APP Adult Critical Care Fellowship Program | MCW Advanced Practice Providers

The APP Adult Critical Care Fellowship is an innovative 12-month training program that teaches APP fellows to become highly skilled in the multidisciplinary, collaborative, and evidence-based management of complex and critically-ill patients in intensive care units. It attracts NPs and PAs seeking a structured educational program to support and guide their development of proficient clinical decision making and their application of specialized skills in the care of the critically ill.

Who should consider an APP critical care fellowship?

APPs with interest in advancing their clinical skills to assess, diagnose, and treat complex, critically ill patients.

APPs interested in transitioning to practice in a mentored environment to build a professional network and clarify through experience a best fit for clinical practice and starting their career.

What are the benefits of an APP critical care fellowship?

Hands-on learning and time to develop competency and confidence needed to thrive in an intense, diverse and complex environment.

Structured experiences targeted to new graduates or APPs transitioning to a new practice area.

Mentored learning in clinical rotations across six (6) ICUs and in specialty rotations.

Provides the opportunity to develop a wide range of clinical and critical thinking skills and professional development with application across diverse clinical specialties.

Apply to the APP Adult Critical Care Fellowship Program

Fall and Spring start dates are available; up to 4 fellows are selected annually, split between cohorts.

Learn more about application details, including information about interviews, salary, and benefits.

Apply now

A Day in the Life of an APP Adult Critical Care Fellow

Clinical Rotations

Acute Care and Mini-Rotations
Fellows can expect a traditional 8 a.m. - 5 p.m., Monday-Friday schedule during these rotations. These rotations serve to enhance the fellow experience through exposure to consultative and procedure-based services, team structures and workflows, and specialty knowledge acquisition.

ICU Rotations
Each day, APP Fellows work in conjunction with an APP preceptor to care for a panel of 3-6 critically ill patients. APP Fellows are integrated into the academic, multi-professional critical care team. Fellows can expect to work 13-hour shifts with variable start times by rotation, work both day and night shift and some weekends.

ICU Day Shift

0630: Arrive in the ICU team room, confirm patient assignments and receive hand off from the night provider.
0700-0800: Pre-rounding. Review data, assess your patients, and discuss any updates with the bedside nurse. Prepare for rounds, formulate a plan of care for the day, and discuss questions with APP preceptor.
0800-1100: Academic critical care team rounds. Active participation in academic patient care teaching rounds for all patients on the critical care service. APP Fellows are expected to orally present patients to the multidisciplinary team and collaborate with the critical care team to facilitate workflows and patient management. Patient-based, hands-on bedside teaching by the critical care team.
1100-1900: Critical Care Management. APP Fellows provide ongoing assessment and management of their patient panel, including writing critical care notes, completing procedures, following up on changes in patient condition and updating patients and their families. APP Fellows work within the team to transfer, discharge and admit patients throughout the day. APP Fellows attend service-based education as appropriate. At the end of shift, APP Fellow provides hand off to the night provider.

ICU Night Shift
APP Fellows work in conjunction with APP preceptor to care for and manage 8-12 critically ill patients. Night workflows include providing active management of patients including rounding and cross-coverage needs, admitting new patients, and performing necessary procedures. Night shift provides unique opportunities for hands-on management, individualized teaching, and close collaboration with critical care APPs and intensivists.

Didactic Education

Education/Program Days
Scheduled 2-3 times per month, full (8 a.m. - 4 p.m.) or half days on campus with all program fellows dedicated to didactic education, program meetings and fellowship connection. Schedule varies by day, but may include expert lead chalk talks, simulations and skills labs, case-based learning, peer lead curriculum including fellowship scholarly journal club, case presentations and point of care ultrasound and professional and leadership development curriculum. Additionally, program meetings including program touch bases, quarterly reviews and mentorship meetings may be scheduled. Finally, fellows have time to complete asynchronous education and work on their fellowship projects.

How We Learn

The APP Adult Critical Care Fellowship Program focuses on hands-on, clinical experiences across all six (6) ICUs in addition to key acute care specialties as the foundation for critical care practice. In addition to clinical rotations providing patient experiences across each specialty ICU, the core critical care curriculum provides continuity and skill development focusing on 15 aspects of essential critical care skills throughout the 12-month program.

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Didactic Education

The program integrates additional multi-faceted didactic opportunities to enhance the clinical learning experience including:

In-person lectures
Skills lab
Case presentations
Online didactics and learning modules
Dedicated self-reflection
Peer-led curriculum
Scenario-based learning
Specialty focused didactics including lectures, M&M, and journal clubs

Core Critical Care Curriculum

Hemodynamics
Respiratory failure
Sedation and analgesia
Altered mentation and delirium
Renal failure
Metabolic and electrolyte abnormalities
Glycemic management during critical illness
Acid/base disorders
Sepsis and infections
Hemorrhage and coagulopathy
End-of-life
Assessment and management of critically-ill patients
Critical care nutrition
Critical care quality
APP critical care practice and team-based care

Certification Courses

Society of Critical Care Medicine Fundamental Critical Care Support Course
BCLS
ACLS
ATLS (as available)

Procedural and Skills Opportunities

Skills labs
- Suturing
- Central line insertion
- Lumbar puncture
Mechanical ventilation management
Basic and Advanced EKG
Ultrasound
- Online didactic
- Clinical experience
Hands on clinical experience in all rotations in addition to the procedural rotation

Critical Care Rotations

Fellowship Onboarding
Introduction to the APP Critical Care Fellowship program and participation in provider onboarding to prepare APP fellows for clinical experience including fellowship onboarding, organizational overview, EMR and technology training, introductory education for critical care, and foundational professional skills.

