ICU/Critical Care Rotations

You will develop your competency level in critical care as you manage patients and learn a variety of intensive care procedures.

During our ICU/critical care rotations, you will care for patients admitted or transferred to the ICU services. On a daily basis, your duties will include interviewing patients, performing physical examinations, formulating a care plan and reviewing laboratory and diagnostic studies. During the staffing round, the staff physician will rely on you to provide all patient information and lay out patients’ management plans.

We require you to take at-home call for the service on weekends and nights. You will share weekend call with other fellows.

Our critical care rotations let you experience multidisciplinary cooperation among different health professionals including nurses, dietitians, respiratory therapists and pharmacists.

You will be responsible for rounding daily with the residents assigned to the service. Directing the residents in patients’ daily care, you will have significant input in patient management. While overseeing these residents and interns, the attending physicians will supervise you. Later in your training, you will act as a team leader in the ICU; this hierarchical structure enables you to learn from our experienced physicians while assuming supervisory roles.

Comprehensive Training

We provide you with a variety of learning methods in these rotations. You will hone your skills via daily bedside rounds, which give you opportunities to discuss pertinent findings. You will also acquire knowledge through our daily teaching rounds that focus on current or past patients and review similar cases and findings.

We'll further augment your learning experience when you participate in our didactic conferences and attend semiweekly didactic lectures. Moreover, you can depend on the attending physicians to provide outside sources of information that will help steadily expand your knowledge base.

Invasive procedures are an important component of critical care. As part of your training, you will learn the indications, contraindications and relative risks for procedures including:

  • endotracheal intubation
  • set up and initiation of mechanical ventilation
  • percutaneous cannulation of arteries (radial, femoral, axillary)
  • placement of pulmonary artery catheters
  • thoracostomy tube insertion
  • basic and advanced cardiac life support
  • percutaneous cannulation of veins (subclavian, internal and external jugular, femoral)
  • cardioversion
  • use of ultrasound in the ICU

You will become familiar with indications for procedures including:

  • pericardiocentesis
  • peritoneal dialysis
  • peritoneal lavage
  • percutaneous needle aspiration and/or cutting lung biopsy
  • aspiration of major joints
  • transvenous pacemaker insertion
  • endobronchial cryotherapy and/or laser therapy
  • intracranial pressure monitoring

In addition, the attending physicians will work closely with you while you:

  • gain familiarity with analyzing clinical data
  • refine your interpretive skills as you review chest roentgenograms, radionuclide scans, computed axial tomograms and pulmonary angiograms

Clinical Sites

You will rotate at the ICUs of two of our clinical training sites:


You can expect to see more than 100 patients per rotation at the Buffalo General Medical Center ICU. At the Buffalo VA Medical Center, you will see at least 50 patients per rotation.

Length of Rotation

First year

  • 2 modules at the Buffalo VA Medical Center ICU 
  • 3 modules at the Buffalo General Medical Center ICU

Second year

  • 1 module at the Buffalo VA Medical Center ICU
  • 2.5 modules at the Buffalo General Medical Center ICU

Third year

  • 1 module at the Buffalo VA Medical Center ICU
  • 2.5 modules at the Buffalo General Medical Center ICU