Critical Care Medicine Fellowship

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GME Trainees

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Peer-Reviewed Publications in 2023

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Active Clinical Trials

Welcome

Curriculum

The Department of Medicine and the Department of Anesthesia and Critical Care at Houston Methodist Hospital offer a Critical Care Medicine (CCM) Fellowship Program accredited by the ACGME (Accreditation Council for Graduate Medical Education). Before the start of the fellowship, applicants must have completed residency training in internal medicine accredited by the ACGME.

The CCM fellowship program consists of 24 months in duration.


Message from the Medical Director      

Faisal Masud, MD, FCCP, FCCM
Medical Director, Center for Critical Care
Professor of Clinical Anesthesiology & Critical Care, Academic Institute
Mary A. and M. Samuel Daffin, Sr. Centennial Chair in Anesthesia and Critical Care, Houston Methodist

Welcome, to the Multidisciplinary Critical Care Fellowship Program

I’m thrilled to have you join the program and congratulate you on embarking on this journey of learning and growth.

If you are here exploring more information about this program, welcome and I hope you find this information helpful.

This program has been carefully designed to provide you with comprehensive training that covers a wide range of essential topics. You’ll be engaging in both didactic and non-didactic learning experiences, ensuring that you not only absorb the knowledge you need but also develop practical skills that will serve you well in your professional career.

Houston Methodist has long been recognized for its commitment to nurturing talent and driving innovation. Our reputation for excellence is built on a foundation of core values—integrity, collaboration, and a relentless pursuit of continuous improvement. This strong legacy reflects our dedication to providing our people with the essential tools and knowledge to thrive. At Houston Methodist, we take pride in being at the forefront of medical advancements, delivering compassionate and respectful care, and maintaining an unwavering focus on quality and patient safety. You’ll find that this program offers unique access to leadership across all key areas of the institution.

Moreover, our department is deeply invested in the growth of both faculty and residents, focusing on several critical areas, including personal well-being and resilience, innovative educational approaches, research methodology and statistics, and the development of lasting scholarly contributions.

As participants progress through this program, they will find that the skills and insights gained here will be invaluable for career advancement, both within our organization and beyond. If you haven't done so yet, I highly recommend exploring our program in detail. It is designed to help you achieve your goals, whether you're aiming for a subspecialty fellowship, a career in private practice, or a role in academics.

Thank you for being a part of this exciting opportunity. We look forward to seeing all that you will achieve!

Message from the Program Director

Iqbal Ratnani M.D, MS, Ed.D, FACP, FCCP, FCCM
Director, Multi-Disciplinary Critical Care Fellowship

Welcome, and thank you for visiting the website of our new multi-disciplinary (aka straight) Critical Care Medicine Fellowship program at Houston Methodist Hospital.

Our faculty members engaged in teaching are seasoned educators and clinicians dedicated to the program's success. The fellowship program enjoys a wealth of diverse clinical expertise and patient variety for critical care dimensions like sepsis, ARDS, and all human systems emergencies. Five ICUs (medical, surgical-liver, cardiovascular surgery, cardiac, and neurology/neurosurgery) offer experience in the entire range of care for critically ill patients, including heart, liver, lung and combined organs transplant, ECMO, LVADs, bedside ECHO & Ultrasound, hypothermia, neuromuscular diseases, and innovative procedures. Fellows will also rotate through the virtual ICU and post-ICU care (PICS) clinic at Houston Methodist Hospital as a valuable complement to the clinical experience in the hospital. Due to the high volume of our tertiary care center, having strong hands-on experience with all the procedures is a norm!

Our fellowship program stands out for its unique feature that allows fellows to tailor their electives to their chosen trajectory, be it research or a more sub-specialized practice such as cardiac devices or ECMO in the future.

Houston Methodist has its own Research Institute, and its location in the Texas Medical Center − the largest medical center in the world with two medical schools, multiple nursing schools, a pharmacy school, the largest cancer hospital in the world, and Rice University across the street, provides endless opportunities for those interested in pursuing scientific and clinical research.

