EM & Shock Trauma

[stebb]

Hello...

i understand that there is one can complete an EM residency then pursue the trauma/critical care fellowship at Shock Trauma in Maryland...but to be honest i'm not sure what this fellowship entails. What kind of role would the EM physician have as opposed to a surgeon who pursues this fellowship. Would one be able to be SICU attending?

Anyone complete this program or hear anything about it?

thanks

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[bcrosspac]

Hello...

i understand that there is one can complete an EM residency then pursue the trauma/critical care fellowship at Shock Trauma in Maryland...but to be honest i'm not sure what this fellowship entails. What kind of role would the EM physician have as opposed to a surgeon who pursues this fellowship. Would one be able to be SICU attending?

Anyone complete this program or hear anything about it?

thanks

One of our attendings here did just that. You can email him at [email protected]. He is one of our best attendings and is great with critical patients. His name is Tim McGlaughlin, DO.

 

[stebb]

One of our attendings here did just that. You can email him at [email protected]. He is one of our best attendings and is great with critical patients. His name is Tim McGlaughlin, DO.

Hey thanks a lot!!! I will do that.

 

[beyond all hope]

You must do at least two years of CC training to be able to sit for the European boards. EM docs can't get US board certified in critical care due to political issues.

You could be a ICU doc after the fellowship. Obviously you wouldn't be operating but you could do everything else a SICU surgeon could, and probably more (read an EKG, etc). Lots of SICU care is nonoperative now anyway.

I know someone who did a CC year at shock trauma and now works 75% time in the ED and 25% time in the ICU -> Not just the SICU but also the MICU, in a major academic center. Some hospitals won't hire any EM CC docs.

EM critical care is a hot issue. Search Scutwork and you'll find a number of posts.

 

[ESU_MD]

That's a bit of an offensive statement. A true surgical intensivist can read EKG's, and a lot more. They truly are definitive care providers and can do anything a micu or er CC doc can do- plus solve their problems in the operating room.

Since you have insulted SICU surgeons, I will trade a barb with you in good nature-

What skill would an ER CC doc be best at?
A) speed paging surgery
B) ordering radiology studies and only looking for the report (not looking at the films personally)
C) consulting other services
D) transferring pts to the floor- ie "Dispo'ing"

 

[southerndoc]

That's a bit of an offensive statement. A true surgical intensivist can read EKG's, and a lot more. They truly are definitive care providers and can do anything a micu or er CC doc can do- plus solve their problems in the operating room.

Since you have insulted SICU surgeons, I will trade a barb with you in good nature-

What skill would an ER CC doc be best at?
A) speed paging surgery
B) ordering radiology studies and only looking for the report (not looking at the films personally)
C) consulting other services
D) transferring pts to the floor- ie "Dispo'ing"

Definitely D. We are dispo kings. A, B, and C seems to be ED attending dependent.

 

[mikecwru]

I think the first comment was silly. Obviously, it takes more than a year learn to ask what the white count is and say "I'm not impressed," with a straight face.

mike

That's a bit of an offensive statement. A true surgical intensivist can read EKG's, and a lot more. They truly are definitive care providers and can do anything a micu or er CC doc can do- plus solve their problems in the operating room.

Since you have insulted SICU surgeons, I will trade a barb with you in good nature-

What skill would an ER CC doc be best at?
A) speed paging surgery
B) ordering radiology studies and only looking for the report (not looking at the films personally)
C) consulting other services
D) transferring pts to the floor- ie "Dispo'ing"

 

[roja]

ESU_med-

EM training allows you to adress many nonsurgical issues. Knowing each fields limitations is key. Even when I did trauma with some of the best trauma surgeons I have met, they weren't outstanding at picking out more subtle ekg findings. I also watched them flounder when a (mistakenly) brought in patient really had meningitis (AMS, ffever of 106.5 axillary adn HR of 160)... they gave cardizem until I stopped them and were going to stop at treatment with 2 g of Ceftriaxone (despite his age and homelessness).

Just as I floundered when I was presented with an open belly in the OR....


Regarding CC fellowship and boards: I think you only have to do one year of CC fellowship to sit for the boards (many ICU fellowships are one year. The extra year for trauma is a different story.). If you want to work in an MICU you can do one year of fellowshipa nd sit for the european boards.

 

[MedWiz]

Regarding CC fellowship and boards: I think you only have to do one year of CC fellowship to sit for the boards (many ICU fellowships are one year. The extra year for trauma is a different story.). If you want to work in an MICU you can do one year of fellowshipa nd sit for the european boards.

Sorry, that's not entirely correct-if you want to sit the European Boards, you'll have to have 2 yrs under your belt:

Can an EM resident become "Boarded" in critical care?

No, at least not in the United States. Remember, however, that critical care is not a true boarded subspecialty but rather a "certificate of added qualification." For mainly political reasons, currently there is no American Board of Emergency Medicine (ABEM) examination for emergency physicians (EPs) in critical care. It will likely require a significant increase in the number of EPs fully trained in critical care before the ABEM will be interested in pursuing a certifying exam. Many leaders of critical care, including Ake Grenvik, MD (see linked letter from Dr. Grenvik), one of the founding fathers of critical care, have expressed their strong support for EPs becoming certified in critical care medicine.

However, an alternative route is available for United States (US) EPs who complete an EM residency and then two years of critical care fellowship training. The European Society of Intensive Care Medicine (www.esicm.org) allows US physicians who meet the above requirements to take their European Diploma in Intensive Care (EDIC) exam, the official standard of intensive care unit (ICU) competence for the European Union. The ESICM has an equal and reciprocal relationship with the US-based Society for Critical Care Medicine (www.sccm.org) and its examination is widely regarded as equally rigorous as its American counterpart.

How long is a critical care fellowship?


While some programs (shock trauma in Baltimore, Maryland, for one), are designed to provide a one year experience, most fellowships are two years in length. Many believe that a full 2-year fellowship is the better choice as it allows more training, puts one on an equal standing with other intensivists, and allows one to sit for the European Boards. The drawback of course is the need for an extra year of training.

(Source: http://www2.acep.org/1,5411,0.html)