Hospitalist-->Critical Care Medicine pathway

SDN Members don't see this ad. (About Ads)

With the huge lack of CCM/intensivist taking care of critical ill patients one possible solution is the creation of the pathway for hospitalists who are currently managing ICUs and for those who plan to do hospitalist medicine first..One year of Critical Care Medicine fellowship after 3 years of Hospitalist Medicine. I guess this is one solution that would provide solution to ongoing deficit in intensivist manpower.

What about you? do you think this is good or bad?

Here is the article from the Societies of Hospital Medicine and Critical Care Medicine that support this pathway: http://onlinelibrary.wiley.com/doi/1.../jhm.1942/full

If they're medicine graduates from the medicine program where I'm at, you'd have to make that a 3 year CC program......

Why? Why not fast track them for a 12 month fellowship? Surgeons and anesthesiologists only do 12 months for critical care.

Originally Posted by europeman

Why? Why not fast track them for a 12 month fellowship? Surgeons and anesthesiologists only do 12 months for critical care.

Surgeons and anesthesiologist also have longer training. I was post call and having dealt with lazy sr IM residents who has no buisness graduating much less having the option of doing CC in one year.

Sadly I'm in the camp that believes that IM traing should be increased to 4 years given new work hour restrictions.

But I do know there are some IM programs that produce IM docs who could this tract.

This first posting I had seen about this had suggested mandating a few years of real world work before allowing them to be eligible. But without a doubt, we need more CC docs.

Originally Posted by Hernandez

If they're medicine graduates from the medicine program where I'm at, you'd have to make that a 3 year CC program......

If that 3 year Pulm/CC program includes a year of research and a year of pulm, isolating out just 12 months of clinical ICU may work out to a comparable number of months of managing critically ill patients. Just don't expect to have the same level of knowledge regarding the primary pulmonary processes.

Originally Posted by JacobSilge

If that 3 year Pulm/CC program includes a year of research and a year of pulm, isolating out just 12 months of clinical ICU may work out to a comparable number of months of managing critically ill patients. Just don't expect to have the same level of knowledge regarding the primary pulmonary processes.

Except for call. In 2 years, I've done 8 months CC, and 4 months of call. I have 2 more months of call and 3 more CC months.

Yes some programs are research oriented, but many of those people who go there end up on academic tracts where they only do part time clinical work.

That post was post-call cranky being stuck with lazy incompetent senior residents who I would not give the option of 1 year CC to them. examples were being called to see a pt with a Chem CO2 of 18 for micu eval without residents looking at pt, mismanaging a type 1 dm pt who also had a NSTEMI who's now going into Dka due to their gross mismanagement of insulin, eval of a CAP with PSI score class 2 for micu eval (again without them ever seeing pt) among other gems like that.

And personally, the thought of a full year of CC makes me tired just thinking about it. I do roughly half my year in CC and that's enough, cramming all the necessary CC in a year would be rough. Especially if you have a family.

I'm not opposed to it on paper.....just think the enrollment should be....stringent

So if this does happen will it be available to fm trained physicians who've already completed SHM hospitalist fellowships?

I mean it seems like it should since SHM supports fm being hospitalists...

ACCP does not support this proposal. http://journal.publications.chestnet...icleid=1206594

Originally Posted by RPW

So if this does happen will it be available to fm trained physicians who've already completed SHM hospitalist fellowships?

I mean it seems like it should since SHM supports fm being hospitalists...

Why in the world would a family physician want to be an intensivist?

I think it's great when other non traditional fields do critical care! The more diversity to our field, the better educated our fellows and we become!

ER or ob/gyn critical care practicing docs are great.

That said, a family medicine trained physician just graduated from the Sicu fellowship at Maryland Shock Trauma.

She recognized the lack of post trauma patient primary care and thought her training would give her unique insight into that niche. It's fantastic.

First month or two she had a lot to learn not knowing how to intubated, bronch, do a chest tube, etc..... But those skills aren't that hard and by the time she graduated she was one bad arse intensivist!

Originally Posted by europeman

I think it's great when other non traditional fields do critical care! The more diversity to our field, the better educated our fellows and we become!

ER or ob/gyn critical care practicing docs are great.

That said, a family medicine trained physician just graduated from the Sicu fellowship at Maryland Shock Trauma.

She recognized the lack of post trauma patient primary care and thought her training would give her unique insight into that niche. It's fantastic.

First month or two she had a lot to learn not knowing how to intubated, bronch, do a chest tube, etc..... But those skills aren't that hard and by the time she graduated she was one bad arse intensivist!

Very Interesting. Did she end up taking an academic or private practice job? I assume she is primarily an intensivist but does she do any primary care or just use the FM training as a means to anticipate post ICU departure needs?