ICU requirements

[CaliforniaBound]

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Hey all,

just a quick question. I'm an R1, currently doing a TY year before my anesthesia training. My PD for the TY year said it would be impossible for me to do 2 months of ICU this year due to scheduling issues...blah blah blah.

My question is in regards to the neccesity of this. I was told by my anesthesia PD that I need 2 months done this year, because of the increase in total months requirement.

Does anyone know what
1. the total ICU time requirements are for anesthesia? (I've heard anywhere from 2 to 6 months, lol)
2. Is there a specific requirement that a PGY 1 do 2 months in the first year.

Sorry if this info is listed somewhere else. I couldn't find it. Thanks 🙂

 

[pillowhead]

Hey all,

just a quick question. I'm an R1, currently doing a TY year before my anesthesia training. My PD for the TY year said it would be impossible for me to do 2 months of ICU this year due to scheduling issues...blah blah blah.

My question is in regards to the neccesity of this. I was told by my anesthesia PD that I need 2 months done this year, because of the increase in total months requirement.

Does anyone know what
1. the total ICU time requirements are for anesthesia? (I've heard anywhere from 2 to 6 months, lol)
2. Is there a specific requirement that a PGY 1 do 2 months in the first year.

Sorry if this info is listed somewhere else. I couldn't find it. Thanks 🙂

The requirement is four months. I'm 99% sure that you do not have to do 2 months in the first year.

 

[deleted50478]

The requirement is four months. I'm 99% sure that you do not have to do 2 months in the first year.

You don't have to do 2 months in the first year. You are allowed to count up to 2 months from the first year though. It's obviously nice since it basically trades a terrible month, medicine intern month, for a nice month, anesthesia elective.

http://www.acgme.org/acWebsite/downloads/RRC_progReq/040_anesthesiology_07012008_u03102008.pdf

 

[RickKane]

Conventional wisdom would tell you that doing an "extra" (second) month of ICU will get one of those nasty Q3 or Q4 call months out of the way but the reality is that most programs have there own scheduling obligations. This means that they need to have x number of residents in the unit each month. That obligation is usually spead evenly by the residents. I know in my program everybody does 2 months SICU and 1 CCU. It doesn't matter if you did 1, 2 or even 6 months as an intern...you still put your time in as a resident.

 

[Gimlet]

Conventional wisdom would tell you that doing an "extra" (second) month of ICU will get one of those nasty Q3 or Q4 call months out of the way but the reality is that most programs have there own scheduling obligations. This means that they need to have x number of residents in the unit each month. That obligation is usually spead evenly by the residents. I know in my program everybody does 2 months SICU and 1 CCU. It doesn't matter if you did 1, 2 or even 6 months as an intern...you still put your time in as a resident.

Maybe true for most programs, but not necessarily all. Our PD prefers 2 months to be done in the intern year so he doesn't have to pull CA1-3 residents out of the OR to get their ICU experience.

 

[psychbender]

Conventional wisdom would tell you that doing an "extra" (second) month of ICU will get one of those nasty Q3 or Q4 call months out of the way but the reality is that most programs have there own scheduling obligations. This means that they need to have x number of residents in the unit each month. That obligation is usually spead evenly by the residents. I know in my program everybody does 2 months SICU and 1 CCU. It doesn't matter if you did 1, 2 or even 6 months as an intern...you still put your time in as a resident.

Though, which is preferable, a month of IM or a month of CCM? I traded my third month on the wards this year for a month in the SICU because I have a true dislike of the general medicine wards. Then again, I keep thinking I'd like to do a CCM fellowship after residency, so I already recognize that I am an anomaly.

 

[akpete]

Damn, we do 4 months of ICU intern year.

 

[pgg]

Then again, I keep thinking I'd like to do a CCM fellowship after residency, so I already recognize that I am an anomaly.

I kept thinking I might do a CC fellowship too, and then I'd find myself 3.5 weeks into an ICU rotation thinking "WTF am I doing here? Please god make it stop."

I even did an extra SICU elective as a CA-3 to give it another shot ... my wife openly mocked me when I scheduled that. "Don't you remember how miserable you were at the end of the last one? You *****. Fine, do it. But don't bitch about it to me."

Today I can say "I ain't never going back" and 95% mean it. I think the CCM monkey is off my back. Well, maybe 90%.

 

[CaliforniaBound]

Thanks for the answers everyone. 🙂

 

[Ashers]

Maybe true for most programs, but not necessarily all. Our PD prefers 2 months to be done in the intern year so he doesn't have to pull CA1-3 residents out of the OR to get their ICU experience.

For this, I am so happy. I get out of a month of downtown-y pediatric clinic to go to the PICU.

 

[Gern Blansten]

From the ACGME website with regards to clinical base year requirements:

At least six months of the Clinical Base Year rotations
must include experience in caring for inpatients in
internal medicine, pediatrics, surgery, or any of the
surgical specialties, obstetrics and gynecology,
neurology, family medicine, or any combination of
these. In addition, there should be rotations in critical
care and emergency medicine, with at least one
month, but no more than two months, devoted to
each. Up to one month may be taken in
anesthesiology. Rotations should ensure continuity of
teaching and clinical experience. Each month of
training may be counted only once. For example, a
rotation in a pediatric intensive care unit may count as
either a month in pediatrics or a month in critical care
medicine.

 

[shift_roro]

Do CCU rotations during prelim/TY count towards the "critical care" requirement? I was under the assumption they did, but someone told me today that only MICU time counts.

 

[psychbender]

Do CCU rotations during prelim/TY count towards the "critical care" requirement? I was under the assumption they did, but someone told me today that only MICU time counts.

I'm pretty sure they do. At least, that was my program's justification for why they resisted me adding a SICU month on top of my MICU and CCU this year.

 

[Eta Carinae]

Do CCU rotations during prelim/TY count towards the "critical care" requirement? I was under the assumption they did, but someone told me today that only MICU time counts.

Thank you for the very informative posts on this thread.

I guess corollary to the above question is-

What happens if you don't meet the ICU requirements then as you commence your CA1 year. Does this tack on extra time in residency for you (me)? Or is there enough elective time to make this up, anyway.

I don't care so much if I don't meet the requirements as long as I won't be tacking on an extra two or three months after my projected graduation date.

Thanks again!

 

[lushmd]

No, the extra ICU rotation(s) would be taken from your elective time (at any decent program, this shouldn't affect your ability to meet ABA case numbers and, as such, wouldn't increase the length of residency).

 

[Eta Carinae]

No, the extra ICU rotation(s) would be taken from your elective time (at any decent program, this shouldn't affect your ability to meet ABA case numbers and, as such, wouldn't increase the length of residency).

thanks a lot, lush 🙂

 

[badgas]

For what graduating class does the number of ICU months required increase from 2 to 4 months?

 

[pgy13]

For what graduating class does the number of ICU months required increase from 2 to 4 months?

current CA-1 class.

 

[badgas]

current CA-1 class.

Our program says CA-1s starting in July 2008... so current CA2s. Are there any links that confirm this? Thanks.

 

[MCYan]

Just to be sure, I would check with your anesthesia program whether the ICU months at your prelim/TY hospital counts toward the official ICU requirement. I have heard that some are not transferrable and you might still end up doing 4 months of ICU through your 3 years of clinical anesthesia.

 

[G-Man82]

The PD at my school says that something like CCU wouldn't count because you need to be in a Unit that deals with multiple organs, not just one. I don't know if that's universal or just specific to my school.