Repost: How do Anes CCM docs fit in PP?

[timtye78]

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At OU Trauma ICU, we have both plus Int Med CCM MDs, but what about private practice? In my intern year hospital, pulm/internal medicine trained intensivists ran the show.

At OU, the anesthesiologist CCM docs are second to the trauma surgeons.

What the heck is the point is doing a fellowship in something if you are still are not the 'top dog' in your field? (What? MORE tests?.....ughh.)

Please give me something more practical than "Do what you love...".

Thanks

 

[toughlife]

At OU Trauma ICU, we have both plus Int Med CCM MDs, but what about private practice? In my intern year hospital, pulm/internal medicine trained intensivists ran the show.

At OU, the anesthesiologist CCM docs are second to the trauma surgeons.

What the heck is the point is doing a fellowship in something if you are still are not the 'top dog' in your field? (What? MORE tests?.....ughh.)

Please give me something more practical than "Do what you love...".

Thanks

In my experience, this has been institution dependent. I've seen surgeons and Anesthesiologists take turns running the SICU where they alternate weekly. That seemed to work well.

To run the MICU, we need more medicine training. Granted anesthesiologists are great at hemodynamic/vent management, we need a better understanding of disease processes which we don't get a whole lotta exposure to in anesthesia training. That's where the medicine docs beat us. To better prepare us, anesthesia residency programs should incorporate at least one year of ICU work during residency, so that by the time we finish a fellowship, we would have two years of CC exposure, we'd be better at it and be double boarded.

It'd be nice if we could have the option of choosing a track early in residency for those who were sure they wanted a certain path.

 

[DrDre']

At UIowa, CCM IMs, Surgeons and CCM anesthesia take turns running the SICU.

At (I believe) UCSF, Mayo-rochester, and OSHU, they now have a combined 4 year anesthesia/CCM residency so you will have a total of up to 18 months of ICU. You will be boarded in both once done.

Although internists know far more medicine, my experience so far from 2 months in the ICU is that the amount of medicine needed to take care of pts in the ICU should be picked up between med school, internship and your ICU months leading to the 1 yr fellowship. Anything more sophisticated can be consulted or managed on the floor if they make it out of the unit.

At OU Trauma ICU, we have both plus Int Med CCM MDs, but what about private practice? In my intern year hospital, pulm/internal medicine trained intensivists ran the show.

At OU, the anesthesiologist CCM docs are second to the trauma surgeons.

What the heck is the point is doing a fellowship in something if you are still are not the 'top dog' in your field? (What? MORE tests?.....ughh.)

Please give me something more practical than "Do what you love...".

Thanks

 

[threepeas]

so that by the time we finish a fellowship, we would have two years of CC exposure, we'd be better at it and be double boarded.

you can be double boarded as it stands now.
between elective time in ca-3 yr and icu rotations in intern year + one yr fellowship one can approach the 2 years. MICU isnt that complicated anyway.

 

[aredoubleyou]

At OU Trauma ICU, we have both plus Int Med CCM MDs, but what about private practice? In my intern year hospital, pulm/internal medicine trained intensivists ran the show.

At OU, the anesthesiologist CCM docs are second to the trauma surgeons.

What the heck is the point is doing a fellowship in something if you are still are not the 'top dog' in your field? (What? MORE tests?.....ughh.)

Please give me something more practical than "Do what you love...".

Thanks

Disclaimer: I am not talking about a subject that I really totally understand...but if your talking about in the private sector, as I understand it (I'm doing my internship at a private hospital), its all about compensation. Hospital can pay a Pulm guy 250K to work in an ICU, and he probably sees this as good money for the amoubt of work. An anesthesiologist, who could potentially make more in the OR would be less inclined to take the job. Ultimately, the director and the political capital (as they say) is in the hands of the Pulm/CCM guys, and thats who your boss would be. If anesthesiologists could make the same or more money in CC, then I'd imagine that would start changing.

 

[Dryacku]

UF's program totally runs there SICU. It is all anesthesia and I must admit some of the smartest docs I have seen. NW does also UofC may also. Honestly i spoke to a medicine ICU doc about training. Yeah we lack on the medicine end of the spectrum, but after working in an ICU for an year or two you can understand enough medicine to be a good ICU doc.. just my opinion