Im trained intensivist

[IdontTakeCall]

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the Im program im looking to go to allows 75 weeks of electives over the 3 year program. If i did 75-90% of those rotations in ICU and other critical care formats, is is plausible to think that a community hospital or any hospital for that matter would let me practice as there intensivist, or at a mimimum, allow me to handle the ICU issues for my own patients as a hospitlaist? I love Critical care but i dont have the extra 3 years to do a CC fellowship.

 

[bigtuna]

The answer to your question is no. Also the ACGME limits the amount of ICU time one can do per year during IM residency.

Some hospitalists do a fair amount of critical care in the community in places where there is not an intensivist though. These situations are likely to be less common in the future.

 

[NightVision]

the Im program im looking to go to allows 75 weeks of electives over the 3 year program. If i did 75-90% of those rotations in ICU and other critical care formats, is is plausible to think that a community hospital or any hospital for that matter would let me practice as there intensivist, or at a mimimum, allow me to handle the ICU issues for my own patients as a hospitlaist? I love Critical care but i dont have the extra 3 years to do a CC fellowship.

If you enjoy critical care, you can definitely do more as an internist. I recently finished residency and a lot of the higher paying hospitalist jobs, starting 250 to 300K year in community settings require you do some ICU work. Also, as the internist, you are always the main doctor for your patient, so even if your patient is in the ICU, the critical care team would probably be on consult, so basically you make the decisions. If you want Zosyn and Vanc but the critical care attending wants Levo and Vanc, the decision is ultimately yours. A good internist can do as much as they want without consulting other services. You can do skin biopsies, botox injections, whatever. You don't need to c/s cards for a. fib or heme/onc for a high aPTT. Your patients appreciate the one stop shopping and you make more money.

 

[sluggo]

You can do up to 6 "required months of iCU and up to 2 more months of elective. This can prepare you for ICU basics/community ICU practice, which as stated above, many hospitalists are doing. There are also about 50 IM programs in the country that offer a 1-2 year fellowship in straight ICU. These might help you... I am doing one and really like the idea!

 

[dragonfly99]

I would be skeptical about the amount of "elective" time that these IM residencies claim to have. Many of them like to claim that, but when you talk to actual residents in the program you will find out that a lot of the "electives" are really that you get SOME choice of the rotations you do, but not get to do whatever you want. Often it is just that you have a choice among different consult rotations (i.e. whether to do a month of cards, one of hem/onc and one of GI, vs. doing cards + ID + rheum) and often the programs will force/make everyone do certain rotations or consult services in order to keep them fully staffed.

But I do agree with some of the comments above. I think you can do some ICU work without being critical care certified, but honestly if you are going to manage a lot of ICU patients, especially ones on the vent, etc. then I would recommend doing a critical care fellowship.