critical care

[igcgnerd]

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When someone is dead set on doing critical care. Does it really matter proficiency wise or employability wise if one does it through the anesthesia or IM route?

 

[Planktonmd]

When someone is dead set on doing critical care. Does it really matter proficiency wise or employability wise if one does it through the anesthesia or IM route?

If you want to do critical care but not interested in learning anesthesia then you should go through the IM route , this will give you a more solid theoretical foundation although you might never become as skilled as an anesthesiologist at some procedures but that should no be a big deal for you.

 

[thegasman]

When someone is dead set on doing critical care. Does it really matter proficiency wise or employability wise if one does it through the anesthesia or IM route?

there also seem to be more opportunities for pulm/cc trained docs than anesthesia. Don't get me wrong - there is plenty of demand for anes/CC but it is primarily in the academic setting.

 

[bigdan]

I'm a student interested in CC too; a huge part of what I want to do OUTSIDE of the ICU lies within the realm of anesthesiology, so that's a big factor for me. Let's say your CC set up has you doing two weeks of ICU at a time - what do you wanna do those other two weeks? I'd much rather be in an OR than in a clinic, but that's me. What do you wanna do?

dc

 

[Pilot Doc]

there also seem to be more opportunities for pulm/cc trained docs than anesthesia. Don't get me wrong - there is plenty of demand for anes/CC but it is primarily in the academic setting.

You are correct that most CCM anes work primarily in an academic setting, but I don't think it's because of demand issues.

Pulm/CCM guys don't have the opportunity to work in a very different and better paid setting than the ICU. Anes guys do and that's what most people choose. In general, the people willing to make the pay/lifestyle sacrifices of CCM are going to stay where the zebra hunting is good in academic ICU's.

But it for whatever reason, you want to be a private practice CCM and or Anes guy, you'll have no problem finding a job in any community ICU.

As for what CCM guys do outside of the ICU, there's no reason - in Pulm or Anes - that you would have to do anything other than ICU work. Most community models I've seen are on a day/night shift model and you take X shifts/month like ER. I wouldn't let that influence a choice of career training pathway UNLESS you thought didn't want to work ICU fulltime and needed another outlet. In that case, OR vs. clinic could be a helpful deciding factor

 

[treasurefull2]

What does anesthesia have to with Critical Care anyway???

 

[Planktonmd]

What does anesthesia have to with Critical Care anyway???

Almost everything.

 

[G0S2]

What does anesthesia have to with Critical Care anyway???

Airway plus an incredible knowledge of physiology and pharmacology. Anesthesiology has more to do with the SICU than MICU given their role in perioperative medicine and keeping pts alive during surgery. I don't believe there is anyone more suited for this role than an anesthesiologist trained in CC.

 

[videolectures]

anyone sense a difference between anesthesia attendings who are partly in the OR compared to other anesthesiologist who are strictly in the OR

I always sense the attendings who are off and on in the OR kinda 'tip -toe' compared other attendings who STOMP/STAMPEDE around the OR (and on top of residents)

I also am beginning to take more interest in critical care although from a financial standpoint there is no incentive since it seems we make more money in anesthesia than in CC. Only benefit would be to break up the monotony.

Its through studying anesthesia that I have become more fond of CC. I dont think it works the otherway.

Bottom line: Anesthesia is an awesome field of study!

 

[Hockeyguy]

I agree with eveything being said. One nice thing beside the knowledge gained from doing a CC fellowship - is that for one extra year of training and a board exam you have a whole other career for just one year training. Also IMHO I think CC is the area of Anest with the most upside pontential. It may not make financial sense now but in the future it may. By the way I don't have a strong interest in CC medicine - but I wish I did.

MC

 

[fakin' the funk]

What does anesthesia have to with Critical Care anyway???

I feel rather strongly that anesthesiology is the field most suited to a future in surgical critical care. After all, what are you doing for the patient while they recover from/develop their surgical problem? Sedation/analgesia, ventilation, hemodynamics, fluids, lines, bronchoscopy...i.e. things you do EVERY DAY in the O.R. I think it is a great, and necessary, complement, to the surgeon presence in the ICU.

 

[seinfeld]

I am doing an anesthesia CCM fellowship at the current time. I am finding that i spend the most time reading on nutrition, abx selection, and dialysis (CRRT). Other than that most things for me are intuitive because i had been doing them for years in the OR. There is a literature that needs to be read ie FACT, SAFE, CORTICUS, Early Goal Directed Therapy, but overall these are not mind blowing concepts for the anesthesiogist.
I had thought i would be quicker to consult but then i spent some time in a medical ICU and to be honest they seemed to consult more often.
The hours are not as good as when i was an anethesia resident.