Critical care medicine training and certification for emergency physicians

David T. Huang, Tiffany M. Osborn, Kyle J. Gunnerson, Scott R. Gunn, Stephen Trzeciak, Edward Kimball, Mitchell P. Fink, Derek C. Angus, R. Phillip Dellinger, Emanuel P. Rivers

Research output: Contribution to journalReview article

25 Scopus citations

Abstract

Demand for critical care services is increasing. Unless the supply of intensivists increases, critically ill patients will not have access to intensivists. Recent critical care society recommendations include increased graduate medical education support and expansion of the J-1 visa waiver program for foreign medical graduates. This article proposes additional recommendations, based on strengthening the relationship between emergency medicine and critical care medicine. Demand for critical care services is increasing. Unless the supply of intensivists increases, critically ill patients will not have access to intensivisis. Recent critical care society recommendations include increased graduate medical education support and expansion of the J-1 visa waiver program for foreign medical graduates. This article proposes additional recommendations, based on strengthening the relationship between emergency medicine (EM) and critical care medicine (COM). Critical care is a continuum that includes prehospital, emergency department (ED), and intensive care unit (ICU) care teams. Both EM and CCM require expertise in treating life-threatening acute illness, with many critically ill patients often presenting first to the ED. Increased patient volumes and acuity have resulted in longer ED lengths of stay and more critical care delivery in the ED. However, the majority of CCM fellowships do not accept EM residents, and those who successfully complete a fellowship do not have access to a U.S. certification exam in CCM. Despite these barriers, interest in CCM training among EM physicians is increasing. Dual EM/CCM-trained physicians not only will help alleviate the intensivist shortage but also will strengthen critical care delivery in the ED and facilitate coordination at the ED-ICU interface. We therefore propose that all accreditation bodies work cooperatively to create a route to CCM certification for emergency physicians who complete a critical care fellowship.

Original languageEnglish
Pages (from-to)2104-2109
Number of pages6
JournalCritical care medicine
Volume33
Issue number9
DOIs
StatePublished - Sep 2005

Keywords

  • Certification
  • Critical care medicine
  • Emergency medicine
  • Fellowship
  • Intensive care
  • Training

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    Huang, D. T., Osborn, T. M., Gunnerson, K. J., Gunn, S. R., Trzeciak, S., Kimball, E., Fink, M. P., Angus, D. C., Dellinger, R. P., & Rivers, E. P. (2005). Critical care medicine training and certification for emergency physicians. Critical care medicine, 33(9), 2104-2109. https://doi.org/10.1097/01.CCM.0000173412.43562.B3