Just approved - CC pathway for EM grads

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The American Board of Medical Specialties board of directors voted and approved (the final step) the conjoint training AND CERTIFICATION pathway for EM residents who complete an ABIM approved 2 yr CC fellowship.

http://www.acepnews.com/news/practic...html?tx_ttnews[tt_news]=719

This is a huge step!!

Cheers,
KG

Originally Posted by KGUNNER1

The American Board of Medical Specialties board of directors voted and approved (the final step) the conjoint training AND CERTIFICATION pathway for EM residents who complete an ABIM approved 2 yr CC fellowship.

http://www.acepnews.com/news/practic...html?tx_ttnews[tt_news]=719

This is a huge step!!

Cheers,
KG

Hells Yeah!

KGUNNER's link did not work for me, so I'll post this:

http://www.acepnews.com/index.php?id=514&tx_ttnews[tt_news]=719&cHash=81481b796dc07c2cfbfe1f416c7ebb7d

Hells Yeah!

HH

http://sccmwww.sccm.org/publications..._eNews.htm#sn1

It's exciting news. I never thought I would be considering maxing out my elective time with IM floor months, but such is life. It will be interesting to see how this develops, since it seems like a lot of EPs have done surgical critical care fellowships in the past. Hopefully as critical care develops into a more independent and interdisciplinary field, things like this won't matter as much.

I was at the ACEP CCM section meeting when this was announced. FYI, there is no grandfather clause to allow all those grads that did 1 year surgical CC fellowships at Pitt and Shock/Trauma to become certified. Manny Rivers, who was at the meeting, was less than thrilled, as were a lot of the other old-timers.

This also excludes anyone who wants to do a SCC fellowship. It's medicine only, and for most straight EM grads, they will have to do an extra 2-3 months of fellowship to fulfill all the IM requirements.

It's a huge step forward, and our foot is "in the door", so to speak, but it's also a bit disappointing on many levels. EM grads are handled a bit like (and please excuse my admitted exaggeration) second-class citizens.

I don't think it will be long before surgery is in the "game" in some way. The writing is on the wall and there is getting to be too many voices of reason.

As the old dinosaurs fade out, the new leaders will build bridges rather than walls.

It is a big first step, but not the last. At least we're now recognized, before we were just completely ignored. Remember how long it took EM to become the specialty we know it to be now.

As far as the "extra" months....not exactly so. Just like a basic IM-CC fellowship, there is a core curriculum and rotation schedule and there are electives. The core clinical requirements will still be 12 months of critical care, plus whatever you need to fulfill the 6 months of IM. So that will cut into your electives in the second year of your fellowship. You still will only need 2 years.

KG

Is there any notion as to what will happen with the current EM-based CC fellowships, like at Indy or UAB? Will they disappear or will they be eligible for board certification as well (even after the 5 year grandfather period)?

So just a question.....

Why did EM want to align itself with Medicine for CCM certification. It seems, at least to me, that EM docs would fit more nicely into Anesthesia CCM fellowships. Why not try to achieve certification through ABA?

At our fellowship, we certainly would look at EM docs for training.

Is this the historical trend..alignment with the fleas ?

I think Anesthesiology and Surgery both said, "No!" to EM. Although I am really not sure as to what lead to that decision. SCCM (barring trauma) and ACCM do not seem to fill up their fellowship spots anyway.

Originally Posted by G-Man82

I think Anesthesiology and Surgery both said, "No!" to EM. Although I am really not sure as to what lead to that decision. SCCM (barring trauma) and ACCM do not seem to fill up their fellowship spots anyway.

They are both 1 year fellowships as opposed to 2 for IM CC, right? Maybe they thought that EM grads wouldn't be as well-prepared for fellowship as their own grads and would need that a second year (in spite of the evidence from EM grads who have gone through surgery and anesthesia programs in the past, of course).

That's purely speculation on my part, though.

Originally Posted by K31

They are both 1 year fellowships as opposed to 2 for IM CC, right? Maybe they thought that EM grads wouldn't be as well-prepared for fellowship as their own grads and would need that a second year (in spite of the evidence from EM grads who have gone through surgery and anesthesia programs in the past, of course).

That's purely speculation on my part, though.

Some of the surgical fellowships have an optional second year.

I wouldn't look at the timeline as a matter of EM grads being prepared for fellowship as much as that the emerging specialty of critical care medicine generally requires at least five years of training (4+1 for anesthesia, 3+2 for IM, and typically 5+1 for surgery) and so it would not be reasonable for EM to say that we only need four total.

