How Competitive is it for EM Residents to get into a Critical Care Fellowship?

Doctor Bob

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Just for clarification, is it literally only IM floor months and MICU that count toward this 6 month requirement? Between SICU, PICU and CCU none of these count, correct? If so I only have a single MICU month on my residency schedule and 2 elective months my third year I can use which would only get me to 3 months total towards the requirement. I think I have an uphill battle ahead of me!

Technically it is inpatient medicine services that count. So medicine floor, cardiology floor (not consult service), MICU, (+/- CCU). More often than not you will find that programs will accept consult services as well, so if you spend time on cards consult, nephrology, GI whatever they'll often count that towards the 6 months. Many programs don't care about this rule at all, but some still do (or at least did when I was interviewing a few years ago).

All programs told me they won't count other ICUs (PICU, CVICU, Neonatal ICU, SICU etc) towards the 6 months even though I would argue those make you a great candidate and are higher yield than simply rotating on a medicine floor.

All-in-all you will be ok I think. Tailor your electives towards critical care if you're in a 3 year program and you'll get to ~5 months including consult services. If you're in a 4 year program you have nothing to worry about because you'll have plenty of elective time, though I interviewed with a number of 4 year graduates who hadn't met the requirement because they didn't decide on CCM until late.

Yep. SICU doesn't count. PICU doesn't count.
CCU probably would count.

It's an ABIM requirement which is why they only care about IM and IM subspecialty rotations.

All in all a program isn't going to care much about how many months you need in order to make up the required 6 months, unless they are dependent on fellows to staff a resident-supervising rotation.
I took an EM-trained applicant this past year who still needed two months. But it wouldn't have mattered because the first time he supervised IM residents was 6 months into training. We have enough other ICUs here that I had a lot of flexibility in the schedule. I suppose at smaller places that only have one or two ICUs it could be more of a problem.
 
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partypantss

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Technically it is inpatient medicine services that count. So medicine floor, cardiology floor (not consult service), MICU, (+/- CCU). More often than not you will find that programs will accept consult services as well, so if you spend time on cards consult, nephrology, GI whatever they'll often count that towards the 6 months. Many programs don't care about this rule at all, but some still do (or at least did when I was interviewing a few years ago).

All programs told me they won't count other ICUs (PICU, CVICU, Neonatal ICU, SICU etc) towards the 6 months even though I would argue those make you a great candidate and are higher yield than simply rotating on a medicine floor.

All-in-all you will be ok I think. Tailor your electives towards critical care if you're in a 3 year program and you'll get to ~5 months including consult services. If you're in a 4 year program you have nothing to worry about because you'll have plenty of elective time, though I interviewed with a number of 4 year graduates who hadn't met the requirement because they didn't decide on CCM until late.
Got it, yeah if CCU counts by some places that will get me up to 4 months total after using my 2 elective months. Thank you for the info. My 3 year program is very ED-heavy.
 

partypantss

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Jun 10, 2014
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Yep. SICU doesn't count. PICU doesn't count.
CCU probably would count.

It's an ABIM requirement which is why they only care about IM and IM subspecialty rotations.

All in all a program isn't going to care much about how many months you need in order to make up the required 6 months, unless they are dependent on fellows to staff a resident-supervising rotation.
I took an EM-trained applicant this past year who still needed two months. But it wouldn't have mattered because the first time he supervised IM residents was 6 months into training. We have enough other ICUs here that I had a lot of flexibility in the schedule. I suppose at smaller places that only have one or two ICUs it could be more of a problem.
Okay, thank you this is good insight. I just have to focus on the things that I CAN control and not worry too much about not having enough IM months I guess.
 
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