Just to expand on my original question, my goal is to practice CCM after doing a fellowship. I would also like to work in EM as well, but the point in doing the fellowship would be to be able to practice as an intensivist. Would doing a non-ACGME fellowship For ex IU or UAB make any difference in job prospects? Will not having board certification make a big difference?
I saw that St. Luke's is a one year fellowship, as is UAB (expandable to two yrs if you want to do an MPH). Considering that most if not all IM-CCM programs are two years, is one year enough to get a good grasp on CCM? Anyone have any experience or has anybody heard about the training at these non-ACGME programs?
Thanks.
Would doing a non-ACGME fellowship make any difference in job prospects?
Yes, there are groups/institutions that will not hire/credential someone who did not complete an accredited fellowship and is not eligible for board certification in the US by a traditional route. However, given the current shortage of intensivists in the US and ever increasing demand for end of life care for babyboomers, there are places that do/will make exceptions based on local staffing needs, relative desireability of location, individual contacts/connections within the institution, etc. By the same token, there are CCM jobs where only board certification in pulm/CCM is acceptable due to the staffing model in place and being an EM trained intensivist will not be accepted regardless of future access to ABMS certification.
With regards to the graduates of IU and UAB, they have found jobs splitting time between ED/ICU and full time ICU jobs in some cases.
IU's recent graduates have been hired within the IU system (
http://iu-iusm-emer.ads.iu.edu:8081/iuem/fellowships/em-critical-care/current-fellows).
UAB has had a graduate hired by VCU (Michael Abatazis,
http://www.vcu.edu/mcved/faculty1.html). I believe that he splits time between ED/ICU.
In fact, the PD of the UAB EM-CCM fellowship is a DO (Amy Fellman,
http://medicine.uab.edu/EM/Residency/61432/) who did her EM residency in an osteopathic program at Garden City Hospital.
Alumni from the St. Lukes trauma/CC fellowship have been hired by St. Lukes and seem to work in the ICUs there (Jennifer Axelband, DO; Tony Luizza, MD; Marc Portner, MD;
http://www.mystlukesonline.org/for-healthcare-professionals/resident-education/allopathic-and-application/faculty/bethlehem-faculty.aspx).
Will not having board certification make a big difference?
The lack of traditional board certification (ABMS) does currently make a difference and will very likely continue to make a difference in the future, especially if ABMS allows ABEM to co-sponsor the ABIM CCM exam. In the past and present, given the lack of access to ABMS certification in CCM, EM intensivists used a few work arounds to satisfy hospital credentialing committees via alternative boards.
Many completed the written and oral CC boards in Europe (
EUROPEAN DIPLOMA IN INTENSIVE CARE MEDICINE (EDIC, http://www.esicm.org/Data/ModuleGestionDeContenu/PagesGenerees/03-education/0A-european-diploma/11.asp). This exam is open to EM physicians. Some hospitals and academic medical centers will accept this as CC board certification for EM physicians.
Some used their CC fellowship time and/or actual post-fellowship practice time to apply for board certification in neurocritical care via the United Council for Neurologic Subspecialties (UCNS). The UCNS is a US organization that accredits fellowships and provides certification in various non-ACGME accredited programs/non-ABMS neuro subspecialties. EM intensivists could apply via the "practice track pathway" and sit for the UCNS neurocritical care exam (
http://www.ucns.org/go/subspecialty/neurocritical/certification). To some extent, this may restrict one's hospital privileges/scope of practice, but it helps satisfy the need for some type of recognized board certification that is open to EM physicians. However, the practice track pathway will be closing soon.
Some recent EM residents have chosen specifically to go into UCNS accredited neurocritical care fellowships because the UCNS exam is open to EM physicians. Univ of Cincinnati EM has sent several recent graduates into the Univ of Cincinnati neurocritical care program. These folks have been able to take the UCNS neurocritical care boards and work in the neuroICU.
So, people were able to find work arounds for the lack of access to ABMS certification in CCM. Plus, as noted above, the overall shortage of intensivists and local factors can sometimes work in your favor.
Considering that most if not all IM-CCM programs are two years, is one year enough to get a good grasp on CCM?
It all depends on the program and the intensity/quality of the training. Some 1 year programs may compress the same number of actual primary ICU blocks done at some 2 year programs into a 1 year format. Obviously, this would affect the amount of time available for other rotations, electives, research, etc.
Anyone have any experience or has anybody heard about the training at these non-ACGME programs?
I have heard good things about the IU program.