Department of Medicine

Clinical Rotations

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Clinical Rotations 

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Fellows rotate through a variety of clinical settings, including public hospitals Ben Taub Hospital and Michael E. DeBakey Veterans Affairs Medical Center and private hospital CHI Baylor St. Luke’s Medical Center.

Baylor St. Luke's Medical Center

Medical Intensive Care Unit (MICU)

  • The BSLMC MICU service includes a multidisciplinary team led by a pulmonary/critical care or critical care faculty member. All 18 patients are managed by the MICU team. Fellows gain experience in the management of critically ill patients and also have the opportunity to gain procedural skills, including ultrasound skills and intubations. The fellow acts as a sub-consultant leading a team of residents, interns and nurse practitioners.

Mobile Medical Intensive Care Unit (Mobile MICU)

  • The mobile MICU service assists with the management of unstable patients not located in the ICU (i.e. on the general floor or emergency room) and overflow medical ICU patients located in primarily non-medical ICUs. Two fellows work on this service in a staggered shift model. Fellows will have the opportunity to gain procedural skills and will have exposure to rapid response systems.

Coronary Care Unit (CCU)

  • Fellows will manage medical patients with cardiac disease, such as cardiogenic shock, myocardial ischemia and other cardiac complications. Fellows also will spend time with echocardiography technicians to gain skills in cardiac ultrasound image acquisition and will have formal training in echo interpretation.

Cardiovascular Intensive Care Unit (CVICU)

  • Fellows will work with a multidisciplinary team led by a pulmonary/critical care or anesthesia critical care attending. The main focus will be care of the post-operative cardiovascular patient, particularly those who have undergone coronary artery bypass graft surgery and valve replacements. Fellows will have exposure to patients undergoing minimally invasive surgery and endovascular interventional procedures. Fellows also will gain broader experience in ventilator management and liberation strategies.
  • The main focus is the care of the cardiovascular post-operative patient, particularly those who have undergone coronary artery bypass graft surgery and valve replacements.

LVAD and Transplant ICU

  • Fellows rotating on this service will gain experience caring for patients who have received left ventricular assist devices (LVADs). They will become familiar with how the devices work and complications that may arise. Fellows also will care for patients who are immediately post heart, lung or heart-lung transplant. They will become familiar with early post-operative care of thoracic transplant recipients. Additionally, fellows will gain significant experience caring for patients on extracorporeal life support (ECMO).

Medical Intensive Care Unit (MICU 1)

  • Traditional ICU model
  • Mix of medical and surgical patients
  • Heavy case mix index, with many listed for liver and lung transplant
  • Total of 18 beds
  • Fellow acts as a sub-consultant leading a team of residents, interns and nurse practitioner

Mobile ICU/Rapid Response Team/Procedure Team

  • Team: Attending, two fellows, resident, two nurse practitioners and two highly trained ICU rapid-response-team nurses
  • Small census of 4-6 patients
  • Perform routine ICU procedures
  • Mobile ICU consults and rapid initial stabilization of critically ill patients

CCU/MICU 3/ECHO

  • Medical and CCU patients for first half of the day
  • ECHO lab for second half of the day under the supervision of the ECHO consultant and sonographer
  • Learning US image acquisition in the ECHO and PVD lab
  • Interpretation of ECHO

LVAD and Transplant ICU

  • Gain experience caring for patients who have received LVADs
  • Familiarization with how the devices work and complications that may arise
  • Fellows also will care for patients who are immediately post heart, lung or heart-lung transplant
  • Familiarization with early post-operative care of thoracic transplant recipients
  • Gain significant experience caring for patients on ECMO

Harris Health System - Ben Taub Hospital

Medical Intensive Care Unit (MICU)

  • MICU is a 16-bed closed ICU
  • Two fellows rotate through the ICU each month in a staggered shift model

Neurosurgical Intensive Care Unit (NICU)

  • Fellows will learn about common neurosurgical injuries, such as intracranial hemorrhages, masses and infections
  • Fellows will gain experience with ICP monitoring and ventilator management of the neurosurgical patient

Procedure Service

  • Procedures include bronchoscopy, CVV placement, A-line placement, PA catheterization, right heart catheterization, chest tube insertion and endotracheal intubations

Michael E. DeBakey VA Medical Center

Anesthesia/OR

  • Fellows gain extensive hands-on experience in advanced airway management

Medical Intensive Care Unit (MICU)

  • The MEDVAMC MICU is a 16-bed closed unit (sharing beds with the CCU). Two fellows rotate through the ICU each month in a staggered shift model. Fellows are responsible for overseeing the care of all ICU patients and providing guidance for a team of residents, interns and students. Fellows also perform and supervise procedures, including bronchoscopy, central line placement, arterial line placement, and endotracheal intubations.