Originally Posted by ProwlerturnGas

So just a question.....

Why did EM want to align itself with Medicine for CCM certification. It seems, at least to me, that EM docs would fit more nicely into Anesthesia CCM fellowships. Why not try to achieve certification through ABA?

At our fellowship, we certainly would look at EM docs for training.

Is this the historical trend..alignment with the fleas ?

What makes you think they'd fit better with gas fellowships? Other than airway experience, I don't really see the "better" fit. EM is much more general medical in scope based upon what they mostly see walk in the door and do much more medical type of management in the ED then the sort of intra-op/post-op stuff that anesthesia sees mostly.

I'm just glad somebody manned up and allowed these guys coming out of EM who want to do critical care a pathway to board certification.

Originally Posted by jdh71

What makes you think they'd fit better with gas fellowships?

attention span? I kid I kid......

Originally Posted by jdh71

What makes you think they'd fit better with gas fellowships? Other than airway experience, I don't really see the "better" fit. EM is much more general medical in scope based upon what they mostly see walk in the door and do much more medical type of management in the ED then the sort of intra-op/post-op stuff that anesthesia sees mostly.

I'm just glad somebody manned up and allowed these guys coming out of EM who want to do critical care a pathway to board certification.

Soon we gonna see the pmr guys doing ccm...
Your are clueless regarding anesthesia and ccm connection.
Just read some more and after that type.
2win

Originally Posted by 2win

Soon we gonna see the pmr guys doing ccm...
Your are clueless regarding anesthesia and ccm connection.
Just read some more and after that type.
2win

I don't think PM&R physicians see critically ill patients on a daily basis, nor do they have many ICU months in residency, unlike EM. It doesn't seem like a very useful comparison.

Also, I don't think anyone was disparaging anesthesia, and I'm sure most regular posters in this forum are aware of the extensive historical contributions of anesthesiologists to CCM. I think the poster you quoted was simply saying that the training of EM was more similar to IM than to anesthesiology. It's a pretty subjective point but I'd have to agree.

Originally Posted by 2win

Soon we gonna see the pmr guys doing ccm...
Your are clueless regarding anesthesia and ccm connection.
Just read some more and after that type.
2win

lolwut?!
You're funny kid. Do you even know what your knees are jerking about? I doubt it. Perhaps figure that out and then after that type (and click submit reply)
jdh71

Originally Posted by pseudoknot

I don't think PM&R physicians see critically ill patients on a daily basis, nor do they have many ICU months in residency, unlike EM. It doesn't seem like a very useful comparison.

Also, I don't think anyone was disparaging anesthesia, and I'm sure most regular posters in this forum are aware of the extensive historical contributions of anesthesiologists to CCM. I think the poster you quoted was simply saying that the training of EM was more similar to IM than to anesthesiology. It's a pretty subjective point but I'd have to agree.

Hey look at that! Someone took the time to actually think about what was being said! Amazing.

I've always appreciated that about you pseudoknot. I don't think I've ever seen your knees jerk.

For those of you doing/planning on CC after EM, I know that for other EM fellowships like peds or ultrasound, you are often expected to still work x number of shifts in the ED during your fellowship.

What's the expectation in EM CC fellowships now? I imagine you would be too busy in your ICU rotations to do regular ED shifts?

Also, I know that for the other EM fellowships, you often would have a decent amount of "spare time" during your fellowship to moonlight, offset the pay cut. Is this also possible during the CCU fellowships? I'm guessing you would be too busy, but I wanted to hear from people in the know.

Thanks!

Originally Posted by stretched

For those of you doing/planning on CC after EM, I know that for other EM fellowships like peds or ultrasound, you are often expected to still work x number of shifts in the ED during your fellowship.

What's the expectation in EM CC fellowships now? I imagine you would be too busy in your ICU rotations to do regular ED shifts?

Also, I know that for the other EM fellowships, you often would have a decent amount of "spare time" during your fellowship to moonlight, offset the pay cut. Is this also possible during the CCU fellowships? I'm guessing you would be too busy, but I wanted to hear from people in the know.

Thanks!

Its a good question. I'd like to hear about this as well. I'm sure it varies by program. Our one senior doing a critical care fellowship next year does plan on having a couple of shifts a month to moonlight based on the way the fellowship is structured.