Respirology and ICU

[BK47]

Just wondering, I've heard anecdotally in the past that some people have been able to combine a Respirology and ICU fellowship into a training program that lasts 3 years (instead of 4, 2 for each) because of the considerable overlap between the two.

 

Does this still happen? Is this something that programs are moving away from?

 

I'd appreciate if anyone could shed some light on this

[ploughboy]

Just wondering, I've heard anecdotally in the past that some people have been able to combine a Respirology and ICU fellowship into a training program that lasts 3 years (instead of 4, 2 for each) because of the considerable overlap between the two.

 

Does this still happen? Is this something that programs are moving away from?

 

I'd appreciate if anyone could shed some light on this

 

 

I know people who did this 10-15 years ago, but I don't think it's possible to do anymore. I think it stopped being possible around about the time that formal exams were instituted for ICU as a subspecialty. Maybe cheech10 will see this and comment further.

[burrb]

I'm not sure about Canada, but in the States, most people who enter either respirology or critical care from internal medicine do the combined respirology/critical care 3 year fellowship. You can do respirology only or critical care only (both 2 year fellowships), but it's not the norm.

[Pool Rat]

It is no longer possible to do a combined respirology ICU fellowship in Canada. You must do each one separately. It is still possible to do the 3 year combined fellowship in the US, but to practice in Canada, you would still need to sit both your Canadian exams (I don't know about the eligibility requirements for those exams and whether or not the combined program in the US meets them)

 

Here's a link to Queen's Resp fellowship site, stating that the Royal College no longer allows the combined fellowship in Canada (in case if you want a more official source that random people on a web form)

 

http://deptmed.queensu.ca/divisions/respirology/training_program/combined_respirology_critical_care_training

[A-Stark]

It's true that you can't enter a combined program anymore (a stupid decision if there ever was one, not that these Royal College types are immune from that at all), but all that means is that you have to apply separately from your "base" speciality of Resp/IM.

 

It will be interesting to see "competency-based" training affects decisions like this - it is a lot more difficult to discourage combined training when it pertains to demonstration of specific competencies without a specific time frame.

[medaholic]

There used to be combined programs, there aren't any more, and I think it's more of a result of ICU maturing as a specialty. Secondly, with the job market so pressed for critical care docs, having combined resp/ICU doctors becomes a bit redundant. Most people who were grandfathered in practice either resp or ICU, very few people are able to practice both, at least in larger ICU centres.

[Alastriss]

So I've heard the opposite here, than in fact it may be possible if you can get the two programs t help you out. The reasoning being that there is a considerable amount of elective time in ICU that can be out towards resp but you are still expected to write both board if you want to practice each specialty. Can someone reconcile this for me?

[cheech10]

Currently a combined program is unlikely. Although there is considerable overlap in the subject matter and adequate elective time, the Royal College has lately been taking a dim view of combined programs in general. You would need both program directors onside, and they would need to be prepared to make a strong case on your behalf to the Royal College, and even then the Royal College may not allow it and prevent you from writing one of the exams.

[Alastriss]

Currently a combined program is unlikely. Although there is considerable overlap in the subject matter and adequate elective time, the Royal College has lately been taking a dim view of combined programs in general. You would need both program directors onside, and they would need to be prepared to make a strong case on your behalf to the Royal College, and even then the Royal College may not allow it and prevent you from writing one of the exams.

 

Thanks for clarifying this. This was what my thinking was but in speaking to a few residents here I heard that there was a possibility and it actually got my hopes up.

 

out of curiousity, how does the college view those who did the combined 3 year program in the states (which I believe still exists), and moved back to canada?

[cheech10]

No idea. From here, looks like they do an individual assessment of training.

 

Just to clarify, you can still do sequential training programs, but counting elective time from one training program as time in another program seems to be the big sticking point. Funding for multiple training programs is another sticking point.