Junior Resident

Your goals for the first half of residency training should be focused on establishing a solid base of emergency medicine (EM) knowledge. Almost everything you learn in fellowship will expand upon what you are learning now. Be engaged in all your rotations and establish routines that incorporate regular reading. You should also use clinical time to help decide whether the resuscitation and emergency critical care (RECC) fellowship or a dedicated critical care fellowship is the right fit for you. Ultimately, where you desire to practice upon completion of training will help guide this decision.

Seek mentorship from RECC or critical care faculty. Find out why they chose their paths, what their work/life balance is like and how it relates to what you hope for yourself, and if they would do anything differently. They can also help with letters of recommendation and opportunities for scholarly work. If your program does not have any RECC or critical faculty on staff, consider seeking mentorship outside your institution. Many programs will allow for away rotations or research opportunities.

Advantages of RECC Fellowships

• One year fellowship compared to two years of traditional critical care fellowships in EM.
• Extra training that enhances competency related to the initial management of critically ill emergency department (ED) patients as well as mastering nuances of critical care beyond the first few hours.
• Ideal if you primarily want to work in ED, ED-Intensive Care Unit (ICU), or other ED-based resuscitative unit.

Advantages of Traditional Critical Care Fellowships

• More specialized knowledge of specific types of critical care patient populations. For example, knowledge of how to manage mechanical cardiac support devices in post-operative patients.
• Critical care board-eligible, which means the potential to work in an ICU after fellowship.