GI procedure rooms, building skills critical for emergency airway management and procedural sedation.
Transport
This half block elective allows residents to work directly with the pediatric critical care transport team, participating in ground and air (helicopter/airplane) interfacility transports. Residents gain insight into the stabilization of critically ill children during transfer and the operational logistics of mobile intensive care.
Simulation
This half block elective allows residents to participate in interdisciplinary simulation sessions with educators and the multi-disciplinary simulation team. Residents learn how to facilitate and debrief simulations focused on resuscitation, crisis resource management, team communication, and procedural skills to better prepare for real-time critical care emergencies.
Palliative Care
This half-block elective exposes residents to the principles of pediatric palliative care, focusing on pain management, symptom relief, end-of-life decision-making, and hospice transitions. Emphasis is placed on communication strategies, ethical considerations, and compassionate care for patients with life-limiting illnesses.
Other Electives
Cardiology
This half-block elective can be tailored to the resident interested in critical care, focusing on additional understanding of cardiac pathophysiology, rhythm interpretation, and the medical management of heart failure, arrhythmias, and congenital heart disease. Exposure to diagnostic tools such as echocardiography, cardiac catheterization, and electrophysiologic studies is emphasized.
Nephrology
This half-block elective can focus on the renal aspects of critical illness, including fluid and electrolyte management, acute kidney injury, and renal replacement therapies such as continuous venovenous hemofiltration (CVVH). Opportunities to observe and participate in dialysis care are available.
Pulmonology
This half-block elective can deepen skills in the management of complex pulmonary conditions, with exposure to bronchoscopy procedures, ventilator management, and the evaluation and treatment of chronic lung diseases such as cystic fibrosis and bronchopulmonary dysplasia.
Recommended procedures
- Bag mask ventilation
- Bladder catheterization
- CPR
- Hemorrhage control
- LP
- Peripheral IV/venipuncture
Optional procedures
- Central venous access
- Chest tube
- Defibrillation
- Endotracheal intubation
- IO
- Bronchoscopy
- POCUS
- Procedural sedation
Other Experiences
Critical Care Medicine Divisional Conferences
Residents Selected to Intubate – a longitudinal training program that will train residents in the use of video laryngoscopy for intubation, as well as the RSI process. Residents completing the program will be allowed to intubate select patients in the STS, as well as serve as the second physician manning the checklist in RSI cases.
RESUSC 200 – An advanced version of the baseline RESUSC longitudinal curriculum intended for residents interested in pursuing acute care careers.
Scholarly Activity
Most applicants pursuing Critical Care Medicine participate in a scholarly project. The project does not have to be housed in the Division specifically, but most residents applying for a career in the PICU have completed a project with a Division mentor. The quality the mentoring and methodology are the most important criteria programs consider. Residents should also strongly consider spending time on a dedicated Research Elective to work on their project.
Professional Organizations
Society for Critical Care Medicine (SCCM)
The largest multiprofessional organization dedicated to critical care, covering both adult and pediatric populations. Offers robust resources for education, clinical practice guidelines, and interprofessional collaboration.
Website: https://www.sccm.org
Shock Society
Focused on advancing the science of shock, trauma, and sepsis, particularly through basic and translational research. Membership is research-oriented and includes scientists and clinician-scientists.
Website: https://shocksociety.org
American Academy of Pediatrics (AAP) Section on Critical Care Medicine
Advocates for education, training, mentorship, and policy relevant to pediatric critical care. Offers resources for trainees and early career professionals.
Website: https://www.aap.org/en/community/aap-sections/critical-care/
Annual Meetings
SCCM Critical Care Congress
The premier annual meeting for critical care professionals worldwide. Features multidisciplinary sessions, abstract presentations, and cutting-edge research in both adult and pediatric care.
Conference Info: https://www.sccm.org/Education-Center/Events/Upcoming-Events/Critical-Care-Congress
Shock Society Annual Meeting
Focuses on emerging basic science and translational research in shock, inflammation, and trauma. Includes abstract presentations and networking for physician-scientists.
Conference Info: https://shocksociety.org/annual-meeting/
AAP National Conference & Exhibition
While primarily general pediatrics, there is limited programming and networking opportunities related to pediatric critical care through the Section on Critical Care.
Conference Info: https://aapexperience.org
Key Journals for Critical Care-Specific Research
Critical Care Medicine
The official journal of SCCM, publishes adult and pediatric-focused original research, reviews, and clinical guidelines.
Journal Link: https://journals.lww.com/ccmjournal
Pediatric Critical Care Medicine
Focuses specifically on the clinical and scientific aspects of pediatric critical care, from physiology to outcomes research.
Journal Link: https://journals.lww.com/pccmjournal
American Journal of Respiratory and Critical Care Medicine (AJRCCM)
Published by the American Thoracic Society; includes high-quality critical care and pulmonary research relevant to both pediatric and adult populations.
Journal Link: https://www.atsjournals.org/journal/ajrccm
Additional Journals Featuring Critical Care Content
Nature
Publishes landmark basic science research, including topics related to immunology, inflammation, and pathophysiology relevant to critical care.
Journal Link: https://www.nature.com
Hospital Pediatrics
AAP journal focusing on care within the hospital setting, often includes studies relevant to pediatric ICU care and quality improvement.
Journal Link: https://hosppeds.aappublications.org
Academic Pediatrics
Features educational, quality improvement, and systems-based research, including content relevant to PICU education and practice.
Journal Link: https://www.academicpedsjnl.net
Simulation in Healthcare
A leading journal in medical simulation, often publishing critical care-focused simulation research and training techniques.
Journal Link: https://journals.lww.com/simulationinhealthcare
Pediatric Quality and Safety
Open access journal dedicated to quality improvement, patient safety, and outcomes research in pediatric inpatient care, including critical care settings.
Journal Link: https://journals.lww.com/pqs