This is mostly (slight edit) a cross post from the emergency medicine thread. I'l like to hear any comments on it, even from tradiational non-EM streams who might or might not be in favor of EM trained docs taking positions in critical care (i.e. attending in a unit). Is the EDIC (European diplomat intensive care) really an end-around as regards EM-trained, fellowship-completed doctors getting certified in critical care? What value does the EDIC really have (and no, this isn't rhetorical -- I am also trying to tease this question out for my own career). We need to define what opportunities would exist with and without EDIC certification for those who have completed fellowship, and, for that matter, we need to define what opportunities might exist if we COULD get U.S. board certified. Think of it as three groups of people: 1 - EM trained, fellowship completed, non-boarded 2 - EM trained, fellowship completed, EDIC certified 3 - EM trained, fellowship completed, U.S. board certified intensivist (which, obviously, doesn't exist yet). I have heard, anecdotally, that it is currently possible (usually in community hospitals as opposed to big, academic institutions) for an EM-trained, CC fellowship completed doc to work in both the ED and the ICU. But what I haven't heard is whether or not the people filling these jobs got the job, at least in part, because they were "EDIC certified". If you have completed a fellowship AND you are EDIC certified, does this mean that the number of jobs that you might be eligible for increases? Has anyone actually seen an employment ad that states "EDIC certification necessary if you are coming from an EM residency/CC fellowship background"? For that matter, what if tomorrow, thanks to the EM lobby and the IOM report etc., EM-trained, CC-fellowship completed docs could now get board certification in critical care? Would still more jobs open up? Even in academic centers? The whole notion of board certified really needs to be considered in a critical light (no pun intended). In my ED, you can't work as an attending unless you are "board certified" in EM. But in the units, not only is this not true in some places (fortunate for us in EM) but even if we WERE certified tomorrow, I don't know that it would result in immediate job options for some time.