Emergency Medicine and Critical Care Medicine: Have the Stars (Finally) Aligned?

Forget Paris: Emergency Physicians Can Soon Sit for US Critical Care Boards

Critical Care During the Coronavirus Crisis—Reflections on the Roles of Anesthesiologists in Meeting the Challenges of the Pandemic

Emergency medicine: past, present, and future challenges

324 A 10-Year Look at Emergency Medicine/Critical Care Medicine Fellows: Comparison of Standardized Exams Results

In reply

Critical care fellowship training in the United States differs based on specific specialty and includes medicine, surgery, anesthesiology, pediatrics, emergency medicine, and neurocritical care training pathways. We provide an update regarding the number and growth of US critical care fellowship training programs, on-duty residents and certified diplomates, and review the different critical care physician training pathways available to residents interested in pursuing a fellowship in critical care. Data were obtained from the Accreditation Council for Graduate Medical Education and specialty boards (American Board of Internal Medicine, American Board of Surgery, American Board of Anesthesiology, American Board of Pediatrics American Board of Emergency Medicine) and the United Council for Neurologic Subspecialties for the last 16 years (2001-2017). The number of critical care fellowship training programs has increased 22.6%, with a 49.4% increase in the number of on-duty residents annually, over the last 16 years. This is in contrast to the period of 1995 to 2000 when the number of physicians enrolled in critical care fellowship programs had decreased or remained unchanged. Although more than 80% of intensivists in the US train in internal medicine critical care Accreditation Council for Graduate Medical Education-approved fellowships, there has been a significant increase in the number of residents from surgery, anesthesiology, pediatrics, emergency medicine, and other specialties who complete specialty fellowship training and certification in critical care. Matriculation in neurocritical care fellowships is rapidly rising with 60 programs and over 1,200 neurocritical care diplomates. Critical care is now an increasingly popular fellowship in all specialties. This rapid growth of all critical care specialties highlights the magnitude of the heterogeneity that will exist between intensivists in the future.

The American Board of Thoracic Surgery: Update

The American Board of Thoracic Surgery: Update

Vascular surgery's identity

ASSESSMENT OF THE EFFICACY OF A VIRTUAL MENTORSHIP PROGRAM IN CRITICAL CARE

<!--[if !mso]> <style> v\:* {behavior:url(#default#VML);} o\:* {behavior:url(#default#VML);} w\:* {behavior:url(#default#VML);} .shape {behavior:url(#default#VML);} </style> <![endif]--><!--[if gte mso 9]><xml> 12.00 </xml><![endif]--><!--[if gte mso 9]><xml> Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 </xml><![endif]--><!--[if gte mso 9]><xml> </xml><![endif]--> <!--[if gte mso 10]> <style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} </style> <![endif]--><!--[if gte mso 9]><xml> </xml><![endif]--><!--[if gte mso 9]><xml> </xml><![endif]--> <!--[if gte vml 1]> <![endif]-->It is with pleasure that we launch the inaugural issue of the Sri Lanka Journal of Critical Care. This is an official publication of the Postgraduate Institute of Medicine, University of Colombo, Sri Lanka. The journal is peer-reviewed, and is Sri Lanka's first online-only open access journal. We do not charge a subscription fee, nor do we charge authors. The open-access model is now a favoured model for publication of scientific research, and enables wider dissemination of scientific publications. Making the journal an online only publication greatly reduces the cost of publication, while making it possible to provide it through an open-access model. The journal aims to foster research and education in critical care medicine in Sri Lanka. We are indexed on Google Scholar. Critical Care Medicine is gradually being established as a subspecialty in Sri Lanka. The Specialty Board in Critical Care and Emergency Medicine was established by the Postgraduate Institute of Medicine to function under the Board of Study for Multidisciplinary Study Courses recently. As its first activity, a Postgraduate Diploma in Critical Care was commenced this year, and the first batch of trainees have commenced training. The aim of this diploma programme is to enhance the training of junior doctors working in intensive care units throughout the country. Critical care medicine is essentially a multidisciplinary specialty. In keeping with many models of critical care medicine in Europe, the United States, and other developed countries, we support the view that training in critical care medicine must allow entry from many different disciplines, such as clinical medicine, anaesthesiology, surgery, paediatrics, obstetrics and gynaecology, and many others. We sincerely hope this journal would provide a platform for the dissemination of research, scientific thought and debate in the field of critical care medicine in Sri Lanka. We particular encourage local researchers to submit their work to our journal. We are grateful for the support given towards us towards the establishment of this journal by the Director, PGIM, the staff at the Medical Education Resource Centre of the PGIM, and members of the Specialty Board in Critical Care, and the Editorial Board. We also thank the INASP (International Network for the Availability of Scientific Publications) which supports us to make our journal available online through their Sri Lanka Journals Online project (<a href="/">www.sljol.info</a>). In particular, we thank Mrs Sioux Cumming, Programme Officer, Publishing Support, INASP, for her continuing support and assistance in maintaining the journal. DOI: 10.4038/sljcc.v1i1.936