Community Medical/Surgical ICU
The Froedtert Menomonee Falls ICU rotation offers fellows a unique opportunity to practice their critical care skills in a busy community setting. Through this rotation APP fellows gain exposure to APP practice and role in diverse settings, which is helpful when considering their career after the fellowship.

Critical Care Anesthesia CCA – Cardiovascular ICU
The CCA team functions as a co-management critical care team in collaboration with the Cardiothoracic Surgery and Cardiology teams, caring for patients in a 20-bed cardiovascular ICU. The CCA team provides whole-patient critical care assessment and management including: CT surgery post-operative, Cardiac arrest, Shock, Mechanical Circulatory Support, Advanced Heart Failure, Cardiac Transplant, and other surgical patient overflow such as Thoracic and Vascular. Unique experience on this service include the extensive mechanical circulatory support patient population: Veno Venous & Veno Arterial ECMO, LVAD, RVAD and BiVAD.

Critical Care Intensive
APP Fellows experience an intensive rotation at the end of the 12-month program including 50-60 clinical hours practicing on a critical care service integrated as an APP on the service. The goal is to have at least half night/weekend hours, and promote an experience to continue the professional development journey/transition to a clinical practicing APP. APPs will have another APP or attending as a resource/collaborator.

Critical Care Medicine
The MICU team is a large integrated academic team of residents, fellows, APPs and medical students providing care as a primary management team for all patients admitted to critical care with a non-surgical diagnosis. The MICU team averages >3000 admission per year and cares for populations including: Sepsis and septic shock, diabetic ketoacidosis, GI bleed, acute respiratory distress syndrome, COPD exacerbation, cardiac arrest and pulmonary embolism.

Critical Care Neurology
The Neuro Critical Care team is a multidisciplinary team of fellows, APPs, and residents providing complete medical care to those with devastating neurological conditions. Patient population includes: traumatic brain injury, ischemic stroke, hemorrhagic stroke, neurovascular injury such as ruptured cerebral aneurysm and AVM, status epilepticus, spinal cord injury, and CNS infection. The team also provides post-operative care for the neuro intervention and neurosurgery population.

Critical Care Surgery and Trauma
The critical care surgery team is an integrated multidisciplinary, academic team including residents, fellows, APPs and medical students primarily located in a 21 bed SICU. The team provides critical care management for trauma, acute care surgery, orthopaedics, ENT, surgical oncology, vascular surgery, thoracic surgery, and obstetrics patients. Froedtert hospital is the only level 1 trauma center in southeastern Wisconsin.

Fellowship Elective
Opportunity to select and rotate in a critical care, specialty, inpatient service, emergency medicine, or other qualifying experience with program director approval.

Infectious Diseases
The Infectious Disease team is a multi-professional consulting service that provides experience across medical, surgical, and transplant patient populations. The experience provides opportunities to recognize and manage common infectious disease problems encountered in the quaternary, academic clinical practice, and provides experience on how to approach to the conditions as an infectious disease specialist.

Interventional Radiology
The Interventional Radiology program at MCW is a robust service that provides non-surgical treatments for vascular and non-vascular disease in both the inpatient and outpatient setting. Procedures are performed for a broad range of conditions spanning gastrointestinal/hepatobiliary, gynecology, infectious disease, oncology, pain management, urology and venous and arterial disease. The procedures are performed using US, fluoroscopy, CT and MRI imaging. The Intervention Radiology rotation offers the APP fellow a chance to gain additional hands on procedural experience including venous access placement, paracentesis, thoracentesis, lumbar punctures and bone marrow biopsies and gain first hand exposure to advanced radiologic procedures commonly performed for critical care patients.

Mini-Rotations

Airway Rotation
A 1-week immersive rotation with anesthesia providers in the OR environment focused on advance airway management skills including use of oral airways, BVM and intubation. This rotation is preceded by a dedicated airway curriculum.

Critical Care Nutrition
Experience in-depth education and clinical experience with clinical dieticians in the critical care environment enhancing knowledge of critical care nutrition and promoting team-based patient care.

Diabetes Management
A 1-week rotation on the multi-professional Diabetes Management Team providing APP fellows an immersed experience learning best practices for ICU glycemic control across critically-ill patient populations.

