Icu Elective - Good Places?

[Thunderbirds]

Hello, 

 

Any recommendations for ICU elective (preferably Ontario) outside of BC. 

 

Thanks. 

[W0lfgang]

Any academic institution except U of T.  

[Arztin]

Any academic institution except U of T.  

what about TO?

[A-Stark]

St Mike's

[Tacrolimus]

Debating ICU elective at McMaster and Respirology at Toronto, or vice-versa. Any thoughts? Looking for a good mix of teaching and (some) procedural opportunities. I feel decently comfortable with airway (BVM, LMAs, ETTs, mechanical ventilation) and peripheral IVs at this point, so some next level stuff (central or art lines) would be cool. However, I do understand that residents will get first dibs on those. 

[psychiatry2017]

1 hour ago, Tacrolimus said:

Debating ICU elective at McMaster and Respirology at Toronto, or vice-versa. Any thoughts? Looking for a good mix of teaching and (some) procedural opportunities. I feel decently comfortable with airway (BVM, LMAs, ETTs, mechanical ventilation) and peripheral IVs at this point, so some next level stuff (central or art lines) would be cool. However, I do understand that residents will get first dibs on those. 

I think that as a medical student, you tend to do more in resp than in ICU. When patients' lives are at stake, as a med student with R1-R3 and ICU fellows, you tend to do less procedures and often just write the notes.

In Resp, you tend to do more for bread and butter, asthma, COPD, etc. The team will appreciate a diligent med student who is happy to do the bread & butter consults.

However, it is up to you, if you like ICU more, go for ICU!

[ameltingbanana]

Did ICU elective at Mac (HGH ICU) during clerkship. Was on a team with another medical student, 2 R1s, one R2, one ICU fellow and the attending - pretty hard to get procedural experience. Did get to do some ABGs and assist with some central lines/art lines, but yeah as mentioned before the R1s got priority for learning procedures.

[medaholic]

On 8/1/2017 at 10:45 PM, ameltingbanana said:

Did ICU elective at Mac (HGH ICU) during clerkship. Was on a team with another medical student, 2 R1s, one R2, one ICU fellow and the attending - pretty hard to get procedural experience. Did get to do some ABGs and assist with some central lines/art lines, but yeah as mentioned before the R1s got priority for learning procedures.

All comes down to timing, I did the same elective at the Hamilton General. In two weeks I got to do tons of central lines (IJs, subclavian, femoral), art lines, and an intubation. I happened to do it when there was the principles of surgery exam coming up, so all the residents took time off. It was just the attending, fellow and me, so they were happy to have me around. Granted I showed up early for work, stayed late, volunteered see more patients/consults and was prepared for when the opportunity arose. Staff are happy to have you learn procedures if you can help out and make their lives easier, so they have time to supervise you.

[ameltingbanana]

Agreed, but the caveat there is that all the surgical residents were taking time off. Even if you're a star student and performing well on the elective, the residents will generally take priority for most procedures in a teaching centre, especially the lines. Even more so if you have a bunch of general surgery residents around with an interest in critical care/SICU. I'd say if you're going on an ICU elective in a major teaching center, you shouldn't expect to do a ton of procedures necessarily depending on the setting/number of learners around. If you want that experience I'd suggest a community ICU that takes learners (e.g. Waterloo).

I'm on CTU now as an R1, and it's the same thing but from the other side - our medical students (both core rotation and elective) are excellent, but us residents get priority for most procedures - paracentesis, thoracentesis, ABGs, joint aspirations, even an LP, etc.