critical care

[ucsfer]

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A big plus of anesthesia seems to be that you run the ICUs. I assume you have to do the critical care fellowship to be allowed to do that? After that fellowship, how much of OR anesthesia do you do? Do you split your time between that and the ICU or do you essentially have to choose one or the other? When you are running the ICU, is it shift work?

 

[2ndyear]

I would say that in general, purely anesthesiologist run ICU's are the exception rather than the norm in most places in the USA. I understand that Europe is a different story. Critical care is a one year fellowship after anesthesia. The schedule depends upon that of the group that you're in. Yes, it is shift work. Some places are 12 hour shifts, some 24, some in house full time, others just need to be available by pager from home. As to how much time you spend in the OR vs. the ICU, again that's dependent on what you want to do and what the group needs.

 

[gaseous]

Some of the academic Critical Care Anesthesiologists that I know usually work 3 weeks in the Unit and 1 week in the OR per month. I'm not sure how that compares nationwide but at MD Anderson here in Houston, thats how they schedule it. But there is some flexiblity among the attendings, where some do more ICU weeks and some do more OR weeks. Its a good balance. Even if one loves the Unit, burnout is a problem after awhile. The OR is a nice change of pace.

I'd be interested to hear how other hospitals/groups do scheduling.

 

[nchhabra]

In academics I have seen some places the docs will do a month at a time in the unit. I have also seen it 1 week in the unit and 3 weeks in the OR. As gaseous said he has seen 3 in the unit and 1 in the OR. So I guess the answer is you can find all kinds of variations, but there probably are not a whole lot of Critical Care Management who just do ICU work, as burnout is a problem. That last statement was pure speculation of course, since I have never hand any experience with anyone who just did ICU.