The Art of Teaching in the CICU

In the high-stakes intensity of Yale’s Cardiac Intensive Care Unit (CICU), Elliott Miller, MD, MHS, returns to a single Latin word from his residency training: aequanimitas.

“I try to be calm during the storm,” says Miller, an assistant professor of medicine (cardiovascular medicine).

That calm isn't just for patients—it’s what creates a safe, vibrant space for the dozens of students and trainees who pass through his unit each year. This year, that commitment to education was recognized with the 2025 Fred S. Kantor, MD, Award for Teacher of the Year at Yale New Haven Health System, an honor Miller also received in 2022. In 2024, he won the Francis Gilman Blake Award, designated by the Yale School of Medicine graduating class as the most outstanding teacher of the medical sciences.

In a Q&A, Miller discusses his approach to teaching, what makes the CICU a uniquely rich learning environment, and why he believes there is no better job in medicine.

The CICU is one of the most dynamic teaching spaces in the hospital. We start each morning with an hour of dedicated didactics, followed by several hours of bedside rounds where teaching happens constantly—in real time, in front of patients, with nurses, fellows, interns, and other students all together. The unit itself is compact, which keeps the whole team anchored in the same space, learning from one another. The atmosphere is intense while allowing students to ask questions freely, take risks, and grow. Whether you’re a brand-new clerkship student or an advanced fellow, there’s something to learn every day.

I feed off enthusiasm. If I see that people are engaged, I thrive on that energy. If they’re quiet or hesitant, I turn things up—more energy, more humor, more interaction. I want people to feel like the CICU is a place they belong, where they’re part of a team. I don’t like to single people out; I ask the group questions as a whole and try to create an environment where curiosity is rewarded. You’ll often hear me say there’s no better place in the hospital to be. And I mean it. That sense of joy is something I try to project every day.

When I was training, we were frequently grilled with questions in front of our peers. That worked for me (I actually loved it), but it doesn’t work for everyone. Today’s learners want different things, and sometimes even contradictory things. For example, I’ve created both PowerPoints and chalk talks on core cardiology topics. I’ve learned to read the room and switch gears. I helped develop a CICU curriculum that covers the essentials—cardiogenic shock, arrest, pericardial disease, and more—but I stay flexible. If the group isn’t clicking with slides, I’ll sketch something out on the whiteboard. I still believe the best teaching happens at the bedside, with the patient, all of us learning together.

I don’t try to convince anyone or paint the job as easier than it is. I just try to show them what a day feels like, what kind of patients we see, and what kind of impact we can have. And if students find themselves loving it, then it’s worth it. The training is long, yes, but if you wake up excited to come in, like I do, it doesn’t feel like a sacrifice. To me, it’s the best job there is.

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