ECMO exposure

[CodenameDuchess]

I was just wondering if any of you have any thoughts on the best way to build VV and VA ECMO into my skill set. My program does not run a bunch of cases a year, maybe 20 at most, and I'm not going to be on service for all of them. What is the best way to build this skill so I could sell myself as a viable member of an ECMO team when I grow up? Has anyone added a 4th year specifically for training in this? I feel pretty comfortable with the basics when things are running as they should but need more time with weaning and trouble shooting the pump.

My thought would be after training just cold emailing a bunch of ECMO program directors and asking if they would take me on as a fellow for a year. The only formal program I could find is UPMC which looks like it just started but no other programs are doing this at least from a IM/PCCM trained standpoint.

My other thought would be to go the transplant fellowship route as many of those patient end up on ECMO pre and post op but my interest would mainly be in the mechanical support aspect I don't think the transplant life is for me.

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[Hernandez]

Do you think the attendings at those larger institutions did a fellowship in ecmo?

 

[CodenameDuchess]

Do you think the attendings at those larger institutions did a fellowship in ecmo?

No.

They probably trained in a program where they were exposed to a significant number of cases to feel proficient, or just winged it because the technology is relatively new. What I'm saying is that I'm not sure my exposure will make me feel proficient at the end of 3 years (I'm not sure a lot of programs supply this outside of WashU, UPMC and Columbia). I was looking for input on how to develop proficiency when there are relatively few cases running at my institution.

 

[Hernandez]

Join elso, read the red book and make sure you see every ecmo or in your institution while in fellowship?

 

[sport29883]

One possibility is do an away rotation (of at least one if not more months) in a busy CT-ICU...in our CT-ICU, we see a fair number of ECMO cases. Alternatively, you could spend a year doing a CT-ICU fellowship at one of the busy centers.

 

[yellow]

What are the programs that do a lot of ECMO?

Thanks!!