CCM/pulm Vs CCM (anesthesia)

[RussianJoo]

Just wondering what the job market is like? What's the need? Numbers of MICU vs SICU closed units in the nation? What about working in a combined unit m/sicu? Any difference in Salary?

thanks guys, just trying to see at what disadvantage I would be in if I did an ICU fellowship and left the OR forever..

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[emt30119]

Just wondering what the job market is like? What's the need? Numbers of MICU vs SICU closed units in the nation? What about working in a combined unit m/sicu? Any difference in Salary?

thanks guys, just trying to see at what disadvantage I would be in if I did an ICU fellowship and left the OR forever..

I know this doesn't answer your question exactly, but it may be helpful to you or others.

I'm a MS4 planning to do CC (or P/CC) via the IM route. I was recently on my gas rotation and enjoyed it more than I anticipated and considered changing my plans. I spoke to an attending who does 75-25 gas-CC about each route. He encouraged me to stick with IM if my ultimate goal was to do all or majority CC. His reasoning was two fold.

First, if you go the gas route, most places will have you mostly in the OR because that is where you make the most money for them. Now this is also true to some degree in the P/CC field as I understand it, because you make more money for an institution doing pulm/bronchs/sleep studies, so that is where they want you.

Second he finished his fellowship about 1-2 years ago and went on a job search at that time. Although he did not go so far as to say there were no jobs for gas-cc, he did say that the marketplace was much more interested in IM-CC docs. He ended up staying at his home institution.

Keep in mind that I am just an M4 talking to one recent gas-cc fellow graduate, but that was my experience and I hope it helps.

 

[RussianJoo]

thanks for the reply.

 

[G-Man82]

As far as I know, the jobs for CCM as Anesthesiologists are pretty much in Academic centers. At my hospital, which is a major trauma hospital, the SICU is a trauma surgeon unit with some sick gen surg critically ill patients too. The Anesthesiology attendings are involved in CTICU and NSICU, which they share with the Pulmonologists. There's one private hospital that I know of in NJ where I grew up that has an Anesthesiologist directing the combined Med-Surg ICU (interestingly, Anesthesiology and CCM is a division of Medicine there). I think another, St. Barnabas maybe, has Anesthesiologists in the CTICU. So the jobs are out there. Who knows how this will change in the near future.

There are a couple CCM guys on our anesthesiology boards also who have said that the jobs exist. The problem is that in the private world, we make more money for the hospitals to keep their ORs full churning out the operative cases. It's tragic that the intense labor that goes into resuscitating a critically ill patient on day 5 in the unit is "less important" than a routine lap chole that takes 1 1/2 hours.

 

[RussianJoo]

you're talking about UMDNJ Newark? I am very familiar with St. Barn, unfortunately I haven't rotated in the CTICU but my ultimate goal would be to work at a place like that. It would be pretty cool I think to do the CT surgery as an anesthesiologist and then take care of them in the CTICU. Any idea if the St. Barn's CTICU a closed unit? I know that the combined MICU/SICU/Neuro ICU is a closed unit, I also remember that St. Barn's ICU was about to under go a major updated before I left med school but I haven't seen the final results.

 

[Xerxes1729]

Wash U in St Louis has the model you're looking for. The CTICU is staffed by anesthesia/CCM/cardiac attendings who also work in the cardiac ORs.

 

[RussianJoo]

Wash U in St Louis has the model you're looking for. The CTICU is staffed by anesthesia/CCM/cardiac attendings who also work in the cardiac ORs.

Thank you, I guess academics is the most likely place I would find such settings, but I would prefer to work in the private setting first and then kind of retire in academics.

 

[core0]

Wash U in St Louis has the model you're looking for. The CTICU is staffed by anesthesia/CCM/cardiac attendings who also work in the cardiac ORs.

Emory has the same model and the former Wash U vice chair as their new chair.

 

[G-Man82]

you're talking about UMDNJ Newark? I am very familiar with St. Barn, unfortunately I haven't rotated in the CTICU but my ultimate goal would be to work at a place like that. It would be pretty cool I think to do the CT surgery as an anesthesiologist and then take care of them in the CTICU. Any idea if the St. Barn's CTICU a closed unit? I know that the combined MICU/SICU/Neuro ICU is a closed unit, I also remember that St. Barn's ICU was about to under go a major updated before I left med school but I haven't seen the final results.

UMDNJ Newark's system is a bit weird; the anesthesiologists there have sorta fallen out of the ICU. The MICU is medicine (pulm), the SICU is surgery, the CTICU is like 5 beds, and while its anesthesiology-run, the residents don't rotate for lack of patients.

I'm not at Newark - I did my medicine year there, though. Unfortunately I don't know much else about Barnabas. The other system I was talking about was Englewood in the northern part of NJ. It's a combined med-surg ICU.