First, congratulations on the match, and upcoming medical school graduation. Kudos for doing ICU towards the end of your fourth year (when you could have done an easy relaxed rotation).
A good PCCM fellow has a strong medicine background so being an overall good IM resident is essential.
Find a pulm-ccm faculty member early as a mentor and work with him/her on either poster presentations, oral presentations, or publications in Chest (ACCP), ATS, or SCCM (they all have sections for medical residents). At least it's a free trip away during residency
. Presenting in SGIM or regional/national ACP is also good. Getting good LOR is also important in the process. Your colleagues interested in cardiology/GI/heme-onc are doing the same and as PCCM gets more competitive every year, the expectations will probably be the same. Being a US graduate at a university IM program will also give you an advantage when it comes to application season.
Don't shy away from procedures ... you don't need to go hunting for them (or do procedures when not indicated) but don't shy away from them. As a fellow, you'll be expected to be able to supervise residents doing procedures (and jump in if there is difficulty/troubleshoot)
Be a good communicator - with attendings, fellow residents, but also with families .... you will talk with families a lot.
But overall, be a good IM resident. You might change your mind and do something else.