Procedure Rotation
A 1-week rotation on the multi-professional internal medicine team providing APP fellows with the opportunity to perform frequent procedures in the inpatient and ICU patient populations.

Palliative Care
The Palliative Care team provides consultative management of patients with serious illness. The palliative care team provides whole-patient assessment and management including: advanced care planning, end of life, symptom management and hospice counseling. A unique immersion opportunity on the multi-disciplinary team to provide consultative service that provides experience across all specialties. During this experience, fellows will gain knowledge of multi-faceted approaches to patient and family communication. In addition, collaboration with the multi-disciplinary team will increase knowledge and understanding of resources available to support patients, families and providers.

Transplant Surgery
The Transplant Surgery team provides critical care for a unique set of patients in organ failure at various stages of the transplant process. The team integrates the entire multi-professional transplant surgery, medicine, and interdisciplinary teams. Patient populations include: abdominal solid organ transplants in pre-transplant with evaluation and listing, perioperative transplant care and complications post-transplant both acute and long term.

Case Presentations

All critical care fellows present at least three (3) case presentations and lead an academic discussion to enhance learning and professional development within the fellowship team.

Topics include diverse clinical patient experiences drawn from all rotations including acute biliary pancreatitis, DRESS, end-of-life management, molar pregnancies, clinical assessment of fluid balance, rejection after liver transplant, infective endocarditis, right ventricular failure, mucormycosis, graft versus host disease and many more.

Highlighted Fellow Presentations

Critical Care Bronchoscopy
Nicholas Caruso-Schaefer, PA-C

Interpretation of Diagnostic Imaging: An educational curriculum to better assist new Advanced Practice Providers (APP) in the diagnosis of life-threatening emergencies
Sarah Power, APNP and Liz Amato, PA-C

Implementing an Airway Management Curriculum in the APP Critical Care Fellowship
Averee Zent APNP and Jay Hume PA-C

Integration of Self-reflective Journaling into the APP Fellowship Program
Elizabeth Siegel, PA-C

Facilitating APP Fellowship Rotation Hand-offs
Sarah Tybring, MSN, AGACNP-BC, APNP

Optimization of Critical Care Patient and Family Communication
Justine Emerson, PA-C & Elise Rippelmeyer, MSN, ACACNP-BC, APNP

Pilot of MD/APP Team Patient Cards in the TICU
APP Critical Care Fellowship Patient & Family Communication Curriculum Development

Family Experience in the ICU – Qualitative assessment of family survey responses
Laura Mark, MPAS, PA-C, MPH

Development of an APP Preceptor/Learner Training Program for APP Fellowships
Joy Ikeri, DNP, AGACNP-BC, APNP

Optimization of the External APP Fellowship Website – Driving Change from the Viewpoint of the Applicant
Ravi Dholakia, PA-C

Critical Care Resource and Topic Guide for New Fellows
Sarah Wasz, PA-C and Brittany Lyda, PA-C

Point of Care Ultrasound in the ICU: Didactic and Hands on Curriculum for the APP Critical Care Fellow
Madison Leahy, PA-C and Paula Winiarski, APNP

Operationalizing CBME at MCW
Daniel Handler, APNP

Growing Evidence Based Medicine Skills
Lane Ringer, PA-C

Identifying Peer Engagement and Social Connection Needs for APPs in MCW APP Fellowship Programs
Alison Moody, APNP and Elena Lages, APNP

Growing Evidence Based Medicine Skills Continued: Journal Club in Action
Harry Gray, PA-C and Meaghan Reed, PA-C

Conflicted on Conflict: Recognition, Prevention and Management of Conflict between Clinicians and Surrogate Decision-Makers
Yekaterina Bezpalaya, APNP

Featured Voices

"I decided to pursue an APP Fellowship to gain additional critical care experience, explore new areas of critical care and to ease my transition into practice as a new graduate. In addition, I was seeking procedural experience and wanted to learn and grow as a provider in a supportive environment. I thought MCW would be a great place for me to start out my career as a critical care APP because it is an academic medical center & quaternary care facility with five specialty ICUs and level 1 trauma designation. I also went to school at Marquette and was hoping to stay in the Milwaukee area after graduation."

Keighla Slattery, MSN, APNP, ACNPC-AG, CCRN

"I wanted to gain confidence and critical care skills in an intensive, supportive environment where I would be exposed to diverse patient populations and practice styles. I was drawn to Froedtert Hospital which, as a level one trauma center with five intensive care units, serves some of the most complex patients in and around Wisconsin. It is also a very APP-focused institution. The APP fellowship was instrumental in shaping my practice; it gave me confidence as a critical care provider, experience with varied patient populations, and skills for working on complex, multidisciplinary teams."

Laura Mark, PA-C, MPH

Meet Our Program Team

Education for the APP Adult Critical Care Fellowship program is supported by an APP, MD, and education coordinator leadership team in addition to APP and MD specialists and educators from all critical care specialties and key acute care rotations. Current and past APP fellows enhance the fellowship team through their commitment to learning and engagement.