Development and direction of the American Board of Emergency Medicine

Captaining the Ship During a Storm: Who Should Care for the Critically Ill?

Critical care is an expensive and limited resource in the United States. Estimates from more than a decade ago suggest that over $100 billion a year is spent on critical care services.1 Over the past two decades, the number of patients presenting to the Emergency Department (ED) requiring critical care services has increased at a much higher rate than the growth in overall ED volume.2,3 The proportion of ED patients requiring Intensive Care Unit (ICU) admission has increased 75% over the first decade of the twenty-first century. In addition to the increase in the absolute number of patients requiring critical care admission, the ED length of stay for critically ill patients increased by 60 minutes. This resulted in a total nationwide increase in critical care provided in the ED by more than threefold. This disproportionate increase in critical care time reflects both the increase in critical care volume and the increase in ED boarding of critically ill patients. Data from 2008 reported the median boarding time for a patient waiting in the ED for an ICU bed was more than 5 hours, and 30% of patients waited more than 6 hours for an ICU bed.2,3 This article is protected by copyright. All rights reserved.

Point-of-care ultrasound (POCUS) is an integral aspect of critical care and emergency medicine curriculums throughout the country, but it has been slow to integrate into internal medicine residency programs. POCUS has many benefits for internal medicine providers, guiding diagnostic decisions and aiding in procedures. Additionally, POCUS is a convenient and portable resource specifically for internal medicine providers in the military when practicing in deployed or critical care settings. Critical care and emergency medicine clinicians are excellent resources to lead these courses. We sought to develop a new POCUS curriculum for internal medicine residents within the Naval Medical Center Portsmouth Internal Medicine Residency program with the support of emergency medicine and critical care medicine staff to lead and oversee the training. The project's aim was to increase internal medicine resident confidence with POCUS by 20% and proficiency with POCUS as evidenced by pretest and posttest analysis by 10%. The program consisted of a 2-day, 9-hour, introductory course, combining lecture with hands-on scanning taught by emergency medicine physicians who had completed emergency ultrasound fellowship-level training. This was followed by a longitudinal component of hands-on scanning throughout the academic year built into the residents' schedules. Emergency and critical care medicine ultrasound staff reviewed all studies for quality assurance (QA). The residents were given both precourse and post-course knowledge tests and confidence surveys, which utilized a 5-point Likert scale. The knowledge assessments were analyzed with a paired t-test, and the Likert scale data were analyzed using the Wilcoxon signed-rank test. The Naval Medical Center Portsmouth Institutional Review Board deemed this project nonhuman subjects' research. Twenty participants were enrolled, with 10 (50%) of those enrolled completing all course requirements. The average precourse knowledge assessment score was 76.60%, and postcourse assessment score was 80.95% (+4.35%, P = .33). The confidence survey scores were initially 73.33% and improved to 77.67% (+4.34%, P = .74). A curriculum comprised of a 9-hour workshop followed by a longitudinal hands-on experience can provide improvement in internal medicine resident POCUS knowledge and confidence. This model emphasizes the benefit of emergency and critical care cooperation for ultrasound training and provides an emphasis on medicine-relevant scans and longitudinal training.