Intensive care medicine

Doctors working in intensive care medicine manage the sickest patients in the hospital: critically ill patients who already have organ dysfunction and organ failure.

They also care for patients at risk of developing such problems and who a require level of care and observation than cannot be offered on a normal ward. 

Doctors in hospital

Life in intensive care medicine (ICM) 

You will be part of the multi-disciplinary team providing care for these very sick and at risk patients. You will work closely with other doctors, ACCPs (advanced critical care practitioners), nurses, physiotherapists, pharmacists and other allied health professionals. Together this effective and integrated team work to provide continuous, high-quality health care for the sickest and most vulnerable patients in the hospital. The work will include providing organ system support and the investigation, diagnosis and treatment of acutely ill patients. 

You'll also learn about patient safety, how to care for patients at the end of their life, how to support their families, and how the intensive care unit (ICU) fits into the rest of healthcare provision. 

You will learn to support patients and treat a wide range of conditions: 

  • heart and cardiovascular failure 
  • renal failure 
  • liver failure 
  • patients with reduced levels of consciousness or neurological impairment  
  • gastrointestinal failure 
  • respiratory failure 
  • sepsis and septic shock 
  • patients who have been involved in trauma 
  • acute intoxications and poisoning 
  • patients recovering from major surgery 
  • pregnancy related illnesses and complications 

Doctors in ICM use practical skills and perform procedures to help monitor and manage their patients. You will need to learn how to assess, monitor and review a patient with, or at risk of developing, critical illness. 

You will also learn to support and monitor organs which are failing through:

  • cardiovascular system support, by use of fluids, inotropes (drugs that stimulate the heart) and vasopressors (drugs that raise reduced blood pressure) 
  • respiratory support, using ventilators or other devices to assist breathing 
  • invasive monitoring, including arterial and central venous cannulation 
  • airway interventions such as intubation and tracheostomy  
  • measurement of cardiac output and blood flow around the body 
  • renal support using kidney replacement therapies (haemodialysis or haemofiltration)  
  • how to safely transfer critically ill patients for specialist investigations and interventions such as a CT scan 

How much can I earn? 

You’ll first earn a salary when you start your foundation training after medical school. The basic salary ranges from £32,398 to £37,303. Once you start your specialty training in the NHS, you can expect to earn a salary of at least £43,923, which can increase to between £93,666 and £126,281 as a consultant.

How about the benefits? 

  • make a difference to patients and their families  
  • work in one of the strongest multidisciplinary teams in healthcare  
  • excellent supervision during your training 
  • work flexibly or part-time  
  • high income early in your career   
  • work anywhere in the world   
  • part of an excellent pension scheme 
  • good holiday entitlement 
  • NHS discounts in shops and restaurants 

Must-have skills 

  • excellent communication skills to manage a wide range of relationships with colleagues, and patients and their families  
  • emotional resilience, a calm temperament, and the ability to work well under pressure  
  • teamwork and the capacity to lead multidisciplinary teams  
  • inquisitive mind and excellent problem-solving and diagnostic skills  
  • organisational ability, effective decision-making skills, first class time management and be prepared to learn how to use available resources to benefit your patients

Entry requirements 

Your first step is medical school. Typically, you will need excellent GCSEs and three A or A* passes at A level including chemistry for a five-year undergraduate degree in medicine. Many medical schools also ask for biology and others may require maths or physics.   

If you already have a degree, you could study for a four-year postgraduate degree in medicine.  

You’ll need to pass an interview and admissions test. You’ll be asked to show how you demonstrate the NHS values such as compassion and respect.  

Some medical schools look to recruit a mix of students from different backgrounds and geographical areas, so your educational and economic background and family circumstances could be considered as part of your application. 

What are my chances of starting a career in intensive care medicine? 

There are approximately 783 doctors training in intensive care medicine (ICM) in the NHS in England. In 2021, there were 595 applications for 203 specialty training places. 

How to become a doctor in intensive care medicine 

After medical school, you’ll join the paid two-year foundation programme where you’ll work in six placements in different settings.  

After your foundation programme, you will need to spend three to four years in a paid training programme that provides initial training in ICM. There are several options available: ACCS (Acute Care Common Stem), anaesthesia and internal medicine (IMT). In each of these programmes you will gain experience in intensive care along with experience in at least one other specialty. Spending time in specialties allied to ICM benefits your training enormously by broadening your experience. Remember that patients from all medical specialties and disciplines can need looking after in the intensive care unit when they become very unwell. 

On completion of one of these initial training programmes you can apply for paid specialty training in intensive care medicine. You may choose to specialise in ICM alone, or to train in ICM along with another specialty such as anaesthesia, emergency medicine or one of the acute medical specialties (for example acute medicine, respiratory medicine, renal medicine). 

You may be able to train part time, for example for health reasons or if you have family or caring responsibilities. 

Where a career as a doctor working in intensive care medicine can take you 

During higher training in ICM you will have the opportunity to develop a ‘special skill’ or interest during your training. The intensive care medicine curriculum currently includes the following ‘special skills’: 

  • academic research 
  • cardiac intensive care medicine 
  • echocardiography 
  • extra-corporeal membrane oxygenation 
  • education 
  • home ventilation 
  • neuro intensive care medicine 
  • paediatric intensive care medicine 
  • pre-hospital emergency medicine 
  • quality improvement in healthcare 
  • transfer medicine 

Other roles that may interest you

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