Intensive care medicine
Doctors working in intensive care medicine (ICM) manage critically ill patients with, at risk of, or recovering from, potentially life-threatening failure of any of the body’s organ systems.
This page provides useful information on the nature of the work, the common procedures/interventions, sub-specialties and other roles that may interest you.
Nature of the work
Doctors in this specialty (also called critical care medicine) are involved in all aspects of care of the critically ill. This includes providing organ system support and the investigation, diagnosis, and treatment of acute illness. It also includes systems management and patient safety, ethics, end-of-life care and the support of families.
As an intensivist or trainee in ICM you will help to treat various conditions, including:
- heart and cardiovascular failure
- renal (kidney) failure
- liver failure
- patients with reduced levels of consciousness or neurological impairment (including weakness)
- gastrointestinal failure
- respiratory failure
- sepsis – a serious immune system reaction triggered by infection
- patients with severe trauma
- acute intoxications and poisoning
- patients recovering from major surgery
- maternal complications around the time of birth of a child
Common procedures/interventions
These include:
- assessment, monitoring and review of patients with or at risk of developing critical illness
- provision of organ system support, including:
- use of inotropes (drugs that stimulate the heart) and vasopressors (drugs that raise reduced blood pressure)
- mechanical ventilation – using a machine known as a ventilator to assist breathing
- invasive monitoring, including arterial cannulation where a tube known as a cannula is inserted into a blood vessel, usually for the delivery or removal of fluids
- endotracheal intubation – a flexible tube is inserted through the nose or mouth into the trachea for artificial ventilation or for the administration of gases during anaesthesia
- percutaneous dilatational tracheostomy – a minimally invasive procedure where the trachea (wind-pipe) is opened from the front of the neck to enable air to be passed into the lower air passages
- measurement of cardiac (heart) output
- renal (kidney) support using haemodialysis or haemofiltration (techniques used to ‘purify’ the blood of patients with kidney failure
- transfer of critically ill patients for specialist investigations and interventions such as CT scans
Sub-specialties
Trainees who are training in ICM as a single specialty will have the opportunity to develop a ‘special skill’ or interest during their training. The ICM curriculum currently includes the following ‘special skills’ years*:
- academic research
- cardiac intensive care medicine
- echocardiography
- extra-corporeal membrane oxygenation (ECMO)
- education
- home ventilation
- neuro intensive care medicine
- paediatric intensive care medicine
- pre-hospital emergency medicine (PHEM)
- quality improvement in healthcare
- transfer medicine
* It is that expected that additional options will be available in the future as the specialty develops.
Many intensivists are ‘dual trained’ in ICM along with one of ICM’s partner specialties. Common partner specialties include anaesthesia, acute internal medicine, emergency medicine, renal medicine and respiratory medicine. Those consultants who are ‘dual trainees’ often work in both specialties: the proportion of time spent in each of the specialties is very variable and is based both on an individual consultant’s preference, and/or service requirements.
Want to learn more?
Find out more about:
- the working life of someone in intensive care medicine
- the entry requirements and training and development