Micu/ccu

[Rudy Guliani]

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So I have been talking to many residents about various prelim programs, and one thing that seems to come up a lot is time spent in the MICU vs the CCU, as in "program X has you do 3 months of MICU, but program Y only has you do 1 month of MICU and 2 months of CCU." Having not done any kind of ICU-type rotations thus far, what are the differences between MICU and CCU? Does the MICU have much sicker patients or other characteristics that cause more headaches? Thanks

 

[AJM]

While the rotations have their differences, I think it is pretty even as far as the level of pain involved. The MICU tends to have much sicker patients than the CCU, as they have multiple organs malfunctioning, are often intubated, and will often keep you up in the middle of the night because they keep trying to code. The CCU patients on the other hand, tend to only have one organ system acting up, tend not to be intubated, and there will be a higher proportion of simpler admits than the MICU (for example: the STEMI who is post-cath). However, the turnover in the CCU is much higher than the MICU, so you will have to admit many more patients any given night, and therefore you probably will get just as little sleep in the CCU as you will in the MICU. There also is still the potential for admitting absolute disasters to the CCU, so if you combine 1 disaster admit with 5 simpler CCU admits, it can make your night quite painful.

 

[southerndoc]

While the rotations have their differences, I think it is pretty even as far as the level of pain involved. There also is still the potential for admitting absolute disasters to the CCU, so if you combine 1 disaster admit with 5 simpler CCU admits, it can make your night quite painful.

Painful? Some of us are sick enough that we call that "enjoyment."

Seriously, I loved my critical care months as an intern and look forward to future ICU rotations. We do a total of 6 months in the units. That's one of the reasons I ranked my program so highly.

 

[soon2bdoc2003]

For what its worth micu patients are much more fun to manage than ccu patients. A good medicine prelim will give you 2 months of micu and 1 month of ccu. Any more ccu is a waste of time, any more micu is pure torute. You should also try to find something with at least 1 elective month.

 

[AJM]

Painful? Some of us are sick enough that we call that "enjoyment."

Seriously, I loved my critical care months as an intern and look forward to future ICU rotations. We do a total of 6 months in the units. That's one of the reasons I ranked my program so highly.

I know -- I enjoy it, too. Heck, I like the MICU so much that I'm even doing a fellowship in critical care. 🙂 And the biggest thing I miss now that I'm a fellow is that I am no longer the first responder to codes and other crashing patients -- I unhappily have to restrain myself and let the residents take care of things.... hope that doesn't make me too weird! 🙂

But lots of people are scared of the ICU, or otherwise consider it quite tiring -- that's why I said that it can be painful. I remember some of my own particularly painful nights in the unit.... they were enjoyable, but painful at the same time mostly because of the lack of sleep facor.