Should you have any additional questions or need further clarification about the program, please do not hesitate to contact me or the fellowship coordinator.

Thank you for your interest in our program. We wish you every success in your future career.

Curriculum

Multidisciplinary daily rounds
The Critical Care faculty has dedicated time to providing direct patient care in the Intensive Care units and will directly supervise the fellows. The main teaching rounds are the multidisciplinary ICU rounds. These occur once daily, seven days a week, and last about an hour each. Multidisciplinary rounds include MDs (faculty, fellows, residents), APPs, bedside nurses, pharmacists, respiratory therapists, case managers, social workers and chaplains. These are patient-centered rounds with opportunities to discuss patient management and are opportunities for learning and teaching bedside medicine. Multidisciplinary daily rounds in the ICU are the backbone of CCM fellowship. It will require fellows to present patients concisely and pertinently to a team of nurses, pharmacists, dieticians, respiratory therapists, chaplains, social workers, and case managers. They must outline relevant issues to direct these colleagues in providing their expertise to optimize patient care. With their unwavering support and guidance, the supervising faculty will model these presentations using a communication template and offer feedback, instilling confidence in the fellows. The complexity of patient problems in the ICU also requires effective communication with multiple consultants. Fellows will be asked to formulate specific questions when requesting consultation from a subspecialist and are expected to discuss and coordinate recommendations. Effective communication of diagnoses, management and prognosis in terms that patients and families can understand in the stressful environment of the ICU will be modeled by the supervising faculty and evaluated by direct observation of the fellow. Discussions of end-of-life care and goals of care are expected skills for fellows to develop during the MICU rotation. Communication expertise will be developed by increasing participation in family meetings with the expectation that the fellow can direct such discussions independently by the end of their training.
Didactic Sessions
The twice-weekly scheduled didactic program is based on the core knowledge content and areas defined as a fellow’s outcome in the specialty. It follows the following curriculum. It provides fellows with a Socratic approach to education. Conferences are presented by faculty and visiting professors.

PULMONARY DISEASE
  1. Embolism, hemoptysis, and pleural disease
  2. Airway Management, Asthma, and COPD
  3. Acute Respiratory Distress Syndrome I
  4. Acute Respiratory Distress Syndrome II
  5. Mechanical Ventilation I
  6. Mechanical Ventilation II
CARDIOVASCULAR DISEASE
  1. Hemodynamics, Monitoring, Blood Flow, and Resuscitation I
  2. Hemodynamics, Monitoring, Blood Flow, and Resuscitation II
  3. Myocarditis, Pericarditis, Valvular, and vascular disease
  4. Extracorporeal Membrane Oxygenation (ECMO): Getting the basics right
  5. Extracorporeal Membrane Oxygenation (ECMO): Troubleshooting
RENAL, ENDOCRINE, AND METABOLIC DISORDERS
  1. Acute Kidney Injury
  2. Endocrine Emergencies I
  3. Endocrine Emergencies II
  4. Acid-Base Critical Care
  5. Electrolyte Disorders and Complications
INFECTIOUS DISEASES
  1. Intra-Abdominal Infections
  2. Immunocompromised Host, Host Resistance, and Epidemiology
  3. Infection Control
  4. Pulmonary Bacterial and Fungal Infection
  5. Systemic Fungal and Cardiovascular Infections
NEUROLOGIC DISORDERS
  1. Cerebral Vascular Disease
  2. SCI, Coma, Post-Arrest Hypothermia
SURGERY, TRAUMA AND TRANSPLANTATION
  1. Surgery: Trauma, Cardiovascular, GI, and OB
  2. Surgery: Environmental, General Post-op, and Transplantation
GASTROINTESTINAL DISORDERS
  1. Gastrointestinal Disorders
HEMATOLOGIC AND ONCOLOGIC DISORDERS
  1. Hematologic/Oncological Disorders
PHARMACOLOGY AND TOXICOLOGY
  1. Pharmacology and Toxicology
CRITICAL CARE ULTRASOUND SCANNING
  1. Critical Care Ultrasound Scanning: Knobology
  2. Critical Care Ultrasound Scanning: Basic Cardiac Views and Interpretation of LV Function
  3. Critical Care Ultrasound Scanning: Thoracic US
RESEARCH, ADMINISTRATION, AND ETHICS
Morbidity and Mortality Conference
The Morbidity and Mortality Conference is a key teaching conference during which residents and fellows present complications and discuss them with faculty. The complications are discussed with an emphasis on the current literature and are designed to promote an educational discussion.
Journal Club
Journal Club is held every other month and centers on presenting new clinical and scientific information. Fellows present the articles each month, and faculty assist in discussing them.
Grand Rounds
Grand Rounds are designed to keep fellows and other healthcare professionals up-to-date of new knowledge, procedures, and patient care issues.
MITIE Skills Laboratory
MITIE is a comprehensive training facility for teaching critical care procedures such as airway management, central line placement, and invasive cardiac monitoring.

