Introduction
University of Maryland is already well known nationally and internationally for outstanding training in emergency medicine and critical care, and these residency/fellowship programs consistently rank amongst the top programs in the US. The merger of these two training programs, especially alongside broader foundational training in internal medicine, yields physicians who are uniquely equipped to manage any acutely ill patient. Our graduates are true renaissance men and women, and bring an unparalleled skillset to the prestigious institutions and high level leadership positions they often are recruited to in their careers. Even while they are still residents, we find co-residents and even faculty frequently consulting our EM/IM/CC residents as they bring a uniquely comprehensive and capable perspective to patient care.  The EM/IM/CC program at our institution is a logical extension of our already popular and successful 5-year EM/IM program. Residents in both programs have nearly identical rotations, schedules, and responsibilities for the first four years of their respective programs, and in fact all residents eventually in EM/IM/CC apply and start as EM/IM residents. All EM/IM residents in good standing are offered the option of transitioning to the 6 year critical care track, and for those who do so (about 60-80% of our residents), this decision is made prior to starting PGY-4. Please see the EM/IM section for information regarding PGY 1-4 rotations. Beginning in PGY-5, residents in the EM/IM/CC track assume a supervisory role equivalent to that of a critical care fellow. They are subject to all of the same requirements as critical care fellows, and function in every aspect identically to these fellows while on critical care rotations. During PGY-5 and PGY-6 years, EM/IM/CC residents perform 11 months of dedicated critical care patient responsibilities. These 11 months primarily consist of training in the Medical Intensive Care Unit (MICU), Coronary Care Unit (CCU), Neurology Critical Care Unit (NCCU), and Cardiothoracic Intensive Care Unit (CTICU) at The University of Maryland Medical Center. In addition, EM/IM/CC residents also rotate through the Trauma Intensive Care Units at the world-renowned Shock Trauma Center. Aside from dedicated patient care months, 4 contiguous months are provided for the initiation of critical care research. The remaining months in the latter two years are spent in rotations of Internal Medicine and Emergency Medicine. Please see the block schedule below for a sample grid of rotations.The Facilities Founded in 1823, The University of Maryland Medical Center (UMMC) is one of the nation’s oldest teaching hospitals. The Medical Center is a major tertiary and primary care center with many world-renowned specialized programs. UMMC serves as the hub for the expansive 15 hospital University of Maryland Medical System, which spans the state of Maryland and funnels the most complex and challenging patients to the academic center at UMMC. This spoke and hub system specifically emphasizes critical care at UMMC, and the medical center boasts 13 intensive care units. In parternship with the attached Shock Trauma Center, UMMC is routinely in the top 3 hospitals nationally in Extracorporeal Membrane Oxygenation (ECMO) cases annually, and leads the way in many other advanced therapies such as Molecular Adsorbent Recirculating System (MARS), Heart Transplant, mechanical circulatory support devices such as Impella and many more. University Hospital has outstanding new state-of-the-art facilities in Emergency Medicine and Critical Care. University of Maryland Medical Center is one of the largest providers of intensive care in the Mid-Atlantic region. The MICU, one of the largest units in UMMC, is the hub of much of this advanced critical care, and becomes like a second home to our PGY-5 and PGY-6 residents. It supports nearly every other specialty area of the hospital. The MICU is staffed with 24-hour attending supervision, and outstanding balance is routinely struck between allowing advanced residents to gain experience leading teams, while also having proper attending supervision and support for the level of acuity seen at our hospital. The R Adams Cowley Shock Trauma Center is the nation’s only dedicated Trauma Hospital. Each year, the Trauma Center treats over 7,500 critically injured patients. It is regarded as one of the international standard-setters for the care of injury. Here, EM/IM/CC residents will rotate through the Neuro-trauma Intensive Care Unit and the Multi-trauma Critical Care Unit. Trainees come from all over the world to learn at the Shock Trauma Center, and we are quite fortunate to have unique integration into the units and services provided there. Shock Trauma also grants our residents access to advanced electives such as in the Critical Care Resuscitation Unit – a unique care delivery paradigm focused on stabilizing critically ill patients – and the Lung Resuscitation Unit – a dedicated V-V ECMO unit.
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Applying
It is important to understand that the creation of our EM/IM/CC program does not increase the overall number of combined resident positions. This 6-year program is offered as an extension of our current 5-year EM/IM program. If EM/IM residents are interested and dedicated to critical care training and certification, they have until the start of their PGY-4 year to transition into the 6-year track. Therefore, prospective applicants interested in the EM/IM/CC track should apply and interview for our 5-year EM/IM residency program.
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