Member Spotlight: Bram Rochwerg MD, MSc(Epi), FRCPC, FCCM
Bram Rochwerg MD, MSc(Epi), FRCPC, FCCM, is an associate professor and physician at McMaster University in Hamilton, Ontario, Canada. He became a member of the Society of Critical Care Medicine (SCCM) in 2014 and is the current chair of the Internal Medicine Section. He is an associate editor at Critical Care Medicine, sits as the journal liaison on the Board of Regents and is co-vice-chair of the Surviving Sepsis Campaign Adult Guidelines. His research interests include pulmonary research and sepsis and he leads international randomized controlled trials examining therapies for each. In his free time, you’ll find him hanging out with family, traveling and watching sports. Learn more about Dr. Rochwerg and his journey in critical care.
Why do you love being in critical care?
I have wanted to be an intensive care unit (ICU) doctor since I was eight years old. My grandfather had bypass surgery, and I remember going into the cardiovascular ICU to visit him and being amazed by all the machines beeping, monitors, and systems that were keeping the patients alive. And to think that the staff knew what all these machines did and how to operate them was amazing. Fast forward 35 years, and I'm still amazed at the machines and healthcare professionals who work in the ICU to optimize outcomes for our critically ill patients.
My favorite experience in critical care is when we bring a critically ill patient from the ward or emergency department down to the ICU. Suddenly, there are a flurry of nurses, respiratory therapists, pharmacists, residents, fellows, and doctors at the bedside wanting to help. This team-based approach to medicine is fantastic and always makes me feel proud of the care we provide to patients in their most vulnerable times.
Finally, being able to be involved with patients and families at critical times such as end of life is an honor and privilege. The impact we can have on people's daily lives is awe-inspiring.
How did you get into critical care?
I actually wasn't sure I had the grades to attain my goal of being a critical care physician, but hard work and commitment helped me achieve this goal. My interest in research came later in life. I had some very positive role models at McMaster University and some good early-career experiences in research that opened my eyes to a combined career incorporating clinical medicine and research. The ability to advance the science and collaborate with colleagues across the globe is daunting but very rewarding.
What is your biggest professional achievement?
I have been fortunate to have had many career successes, such as securing large research grants, publishing influential work as first author, and serving in leadership roles at the national, regional, and hospital levels. That being said, failure is a big part of any academic career and for all the successes listed above, I have had ample unfunded grants, rejected manuscripts, and failed applications.
What advice do you have for those starting their critical care careers?
Prioritize personal connections with colleagues and also with patients and families—this will improve job satisfaction immensely. Find a good mentor or sponsor, someone who truly looks out for you, is thoughtful, and makes time to talk through your career aspirations including working through barriers as they come up. Do your best not to work with people who increase your stress—unfortunately, we all have these people in our lives and it’s not always possible to completely avoid them but try your best. Finally, working in critical care, whether it be research, administration, or clinical work, can be all-encompassing, so make sure to find time for the other parts of life. Family, hobbies, exercise, personal time—whatever it is that makes you happy.
What do you see as the most challenging issue facing critical care?
There are always challenges! Staffing remains an important issue, especially on the heels of the pandemic. Many ICUs across the country and world have a higher proportion of junior staff than they're used to. The cost of healthcare continues to rise and has led to disparities in care across the globe even within high-income countries, which is unfortunate. Finally, COVID-19 brought to light the vulnerabilities of our system to stress, and I'm not sure we passed the test or learned the necessary lessons for the future. With climate change, increasing population burdens, and globalization, it is not a matter of if the next stressor will come, but when. Hopefully our community will be prepared.
What are the top advances in critical care since you started your career?
Less is more! Lower tidal volumes, more liberal glucose control, lower doses of continuous renal replacement therapy, fewer blood transfusions, less fluid for resuscitation—we are constantly learning how to take better care of critically ill patients.
What industry trends excite you about the future?
From research and clinical perspectives, personalized therapy is quickly becoming the wave of the future. Using physiologic parameters and biomarkers to subphenotype classic ICU syndromes (sepsis, delirium, acute respiratory distress syndrome) to identify treatable traits and personalize care will become the most exciting advance in how we care for patients in the coming years.
What do you love about SCCM membership?
I have made fantastic connections with colleagues, many of whom are now close friends. I also appreciate SCCM's commitment to evidence and keeping its members up to date with courses, webcasts, journals, guidelines—culminating with the annual Critical Care Congress. Finally, SCCM provides a venue for mentorship. Whether around education, research, or administration, folks can find leaders to help advance their careers and nurture the next generation of critical care leaders.
Connect with @Bram Rochwerg