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. Its 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 its faculty and leadership, mindful of the importance of a good work-life balance for the trainee with strong advocacy for equality, diversity and inclusion. It is an exciting new program, beginning July 2023, in close partnership with the world’s first dedicated critical care training program founded in 1961 at the University of Pittsburgh Medical Center.
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 2 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 Neuro ICU, Surgery/Trauma ICU (Trauma Burn ICU) will be conducted at UPMC Mercy in Pittsburgh. Other electives include: Anesthesia, Transplant ICU, Toxicology, Nuts and Bolts of ECMO, Thoracic surgery, Critical Care US/Echo.
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.
UPMC Community Osteopathic: MSICU
UPMC Harrisburg: MSICU, Neuro ICU, CT ICU, Anesthesia, Palliative Care, ID, Cardiology, Echo/Ultrasound
UPMC Mercy: Neurovascular ICU, Surgical/Trauma ICU
UPMC Montefiore: Transplant ICU
UPMC West Shore: MSICU, Bronchoscopy (Pulmonology), Thoracic surgery
Domingo T. Alvear Medical Library
Brady Building, 1st Floor
UPMC Harrisburg Campus
UPMC Community Osteopathic
West Wing, 1st Floor
UPMC Community Osteopathic Campus
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.
Manuela Modelewski, DO
Dr. Manuela Modelewski is an Emergency and Critical Care physician at UPMC Central PA. She joined UPMC Central PA in 2020. Dr. Modelewski has a love for teaching, both at the bedside as well as giving formal lectures. She is a member of the Critical Care Education Committee for the Internal Medicine Residents at UPMC Harrisburg. Her other passions include difficult airway, critical care ultrasonography, and palliative care.
Joanna Paula Sta. Cruz, MD
Dr. Sta. Cruz joined the UPMC Pulmonary, Critical Care and Sleep Division in January 2021. Prior to joining, she was the Program Director for the Albert Einstein Medical Center (AEMC) Pulmonary and Critical Care Fellowship Program in Philadelphia and the Medical Director for the AEMC Critical Care Unit at its Elkins Park Campus. During her tenure, she held faculty appointments as Clinical Assistant Professor for the Sidney Kimmel Medical College at Thomas Jefferson University and Core faculty for the AEMC Internal Medicine Residency Program.
During her stay at UPMC, she helped organize the Pulmonary Embolism Response Team (PERT) in collaboration with Cardiology and is an active member of its committee. She is also a member of the Pulmonary Medicine Education Committee, creating case modules for resident rotators. Her research areas and special interests include critical illness in liver cirrhosis, critical care ultrasonography, and blockchain technology in healthcare.
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.
Paul Modelewski, DO
Dr. Paul Modelewski joined UPMC Central PA in July 2020. He holds a joint position working in Emergency Medicine and Critical Care Medicine. He also assumed the role of Medical Director for VV ECMO at the UPMC Central PA. Professional interests include cardiac critical care and cardiogenic shock, ARDS, and echocardiography.
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.
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 or participate in a broader project with national leaders in research through University of Pittsburgh’s premier research centers: the Safar Center for Resuscitation Research and Clinical Research, Investigation, and Systems Modeling of Acute illness, CRISMA Center. Multidisciplinary Acute Care Clinical Research Organization, MACRO, and The Health Services Research Data Center, HSRDC, are excellent resources that provide supportive research services to investigators.
UPMC in Central PA fosters diversity as a prerequisite to accomplishing our institutional mission and setting standards for excellence in training fellows and providing safe patient-centered care.
Resident & Fellow Salary & Benefits
A Fellow can have 21 days PTO, 4 educational days each year, and four additional days can be given to graduating fellows for interviews. 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.
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