Senior Resident

• Spend elective time gaining additional exposure to various intensive care unit (ICU) settings.
• Continue to pursue leadership roles in critical care-oriented projects such as research, quality improvement initiatives, and in relevant committees.
• Consider mentoring younger residents or students interested in critical care.
• Take opportunities to present critical care-related lectures at your residency conference, Grand Rounds, or at regional and national conferences.
• Gain proficiency with ultrasonography and its application to critical care resuscitation.
• Work on your fellowship application early in your final years of training. Identify writers for letters of recommendation and update your curriculum vitae (CV) as soon as possible.

Specific Advice for Different Fellowship Pathways

Internal Medicine Critical Care Fellowships

• This is the most common pathway for emergency medicine (EM) physicians.
• Must complete at least six months of internal medicine rotations (i.e. cardiology, nephrology, medical ICU, infecious disease) prior to being able to supervise internal medicine residents as a fellow per ACGME. Most residency programs have built-in rotations that will satisfy this requirement (medical ICU, cardiac ICU, etc.). You can use elective time in residency towards this requirement as well. Many fellowship programs will allow you to finish the remaining few months of this requirement at the beginning of fellowship, but they typically desire applicants who have already fulfilled three-four+ of these months prior to fellowship.
• Start your ERAS application during the end of PGY2/beginning of PGY3. Applications typically open in July of PGY3 and are due in late fall/early winter, with Match Day generally in December.
• Most fellowships are 24 months, however, this may be shortened to 12 months if the individual is EM/internal medicine trained and that program has a track available for this.

Anesthesia Critical Care Fellowships

• Submit a Central Application Service (CAS) form to apply to programs in your second to last year of residency.
• The San Francisco Match takes place in May of your PGY2 (if in a three-year residency) or PGY3 (if in a four-year residency).
• Fellowships are 24 months.

Surgery Critical Care Fellowships

• Most programs are 24 months in duration with the first 12 months serving as a preparatory year/advanced preliminary training.
• Apply through ERAS in your final year of EM residency.
• This pathway is significantly hospital- and program-dependent, with the first year of fellowship varying widely across programs.

Neurocritical Care Fellowships

• Submit a CAS form to apply to programs.
• The San Francisco Match takes place in August of your second to last year of residency.
• Fellowships are 24 months.