ICU rotation necessary during prelim year?

[dvsr]

Hi all,

I'm a matched M4 going into rads, currently looking into making my schedule for my prelim year (internal medicine). Is an ICU rotation mandatory to start a rads residency? Any specific requirements?

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[colbgw02]

Not necessary, assuming your internship doesn't require it, but it may still be worthwhile depending on how yours is structured. That is, I was happy to spend 4 weeks in the unit when the alternative was another month of medicine wards. And that says nothing of the relative value of taking care of the sickest patients. That said, if you're choosing between the ICU and an elective that permits you some free time, then choose the latter.

 

[Shipping News]

ICU is not a strict requirement for intern year for a rads-bound resident.

If I recall correctly, the only strict rule is no more than 2 months of radiology in intern year and those rotations must be done at an institution with an ACGME-accredited residency.

 

[DeucesHigh3]

ICU is not a strict requirement for intern year for a rads-bound resident.

If I recall correctly, the only strict rule is no more than 2 months of radiology in intern year and those rotations must be done at an institution with an ACGME-accredited residency.

Yep, just today I got an e-mail from my rads program, and this was part of it:

Please note: One of the Accreditation Council for Graduate Medical Education (ACGME) guidelines is that Radiology residents can take no more than two electives in Radiology during your Preliminary or Transitional year. If you are going to do an elective in Radiology this coming year, it will need to be at an ACGME-accredited institution. (We will need to have your rotation schedules on file, in order to show the ACGME at our next Site Visit.)​

 

[JoshSt]

Where did this idea that ICU was required come from? Did it used to be required? I remember when I started to browse the rad forums two years ago reading that an ICU month was a requirement.

 

[cbtk18]

I would be very surprised if your internal medicine program didn't require you to do ICU months.

 

[HandOfMrsRoentgen]

ICU is not a strict requirement for intern year for a rads-bound resident.

If I recall correctly, the only strict rule is no more than 2 months of radiology in intern year and those rotations must be done at an institution with an ACGME-accredited residency.

Yep, just today I got an e-mail from my rads program, and this was part of it:

Please note: One of the Accreditation Council for Graduate Medical Education (ACGME) guidelines is that Radiology residents can take no more than two electives in Radiology during your Preliminary or Transitional year. If you are going to do an elective in Radiology this coming year, it will need to be at an ACGME-accredited institution. (We will need to have your rotation schedules on file, in order to show the ACGME at our next Site Visit.)​

Does this mean that if our intern year is done at a community hospital without a Rads residency that we can't take Rads electives? I'm confused as to what exactly the ACGME accreditation refers to.

 

[DeucesHigh3]

Does this mean that if our intern year is done at a community hospital without a Rads residency that we can't take Rads electives? I'm confused as to what exactly the ACGME accreditation refers to.

Bingo. I'm in that situation as well -- my prelim hospital has ~6 residency programs, but not radiology. Most places will let you do a rads elective as an away-rotation if you really want to, though.

I think I'll just do pathology or something... I'm done with watching over shoulders in the reading room.

 

[colbgw02]

If you're going to a transitional year or an elective-heavy preliminary program that has any substantial history of radiology preselects, there's a good chance that there's already a relationship with an accredited radiology residency, provided one is nearby. We routinely used to get radiology preselects from a nearby transitional program, as we were the only game in town, so to speak. If no such relationship exists, the leg work to set it up may be prohibitive for someone already very busy and only around for a year, assuming your program is even willing to accomodate you in the first place.

 

[HandOfMrsRoentgen]

Bingo. I'm in that situation as well -- my prelim hospital has ~6 residency programs, but not radiology. Most places will let you do a rads elective as an away-rotation if you really want to, though.

I think I'll just do pathology or something... I'm done with watching over shoulders in the reading room.

If you're going to a transitional year or an elective-heavy preliminary program that has any substantial history of radiology preselects, there's a good chance that there's already a relationship with an accredited radiology residency, provided one is nearby. We routinely used to get radiology preselects from a nearby transitional program, as we were the only game in town, so to speak. If no such relationship exists, the leg work to set it up may be prohibitive for someone already very busy and only around for a year, assuming your program is even willing to accomodate you in the first place.

Thanks!

For others who might be interested, the link is: https://www.acgme.org/acgmeweb/Port...equirements/420_diagnostic_radiology_2016.pdf

 

[Shipping News]

Does this mean that if our intern year is done at a community hospital without a Rads residency that we can't take Rads electives? I'm confused as to what exactly the ACGME accreditation refers to.

If your institution has an ACGME-accredited radiology program, you can do PGY-1 electives there (no more than 2 mo). If your institution doesn't have an ACGME-accredited radiology program, your only option would be to do away rotations (which probably aren't worth it unless they're nearby and the process of getting in is easy).

Though honestly, what are you actually going to learn on an intern-level diagnostic radiology rotation? You'd be shadowing residents and fellows. It's a blow-off rotation if anything.

 

[Shipping News]

Where did this idea that ICU was required come from? Did it used to be required? I remember when I started to browse the rad forums two years ago reading that an ICU month was a requirement.

Not sure if it used to be required, but it definitely isn't. See the link posted above. The only strict requirement is no more than 2 mo of rads and the rads has to be at an ACGME-accredited radiology program.

The review committee for radiology has some recommendations for transitional years here in this document:
https://www.acgme.org/acgmeweb/portals/0/pdfs/faq/420_diagnostic_radiology_faqs.pdf

There are a bunch of "recommendations" but nothing is particularly required.

Contrast this with anesthesia, which has pretty strict requirements about the PGY-1 year if it is done separately from the advanced anesthesia program:
http://www.acgme.org/acgmeweb/portals/0/pfassets/programrequirements/040_anesthesiology_07012014.pdf

 

[tco]

If you're even considering IR at ALL, do an ICU month.

That's just from someone who is biased, though.

 

[Shipping News]

My intern year doesn't have interns in the ICU (it's a PGY-2 rotation for the categoricals). Not sure how I feel about it now that my year is essentially over. Felt like I missed out a bit. But it definitely made my year a bit cushier.

 

[DeucesHigh3]

My intern year doesn't have interns in the ICU (it's a PGY-2 rotation for the categoricals). Not sure how I feel about it now that my year is essentially over. Felt like I missed out a bit. But it definitely made my year a bit cushier.

Heh I'm scheduled for 4.5 months of ICU... not sure how I feel about that!

 

[colbgw02]

Heh I'm scheduled for 4.5 months of ICU... not sure how I feel about that!

That could work out to your benefit, obviously depending on the specifics of your hospital/rotation. I would gladly have chosen ICU over the time I spent on covering the medicine or general surgery wards.

 

[Shipping News]

That could work out to your benefit, obviously depending on the specifics of your hospital/rotation. I would gladly have chosen ICU over the time I spent on covering the medicine or general surgery wards.

General medicine floors do indeed suck. I don't think I learned anything useful for radiology except to have pity on poor interns ordering random studies at 3am. I learned far more on my consult service rotations, where everyone was nice and loved tying their field to radiology in some way so I got more out of it.

 

[tco]

General medicine floors do indeed suck. I don't think I learned anything useful for radiology except to have pity on poor interns ordering random studies at 3am. I learned far more on my consult service rotations, where everyone was nice and loved tying their field to radiology in some way so I got more out of it.

Yeah, it's hard to learn anything when, as soon as an image comes up they yell at you, "Dr. tco, please come and read this study." While walking over, you continue to reinforce the fact that they are as much of a Radiologist as you are, but they just laugh and ask again for your read.