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The Critical Care fellowship at UPMC Harrisburg is a two-year, ACGME-approved program that offers 3 positions each year for candidates who have completed an ACGME-accredited residency in Internal Medicine or Emergency Medicine.
Our mission is to combine an innovative, evidence-based, multidisciplinary learning experience with a compassionate, patient-centric approach to healthcare reflective of the core values of our faculty and leadership, mindful of the importance of a good work-life balance for the trainee.
Our program, launched in July 2023, was created in close partnership with the world’s first dedicated critical care training program, founded in 1961 at the University of Pittsburgh Medical Center. We maintain strong ties with the University of Pittsburgh Medical Center, with our first-year fellows spending some of their first-year training in Pittsburgh. We are thrilled to share that our graduating class has successfully secured their ideal positions.
In the first 2 weeks of fellowship, fellows will be given the chance to adjust to the UPMC system and to living in Harrisburg. During this period, a “Fellows Boot Camp” will be held consisting of hands-on sessions on ventilator management, point of care ultrasound (POCUS), difficult airway management and procedural training on central/arterial line insertion, thoracentesis, chest tube insertion and management, etc. at our surgical skills laboratory. They will also be given a chance to shadow an attending to see the daily workflow of the program’s primary service, the Medical/Surgical ICU (MSICU) rotation.
Patients under the MSICU service are primarily located at the 22-bed Medical-Surgical ICU but may overflow to the 17-bed Cardiovascular ICU at UPMC Harrisburg. They are followed by 1 of 3 teams which may consist of Critical Care fellows, residents from IM/EM, medical students, or APPs under the leadership of attending intensivists with backgrounds from Pulmonology, Emergency Medicine, Neurology, Nephrology, Anesthesia, or Cardiology. Fellows are expected to play an active role in resident and medical student supervision and teaching. They will work closely with an excellent team of APPs, nurses, respiratory therapists, pharmacists, physical therapists etc. creating a truly multidisciplinary learning environment.
Once the fellow finishes an MSICU rotation, they can then be assigned to MSICU Night float. The fellow will have sufficient autonomy as they enhance their clinical decision-making skills in a busy critical care environment. All admissions and difficult situations are discussed by the fellow with the remote tele-Intensivist, but if attending presence is necessary, an on-call intensivist is available to come in immediately to provide support.
During the first year, fellows may also rotate under specialty services providing consultation to critically ill patients such as Infectious Disease, Cardiology, Pulmonology, and Palliative care. Pulmonology further provides fellows with additional opportunities for mastering bronchoscopy and management of noninvasive ventilation. Experience in specialized ICUs such as Medical- Neuro ICU, Trauma Burn ICU will be conducted at UPMC Mercy in Pittsburgh. Other electives include: Anesthesia, Thoracic surgery, Critical Care US/Echo, Infectious disease, Nephrology, Palliative Care Medicine.
The second year fellows assume a junior attending role focused in enhancing leadership and teaching skills. They will be given the opportunity to lead multidisciplinary teams at ICUs in community-based settings at UPMC West Shore, Community Osteopathic, and Memorial Hospitals. An intensivist attending will be present and working with the fellow to provide feedback and assure appropriate patient care.
More flexibility and elective rotations are offered in the 2nd year of fellowship. During this period, the fellow is also expected to finish a quality improvement project that would benefit the community’s specific needs.
Several opportunities are available for teaching rotating residents (internal medicine, family medicine, emergency medicine, orthopedics) and medical students. Also, you are given the opportunity to participate in educational workshops to improve your teaching skills. Senior fellows will have the ability to participate as “Junior Attendings” in their second year of training at our various ICUs, under the supervision of board certified critical care medicine faculty.
To ensure that you acquire adequate knowledge and develop the appropriate technical skills to meet program expectations, fellows performance is monitored carefully during the Critical Care Internal Medicine Fellowship. You will be formally evaluated by supervising faculty members on a regular basis and meet with the program director to review these evaluations. In addition, you will also regularly evaluate the faculty to confirm that your educational needs are being met. Our program is very open to feedback and our goal is to create and nurture an open mindset in our trainees.