The Inanimate Skills Laboratory is centrally located on the fourth floor of Houston Methodist Hospital, in the Fondren wing. Residents and fellows have access so that they can work at their own pace and on their own schedule.
Procedural Competence
Procedural competence will be assessed using a competency-based approach throughout the Critical Care Medicine program. For each procedure, progressive levels of competence will be defined, and the fellow will be assessed for levels of competency or proficiency at each level by his/her attending physicians. At each level, a decision will be made whether the fellow is competent to proceed to the next level of procedural difficulty/complexity. During each clinical rotation that involves procedural skills, the supervising attending must document a formal assessment of procedural skills for each relevant procedure. Compliance with requirements for procedure competency will be reviewed at the fellow’s semi-annual and annual reviews with the Program Director.

The fellow must maintain a log of all required and essential procedures performed in the procedure logger located in New Innovations, the residency management software system; the supervising faculty must select the level of skill observed in the procedure (i.e., the level of “mastery”), including but not limited to:
  • Central lines via jugular, subclavian, and venous routes
  • Arterial line via radial, femoral, and axillary routes
  • Chest tubes (both pigtail and large bores)
  • Intubations, including difficult airways
  • Emergent tracheostomy
  • Bronchoscopy
  • Thoracentesis
  • Paracentesis
  • Lumbar Puncture
  • ECMO cannulation and management
  • Bedside POCUS and FOCUS

For assessing procedural competence, the program has developed a series of steps for developing procedural competency. The fellow is expected to complete these steps to achieve procedural competence. The process includes:
  1. The fellow will receive an introduction to the basic skills and concepts of each procedure; this will occur initially at the beginning of each rotation for specific procedures to be performed or as part of a scheduled educational session.
  2. The fellow will receive procedural training in sedation knowledge and skills and some critical care procedures in the Methodist Institute for Training, Innovation, and Education (MITIE) simulation laboratory, the Methodist Bronchoscopy Unit, and the MICU.
  3. Throughout the two years of fellowship training, the fellow will observe the attending faculty physician(s) or other certified healthcare provider(s) perform the procedure on the clinical rotations.
  4. The fellow will demonstrate all procedural skills under the supervision of the attending faculty physician.
  5. Regardless of the fellow’s level of skills in performing procedures, all procedures must be performed under the supervision of a faculty physician authorized (i.e., credentialed) to perform these skills by Houston Methodist Hospital except in life-threatening emergencies (i.e., need for intubation). In emergencies, a fellow may perform a procedure in which they have demonstrated competency pending the arrival of the attending faculty.
Learning Environment and Resources
The faculty will monitor fellow performance and learning on an ongoing basis. Fellows will always be under the supervision of the attending faculty. That means the fellows are monitored during rounds, consults, and procedures. There will be close working relationships and interactions with faculty and program staff. All academic resources available via the program, GME office, and the Hospital, such as library access, grand rounds, journal clubs, symposiums, training on scientific writing, and IRB applications, will be offered. Fellows receive instruction about the institutional resources of the Hospital and the GME Office during orientation and are encouraged to use these resources.
Our Program Leadership
Faisal Masud, MD, FCCP, FCCM
Professor of Clinical Anesthesiology & Critical Care, Academic Institute
Medical Director, Center for Critical Care
Mary A. and M. Samuel Daffin, Sr. Centennial Chair in Anesthesia and Critical Care, Houston Methodist
Weill Cornell Medical College
Iqbal Ratnani, MD, FCCM, FCCP
Program Director
Associate Professor of Clinical Anesthesiology & Critical Care, Academic Institute
Houston Methodist
Weill Cornell Medical College
Bassel Akbik, MD
Deepa Bangalore Gotur, MD
Associate Professor of Clinical Medicine, Academic Institute
Associate Clinical Member, Research Institute
Houston Methodist
Weill Cornell Medical College
Navneet Grewal, MD
Constance M. Mobley, MD, PhD, FACS
Associate Professor of Clinical Surgery, Academic Institute
Associate Clinical Member , Research Institute
Associate Director of Liver Transplantation, J.C. Walter Jr. Transplant Center
Houston Methodist
Weill Cornell Medical College
Anh T. Nguyen, MD
Divina Tuazon, MD
Asma Zainab, MD
Assistant Professor of Clinical Anesthesiology & Critical Care, Academic Institute
Assistant Clinical Member, Research Institute
Houston Methodist
Weill Cornell Medical College
Megan Gooch, MD

