Venovenous extracorporeal membrane oxygenation (VV ECMO) candidacy decision-making processes vary within and between centers.^1-3 An underexplored potential contributor to this variability is the care model. Fundamental differences in infrastructure, culture, pace, and clinical frameworks between surgical intensive care units (SICUs) and medical intensive care units (MICUs) may affect decision-making processes.^4,5 A recent international survey of 316 VV ECMO centers worldwide identified international intercenter variability.¹ In this prespecified secondary analysis following A Consensus -Based Checklist for Reporting of Survey Studies (CROSS) guidelines, we investigate whether processes differed meaningfully between centers where VV ECMO patients are managed in SICUs versus MICUs and where candidacy decisions are made exclusively by surgeons versus medical intensivists.