We understand that mentorship and sponsorship is critical in academic medicine, which is why we have multiple avenues for fellows to obtain mentorship. All fellows will be assigned mentors when they begin training to help with the transition from residency to fellowship. Fellows will also seek out research mentors to help with scholarly projects. Fellows regularly interact, work, and collaborate with critical care faculty from backgrounds in internal medicine, emergency medicine, anesthesiology, surgery, neuro-critical care, pulmonology, nephrology, infectious diseases and cardiology. There will always be faculty mentors available to you to guide you through your fellowship journey.
Kira Matrunetski, DO
Residency: Philadelphia College of Osteopathic Medicine
Medical School: Philadelphia College of Osteopathic Medicine
Konstantin Nestoiter, MD
Residency: Piedmont Athens Regional Medical Center
Medical School: Medical University of the Americas (Nevis)
Omar Al-Janabi, MD
Residency: Jamaica Hospital Medical Center
Medical School: University of Al-Mustansiriyah College of Medicine
Sahar Karim, MD
Residency: Piedmont Athens Regional Medical Center
Medical School: AGA Khan Medical College
Manny Shergill, DO
Residency: Garnet Health Medical Center
Medical School: New York Institute of Technology College of Osteopathic Medicine
Domingo T. Alvear Medical Library
Brady Building, 1st Floor
UPMC Harrisburg Campus
UPMC Community Osteopathic
West Wing, 1st Floor
UPMC Community Osteopathic Campus
UPMC Memorial
Outpatient Services Building, 3rd Floor
UPMC Memorial Campus
University of Pittsburgh’s Health Sciences Library System.
Access to E-resources such as online journals, databases, etc.
Interlibrary loan and document delivery services available to provide journal articles and book chapters not available in the digital library collection
Information services such as reference consultations and literature searches provided by HSLS librarians
The surgical skills laboratory allows the fellow to become proficient in procedural techniques in a zero-risk, stress free environment. Equipment for central/arterial line insertion, thoracentesis, chest tube insertion and management, emergent airway techniques, etc. are available to fellows either as formal instruction at Fellows Boot Camp or anytime they would like to devote in mastering a skill.
The Simpson Simulation Laboratory has been in existence for 20 years. The learners range from medical trainees, nurses and paramedics. Services range from simple simulation scenarios to more complex ones including cardiac arrest, procedural sedation, endotracheal intubation and difficult airway management, as well as management of the complex ICU patient in multisystem organ failure.
Navitha Ramesh, MD
Dr. Navitha Ramesh is a board-certified Internal Medicine, Pulmonary and Critical Care Medicine physician at UPMC Central PA. Dr. Ramesh has been involved in clinical research and has published in her areas of interest which include sub-massive pulmonary embolism, severe asthma, sepsis and medical humanities in critical care medicine. She continues to mentor our Internal Medicine residents with their various research projects. She has received educational grants from CHEST/ATS and from SCCM/CDC. She has a special interest and competency in Point of care and Critical care Ultrasonography, and she holds testameur status in advanced critical care echocardiography with the National Board of Echocardiography. She is faculty at national societies such as American Thoracic Society and CHEST where she teaches POCUS, ICU procedures and overall care of critically ill patients. She is the President of the Pennsylvania Chapter of Society of Critical Care Medicine and has recently directed our inaugural fundamental critical care support (FCCS) course. Prior to joining UPMC in Central PA, Dr. Ramesh was the ICU medical director at UPMC Williamsport.
Matthew Zaccheo, DO
Dr. Zaccheo joined the UPMC Pulmonary, Critical Care and Sleep Division in August 2021. Prior to joining, he practiced as a Medical Intensivist at Bronson Methodist Hospital and University of Michigan - West in Southwest Michigan where he acted as the Vice Chair of the Critical Care Medicine service line, Trauma Liaison, Co-director of the ICU Performance Improvement Committee, and Director of the ICU advanced practice provider program. During his tenure, he held faculty appointments as a Clinical Assistant Professor for the Western Michigan University Homer Stryker School of Medicine, Michigan State University College of Human Medicine, and the Michigan State University College of Osteopathic Medicine.
