The CA -2 Critical Care Rotation expands on the CA -1 year with a deeper exposure to critical care consultation. The CA -2 year goals focus on:
• critical evaluation of clinical data necessary to formulate a diagnostic and therapeutic plan
• formalize the plan with necessary communication with the ICU and surgical teams to effect management of critical care
• gain further experience in more complex critical care procedures with multiple organ system physiologically unstable patients and higher risk concerns

The Resident will demonstrate further advancement in the competency skills described for the CA -1 rotation.
1. Patient Care
• In the CA -2 year the resident is expected to undertake critical care presentation in greater detail emphasizing the accuracy of data inconsistencies and/or gaps in the data requiring further fact finding and diagnosis
• gain further experience in organ dysfunction and competing therapeutic goals of multi organ resuscitation
• gain experience in dynamically changing critical care management due to new medical and surgical complications of both underlying pathology iatrogenically induced physiologic changes
2. Medical Knowledge
The The CA- 2 resident shall demonstrate further knowledge of:
• respiratory failure
• ARDS
• advanced ventilatory modes
• complex shock management with cardiac, hypovolenic and septic components and relevance of adrenal function evaluation and treatment
• the importance of tight glucose control to critical care outcomes
• management of renal failure and the RIFLE standardized nomenclature
• controversies in fluid, colloid and blood product usage in the major trauma/shock patient
3. Practice-based Learning Improvement
The resident will demonstrate ongoing proficiency with the goals defined for the CA -1 Year.
• The CA -2 resident is expected to gain further proficiency of the limitation and applicability of published studies and clinical trials to individual patient care
4. Interpersonal and Communication Skills
Residents shall demonstrate interpersonal and communication skills that result in effective information exchanged with patients, families and the ICU care teams and specialty consultants involved in the care of critically ill patients.
5. Professionalism
Residents will demonstrate the ability to:
• maintain sensitivity and responsiveness to patients’ culture and religion and care for all patients in a nonjudgmental fashion
• demonstrate a commitment to ethical practices, including patient confidentiality, informed consent, and equal treatment of all patients
• respond in a timely manner to requests by surgeons and nurses of the ICU
6. Systems-based Practice
Residents are expected to:
• present and integrate their presentations and clinical notes to reflect critical care confluence with the surgical diagnostic and management plan
• understand how to maximize critical care therapeutic end points in a system based approach and define when systems based information of end points requires change
• understand how to individually modify drug protocols to individual patient needs

RESIDENT ASSESSMENT
The final evaluation of the CA -2 resident is performed by Dr. Rie, director of the trauma anesthesia and surgical critical care consultation service with input from trauma surgical attendings who have worked with the resident.
Additionally, an individual oral interview with the resident will afford the resident a chance to undertake a “cold case” oral evaluation to evaluate the residents progress with the above described competencies.