International critical care training recognition

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kaleb

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Hi,

I am a PG-Y2 in IM and thinking about applying to critical care fellowship. I had a previous official training in critical care in Europe, is there a way for the boards to recognize my critical training and exempt me from re-doing the fellowship ?

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No. Plenty of small hospitals where you can also work in an ICU without board certification however you might have issues with credentialing for procedures if you arent getting the exposure you need in your residency.
 
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Procedures should not be a problem as I am doing my residency in IM in the US. What about compensation ? does it get to the level of hiring an intensivisit ?
 
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Procedures should not be a problem as I am doing my residency in IM in the US. What about compensation ? does it get to the level of hiring an intensivisit ?

Probably not. As much as it sucks to repeat training, this is the nature of the game for IMGs. And although it sucks, there are many reasons for why standardized training exists. If you want an intensivist job, that pays intensivist $, in a decent location in the US, you will probably need ACGME CCM training and BE/BC status. There are definitely desperate hospitals out there (due to undesirable location/can't afford trained boarded intensivists/other reasons) that may be willing to hire you as a "ICU hospitalist", especially for night time coverage. This can be something to consider.

Don't expect procedural credentialing to be a cake-walk just because you are doing an IM residency. You may have a challenge getting credentialed especially for things like airway/chest tubes/bronchs and I doubt there will be any way for you to get credentialed for some of the more fancier things like perc trachs, ICP monitors, temporary pacers, echo etc. Things like central lines shouldn't be an issue as long as you do enough in residency.

I would encourage you to keep the medico-legal aspect of things in mind in this country before embarking on this path. In the event of a bad outcome/lawsuit, you will be held to the same standards as a boarded/US trained CCM physician. One particular case always comes to my mind - someone I know took a hospitalist job that required managing ICU patients for 24-48 hours until they were seen by a CCM consulting physician - he ended up taking care of a very sick young asthmatic who had a poor outcome and ended up getting sued. Not having CCM training was something that was used against him.

Wish you the best.
 
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Probably not. As much as it sucks to repeat training, this is the nature of the game for IMGs. And although it sucks, there are many reasons for why standardized training exists. If you want an intensivist job, that pays intensivist $, in a decent location in the US, you will probably need ACGME CCM training and BE/BC status. There are definitely desperate hospitals out there (due to undesirable location/can't afford trained boarded intensivists/other reasons) that may be willing to hire you as a "ICU hospitalist", especially for night time coverage. This can be something to consider.

Don't expect procedural credentialing to be a cake-walk just because you are doing an IM residency. You may have a challenge getting credentialed especially for things like airway/chest tubes/bronchs and I doubt there will be any way for you to get credentialed for some of the more fancier things like perc trachs, ICP monitors, temporary pacers, echo etc. Things like central lines shouldn't be an issue as long as you do enough in residency.

I would encourage you to keep the medico-legal aspect of things in mind in this country before embarking on this path. In the event of a bad outcome/lawsuit, you will be held to the same standards as a boarded/US trained CCM physician. One particular case always comes to my mind - someone I know took a hospitalist job that required managing ICU patients for 24-48 hours until they were seen by a CCM consulting physician - he ended up taking care of a very sick young asthmatic who had a poor outcome and ended up getting sued. Not having CCM training was something that was used against him.

Wish you the best.
Thank you very much for this clear explanation.
 
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