During his time at UPMC, he continues to practice as a Medical Intensivist. He also serves as the Section Chief of Critical Care Medicine and Regional ICU Medical Director of the UPMC Cental Pennsylvania region. He works alongside a group of multidisciplinary trained Intensivists, acute care advanced practice providers, hospital administrators, and providers from medical and surgical service lines to coordinate and operationalize ICU evidence-based best practice across a seven-hospital network encompassing 120 licensed and operational ICU beds. His special interests include percutaneous tracheostomy in the ICU, bedside clinical education, and system practice-performance improvement initiatives.
Akshay Avula, MD
Prior to joining UPMC, Dr. Avula worked as a Pulmonary and Critical Care physician at St. Barnabas Health system in the Bronx, New York. He also held a faculty position as Clinical Assistant Professor at the City College of New York. During his time in New York, he was an academic Internal Medicine Hospitalist for three years prior to fellowship and trained numerous residents and medical students. At UPMC, he has been an active member of the Lung Cancer Screening, Severe Asthma, and Pulmonary Education Committees. His research interests include Critical Care illness in the elderly, Critical Care ultrasonography and Pulmonary Vascular Disorders.
Christopher Franz, MD
Before joining the division, Dr. Franz completed Pulmonary and Critical Care Fellowship at the University of Pittsburgh where he did research in the ICU delirium and inflammatory subphenotyping in ARDS.Since joining UPMC in Central PA, Dr. Franz has been actively engaged in the educational mission of the division and given lectures covering point-of-care lung ultrasound, COPD, and spirometry. Dr. Franz’s academic interests include mechanical ventilation education, critical care ultrasound, and simulation/procedural training.
Kevin J. Misner, MD
Dr. Misner joined the UPMC Central PA Critical Care, Pulmonary and Sleep Division in August 2021. He previously completed his Pulmonary and Critical Care Fellowship at the University of Pittsburgh where he performed research involving rare surfactant protein mutations in patients with familial Idiopathic Pulmonary Fibrosis. He has been involved in the education of medical students and residents for their rotations in the intensive care unit and in both outpatient and inpatient pulmonary rotations, as well as instruction in non-invasive ventilation, CPR, and ICU/Pulmonary procedures. Areas of interest include interstitial lung disease in the ICU, ARDS, and critical care communication.
Anil Nalla, MD
Dr. Anil Kumar Nalla joined the UPMC Critical Care Division in July 2020. He finished his Critical Care Fellowship at Montefiore Medical Center in New York. He is very enthusiastic about educating residents and medical students. In fact, he was associated with the SUNY School of Medicine, New York, NY during residency and played a key role in developing a core curriculum of clinical rotations for medical students and was core faculty of the simulation lab at Montefiore Medical Center in New York during his fellowship. During his stay at UPMC, he helped implement CRRT at the UPMC Memorial Campus. He is also the Site Director of the Critical Care Unit at UPMC Memorial. His areas of interest include CRRT, metabolic disorders in the critically ill, Critical Care Ultrasonography, and ECMO.
Morgan Oskutis, MD
Before joining the division, Dr. Oskutis completed her Emergency Medicine Residency at Cooper University Hospital in Camden, NJ followed by a Critical Care Fellowship at Emory University in Atlanta, GA. Dr. Oskutis' academic interests include care for the critically ill pregnant patient, medical education, and facilitating working relationships between the Emergency Department and the Intensive Care Unit.
The Division of Critical Care places utmost importance on scholarly activity. Fellows are given dedicated research time starting their first year and may initiate research locally at UPMC Central Pa. campuses. Fellows will work closely with our dedicated GME research coordinator, GME statistician as well as IRB staff to gain an in-depth understanding of clinical research.
Fellows have 21 days PTO, 4 educational days each year, and additional time to attend job interviews, required exams and certifications each year. Each fellow will have the opportunity to attend one of the annual conferences with registration and lodging shouldered by the division. Review books and educational materials can be available to fellows upon request and approval by the Program Director.
UPMC in Central Pa. is a participating member of the Electronic Residency Application Service (ERAS) and the National Resident Matching Program (NRMP) and all applicants must register with these programs. Email and fax applications will not be accepted.
H1B and J1 Visas are sponsored. View the Resident/Fellow Visa Policy (PDF)
Applications will be accepted starting July 1, 2025.
Robbie Kribell
Medical Education Program Sr. Dept Manager
Phone: 717-231-8673
kribellrl2@upmc.edu
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