Anesthesia-CCM fellowships with closed, mixed ICUs?

[posthumousmyrtle]

Hi everyone,

I'm a Canadian Anesthesia resident interested in doing Anes-CCM training in the US and hoping for some advice.

At most Canadian centers, ICUs still run in a closed unit, mixed-ICU model (with trauma/micu/sicu etc patients all in the same ICU) with most academic centers having specialized CSICUs (run mainly by cardiac anes without formal ICU training). As many of you know, our CCM training is standardized across all base specialities and we all do the same 2 year fellowship afterwards. The current expectation for most jobs at this point in Canada is still for coverage of the full spectrum of ICU pathology (exception of CSICU). Since my ultimate goal is to return to Canada, I am wondering if anyone knows of good fellowship programs that may have a similar model?

Many Anes-CCM programs ive looked into are CSICU/SICU focused and so I'm specifically interested in hearing about programs mainly dedicated to mixed-ICUs and hopefully also closed units. If anyone has any insight on this that would be extremely appreciated.

Most anes-icu staff in Canada also do a 3rd fellowship year in cardiac anes in order to get an academic job, but as the job market is increasingly more saturated I am wondering if anyone has suggestions on niche areas within anesthesia that I could pursue on top of CCM to enhance my skillset/secure employment.

If anyone has any experience asking to prolong their training to 2 years, that would be helpful as well.

Thank you all so much for your help!

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[CCM-MD]

Why do you want to do your fellowship in the US? As you noted, Canadian CCM fellowships are 2 years vs 1 year anesthesia CCM fellowships in the US: have you looked into how you are going to become eligible to take the RCPSC exam? Are you a dual US/Can citizen or will you need a visa? Have you looked at the requirements for a J1 or H1b visa?

Why not do your training in Canada? There are many great training programs there. If your goal is to work in Canada, do your training in Canada. I say this as a Canadian citizen that trained in the US and now works in the US as an intensivist. I took the RC exam and becoming eligible to take it was a pain. I don’t know what your reasons are for coming here but unless it’s a really good one, you’re better off staying there.

 

[posthumousmyrtle]

Thanks for responding CCM-MD!

My main reasons are 1) clinical training - I believe we have strong training programs here but I am interested in exploring different styles/cultures of practice and I imagine the top American institutions would be light years ahead in certain niche fields within ICU and would like to gain exposure to this and 2) potentially to stand out when it comes to getting a job in Canada. I haven't exactly looked into everything else like RCPSC but I've completed all three steps of my USMLE and hope that it'd open up more options for visas. Thanks for your input, it sounds like training in the states may be an uphill battle.