Critical care fellowship after EM

[reedman]

What do y'all think about doing a critical care fellowship after emergency medicine residency? Is this a smart way to go if I'm interested in critical care, but like the flexibility of EM? I keep thinking that it might be possible to split up your time between ER and ICU. Any insight?

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[G-Man82]

I've heard of people either doing a combined EM/IM/CC residency/fellowship or doing EM and taking CC boards in Europe, but I'm not sure if you can do ICU coming out of purely EM. If you like CC that much, but still enjoy the thrill of emergencies, why not anesthesiology? Their hours are quite flexible, too, and while on OR duty, no calls about crashing patients while you're outside the hospital.

 

[howelljolly]

If you continue to be interested in it, go for it.

The issue is, you can not go into Medical CC fellowship unless you've completed an IM residency. (as in an EM/IM combined program)

However, you can try an get into a Surgical CC fellowship after an EM residency. They normally require having done a residency in Surgery or Anesthesia, but have been known to accept EM docs.

Its more difficult to do it that way, but it can be done.

 

[Tigerz_Fan]

I believe that currently the only way for EM to become board-certified in CCM is through EM/IM/CCM. Some CCM programs (surg and IM) have been known to accept EM. I know that UPitt's CCM program does. But unfortunately, since this is a subspecialty of ABIM, I believe that EM people cannot sit for the CCM boards. EM to CCM fellowships may be out there, and I have heard of them, however, they are not ACGME accredited.

 

[Groove]

Aren't Neurocritical Care fellowships open to BCEM physicians? I thought you could sit for the boards upon completion.

 

[Tigerz_Fan]

Aren't Neurocritical Care fellowships open to BCEM physicians? I thought you could sit for the boards upon completion.

A couple of our attendings just sat for the neurocrit boards, and they were IM/CCM. They told me that the rules are changing. Apparently, in order to sit for the neurocrit boards you have to be neuro/CCM. However, I did just hear that from another, so that could be wrong.

 

[Hernandez]

A couple of our attendings just sat for the neurocrit boards, and they were IM/CCM. They told me that the rules are changing. Apparently, in order to sit for the neurocrit boards you have to be neuro/CCM. However, I did just hear that from another, so that could be wrong.

This is all I could find

1. Applicants must be a Diplomate in good standing of the American Board of Medical Specialties in one of the following:
a. Neurology
b. Neurological Surgery
c. Internal Medicine
d. Anesthesiology
e. Surgery
f. Emergency Medicine
g. Pediatrics
h. Equivalent certification by the Royal College of Physicians and Surgeons
of Canada.​

 

[Groove]

The NCC chair at my institution told me about the fellowship and insinuated that the accessability of the NCC boards to physicians in other specialties was a relatively new evolution. He made it sound like a very viable option for EM physicians looking to work in the NCC along with the ED. He also told me something about the fact that since it's under the UCNS and not ACGME fellowship, that you can make more money as a fellow since you aren't locked at that ~PGY4,5 salary stipulation?

 

[Tigerz_Fan]

This is all I could find

1. Applicants must be a Diplomate in good standing of the American Board of Medical Specialties in one of the following:
a. Neurology
b. Neurological Surgery
c. Internal Medicine
d. Anesthesiology
e. Surgery
f. Emergency Medicine
g. Pediatrics
h. Equivalent certification by the Royal College of Physicians and Surgeons
of Canada.​

I had heard it from an attending, so I wasn't certain.

Thanks for the info!

 

[KGUNNER1]

I believe that currently the only way for EM to become board-certified in CCM is through EM/IM/CCM. Some CCM programs (surg and IM) have been known to accept EM. I know that UPitt's CCM program does. But unfortunately, since this is a subspecialty of ABIM, I believe that EM people cannot sit for the CCM boards. EM to CCM fellowships may be out there, and I have heard of them, however, they are not ACGME accredited.

There are over 100 practicing critical care docs that have formal EM training. About 75% are pure EM/CCM. The vast majority of critical care that is delivered in the US is delivered by non-critical care trained/certified general internists or general surgeons. With that being said, EM has been traditionally an "outpatient" specialty. It would be very difficult (not impossible) to get ICU privileges without formal training and some sort of board certification.

Check out the CCM section at ACEP. It has a lot of information.
http://www.acep.org/ACEPmembership.aspx?id=24892

KG

 

[Tigerz_Fan]

There are over 100 practicing critical care docs that have formal EM training. About 75% are pure EM/CCM. The vast majority of critical care that is delivered in the US is delivered by non-critical care trained/certified general internists or general surgeons. With that being said, EM has been traditionally an "outpatient" specialty. It would be very difficult (not impossible) to get ICU privileges without formal training and some sort of board certification.

Check out the CCM section at ACEP. It has a lot of information.
http://www.acep.org/ACEPmembership.aspx?id=24892

KG

Agreed. The majority of ICU's are "open." And there are many GS/AN/IM to CCM out there. I work with several.

It appears that a joint board certification for IM/EM CCM may be in the works.

 

[KGUNNER1]

It appears that a joint board certification for IM/EM CCM may be in the works.

There is already a joint program approved by ABEM and ABIM. It is a 6 yr EM/IM/CCM program (it shaves one year off the EM/IM 5 + CC 2). Only a few places have this program, like Henry Ford and Pitt.

What is new is some very high level discussions between ABEM and ABIM about future collaborations. Very interesting indeed. Stay tuned......

KG