Critical Care

[Satsuma]

Hi everyone,

 

I have a few questions about critical care I was hoping someone might be able to answer:

 

1) How competitive is a critical care fellowship - from either entry route - emerg, internal, anaesthesia (does competitiveness vary from specialty or are the fellowships fair game for all?)

 

2) What are the advantages/disadvantages of going to critical care from emerg vs another specialization? Does it make any difference in the end in tems of jobs etc. given that the emerg entry route is relatively new I believe

 

3) What is the lifestyle like?

 

4) Is it feasible to split your time between critical care and whatever else your specialty is (part-time ICU and part-time emerg or anesthesia)...or do you end up doing just critical care?

 

Thanks

Sats

[Kirsteen]

4) Is it feasible to split your time between critical care and whatever else your specialty is (part-time ICU and part-time emerg or anesthesia)...or do you end up doing just critical care?

Hi there,

 

In fact, there's at least one staff person in Toronto who completed his training in anesthesia then a critical care fellowship and does both at one of the large hospitals.

 

Cheers,

Kirsteen

[Nephets]

Hi Satsuma,

 

1. Critical care is a relatively competitive specialty. I don't have a ranking for you but I know it's near the top. You can get to it from IM, general surgery (trauma), EM, Anaesthesia, and some others (although they are less common). I believe all are equally competitive when applying to critical care. IM is the quickest route as you can apply after 3 years whereas most others require you complete the 5 year residency first.

 

2. As for advantages/disadvantages, I can't really speak to that point. They obviously feel that all are appropriate and give you an adequate base.

 

3. The lifestyle varies depending on where you work (i.e. smaller centre versus teaching hospital) and what you do. Some combine ICU with another specialty and others do teaching or research. At one hospital I worked at, the doctors worked 1 week in 4 (but that 1 week was 24/7).

 

4. It is definitely feasible to split your time with another specialty. This is more often seen in smaller centres and the most common is respirology (especially in the United States). However, as with most things in medicine, you can tailor your career to your interests.

 

Hope that helps,

 

N.

[Satsuma]

Thanks for the replies

Sats

[kosmo14]

Speaking from an Anesthesia point of view, it is very common for anesthesiologists to do ICU. In our program we have had numerous residents go on to do ICU after they completed thier residency. It is quite common for the people who do thier fellowship in Critical Care to split thier time between the ICU and thier primary specialty. In fact the director of our health regions ICU's is an Anesthesiologist with a critical care fellowship. She does do some anesthesia as well. As far as competitiveness goes I am not too sure what it is like for other specialties but certainly it doesn't seem horribly competitve to move to an ICU fellowship from anesthesia. The poeple I know that have done it stated that it is quite easy to secure a fellowship if you are willing to move around (reminiscent of CaRMS). I do believe there are a few programs in Canada that will allow you to combine your final year of your primary speciality with the first year of ICU fellowship allowing you to complete your fellowship in Critical Care 1 year after your primary speciality. As far as Int. Med being the quickest way to ICU fellowship, it is quite uncommon for someone to do a ICU fellowship after only thier 3rd year of Int. Med residency. Typically the int. med people do a fellowship within thier specialty (commonly Resp. but many others or maybe GIM) and then go onto a Critical Care fellowship. To my knowledge you would not be able to practice in internal medicine without at least GIM.