Eligibility and Application

To be eligible for our Critical Care Medicine Fellowship Program position, general requirements must be met:


Requirements

  • Must be a U.S. Citizen, green card holder, or J-1 visa holder.
  • Disclosure if in seventh year of J-1 visa training.
  • Must have completed an ACGME-accredited residency program under Internal Medicine.
  • For the one-year track, candidates also must have completed a subspecialty fellowship under Internal Medicine.

Houston Methodist is committed to improving the health of our patients, employees, and communities around us. As a health care provider, it’s our responsibility to promote a healthier environment for our employees.


Responsibility
  • Drug and Tobacco Screening- Job seekers will be tested for nicotine and drug usage during the post-offer physical. If a job seeker tests positive for nicotine use, including nicotine gum and patches, the offer will be rescinded, and individuals will be given the opportunity to participate in a free Houston Methodist-provided tobacco cessation program. Job seekers wishing to reapply after testing positive for nicotine may do so 90 days after the date the initial offer was rescinded. If the job seeker tests positive for drug use, the offer will be rescinded. Job seekers wishing to reapply after the drug screening is positive may do so one year after the date the initial offer was rescinded.
  • Background Check - Prior to employment start date, job seekers must complete a criminal background check.

Application Process                   
For the Critical Care Medicine Fellowship, we exclusively use ERAS. Applications are accepted through ERAS beginning in July each year.

To submit applications through ERAS, applicants must contact the ERAS Fellowship Documents Office and request an electronic token, which is then used for access to the ERAS application site. The following materials must be submitted through ERAS:
  • ERAS application/li>
  • Curriculum vitae (ERAS format is acceptable)
  • Personal statement
  • Three letters of recommendation
  • Medical school transcript
  • USMLE results
  • A copy of your ECFMG certificate and visa, if applicable

Interview Days                                                              
September - March

Get In Touch

Program Contact

Ellie Saenz-Garza, MBA, C-TAGME
Senior Residency Coordinator
6565 Fannin Street, Suite B440
Houston, TX 77030
Tel. 713.441.3939 | Fax 346.238.8858
Email: CCMHMH@houstonmethodist.org

Upcoming Academic Events

Grand rounds, tumor boards, regularly scheduled series and case presentations are offered in multiple clinical disciplines and Houston Methodist locations.
Effective Strategies for Writing NIH K Award Applications

Shailaja K. Mani, PhD, Mary Ann Ottinger, PhD

Oct 09 @ 12PM

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Heart Center Grand Rounds: Coronary CTA Plaque Imaging: From Research to Clinical Applications

Oct 10 @ 8AM

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Grand Rounds conducted in 2023
These educational events are held according to varying schedules by departments and divisions within the Houston Methodist Academic Institute

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