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Abstract

Introduction: Emergency Medicine (EM) trainees have been pursuing critical care medicine (CCM) training for numerous years. During her 2011 national conference remarks, former president of SCCM, Dr. Lipsett, specifically addressed the need to provide EM physicians fellowship “training equivalent to that of our internal medicine, anesthesiology, and surgery colleagues”. There has been an increased interest in formalizing approved CCM fellowship training for EM graduates (grads) within existing ACGME Anesthesiology Critical Care Medicine (ACCM) Fellowship Programs (FP). Hypothesis: EM grads are trained in the triage/resuscitation of undifferentiated critically ill pts and frequently manage multiple sick pts simultaneously. They also, by virtue of their training, are competent in a wide variety of CCM procedural skills (airway techniques, central venous access, bedside ultrasound, cardioversion, etc). We propose that existing ACCM programs could incorporate EM grads for formal training and certification. Methods: Currently, 51 ACCM FP exist in the United States. A survey was circulated amongst the ACCM program directors (PD) to assess attitudes and perceptions regarding the training of EM grads. We also requested information regarding ACCM FP that have previously or are currently training EM grads. Results: 46/51 (90%) ACCM FP replied. 20 (43%) programs are currently or have trained EM grads. 38 of 46 respondents (83%) either “strongly agree” or “agree” that EM trainees have the potential to be good intensivists. 35/46 (76%) “strongly agree” or “agree” that a pathway for training and board eligibility in CCM should be available for EM trainees in ACCM. 56% felt that the training should be 2yrs in length, while 28% felt it should be 1yr. Based on these results, a formal letter (endorsed by SCCM) of recommendation supporting the creation of a specialty track within ACCM FP was submitted to the Anesthesiology Residency Review Committee and the American Board of Anesthesiology. Conclusions: EM trainees are currently being trained in ACCM FP. The majority of ACCM FP would accept a formalized training tract leading to board certification. Further steps need to be taken to delineate a formal curriculum for EM/CCM fellows.