Training and development (Intensive Care Medicine)
This page provides useful information on the training and development for this specialty and also has tips for people at all stages of their training including medical school.
Training
Intensive Care Medicine (ICM) training takes a minimum of seven years on the single training pathway and 8.5 years on the dual training pathway.
There are four main training pathways for intensive care medicine:
Acute care common stem training (ACCS) - any of the ACCS training pathways: anaesthetics, acute medicine route (AM), or emergency medicine (EM), these are three-year programmes
Core anaesthetic training (CAT), which is a two-year programme
Internal medicine stage 1, which is a two to three-year programme. Trainees may join intensive care medicine after year 2 if they have full MRCP Diploma
In addition, trainees need to complete the respective specialty examination for the pathway:
MCEM (parts A, B & C) for ACCS EM candidates
Primary FRCA for CAT's or ACCS (anaesthesia) candidates
A pass in one of these primary examinations confers eligibility to sit the FFICM Final examination (Fellowship of the Faculty of Intensive Care Medicine).
Trainees can enter specialty training in ICM at ST3 level. Training takes a minimum of five years (ST3-7). During ST3&4, trainees develop the core competences that they have not covered already in their core training in addition to extending their ICM experience. This may include additional time in anaesthesia, ICM and AM.
In ST 5 & 6, trainees gain experience of sub-specialty ICM including cardiothoracic, neurosciences and paediatric ICM in addition to further general ICM experience. Their training may also include the development of a specialist skill relevant to ICM. This year is aimed at developing trainees’ interest in a specific aspect of ICM work. Opportunities include academic ICM, management, pre-hospital medicine, education and echocardiography (see above – Special Skills in ICM).
Individuals are required to pass the Final FFICM examination in order to progress to the final year (ST7). The final year is spent exclusively in ICM and is aimed at developing high-level clinical and non-clinical skills.
Some trainees may wish to undertake a dual CCT programme leading to a qualification in both ICM and a partner specialty. A trainee must be appointed to a dual training programme before the end of their ST5 training year.
Depending on the individual’s previous experience and chosen partner specialty, dual training will extend the training period to a minimum of 8.5 years. Recruitment is stepped, ie trainees enter the first specialty (either ICM or partner) in one recruitment episode and compete for entry to the second specialty the following year. If the trainee enters the second specialty more than 18 months after entering the first, then the GMC will award them a CESR(CP) in the second specialty, not a CCT. For Dual CCT trainees, training during their special skills year will be undertaken in their partner specialty.
Application to the partner specialty is through competitive national interviews. Dual programmes are available in:
consider becoming a student member of the BMA (the British Medical Association is the trade union and professional association for doctors and provides careers advice)
make your specialty decision in good time so that you can test it out before committing yourself, e.g. by using hospital visits and clinical placements arranged as part of your course to ask questions and observe people at work
choose the topic of your supervised research project carefully to test out your thinking
remember your first priority is to demonstrate that you have developed the personal, learning, clinical, practical and management skills needed by all doctors
think laterally when applying for rotations – vacancies may not be available in ICM so apply for a rotation in a related field such as anaesthesia, renal medicine, respiratory medicine, acute internal medicine or emergency medicine
participate in the RCP career mentoring scheme for the chance to be mentored by an ICM consultant or trainee
talk to your clinical and educational supervisors about particular areas of interest to explore
use full placements to experience specialties that you might be interested in or apply for taster experiences if you can’t get a placement
talk with your peers about their career ideas and experiences – you may be able to help each other
listen to information and advice from more experienced doctors but make your own decisions
taking part in a clinical audit is important for your development as a doctor but you may be able to choose an audit project related to a specialty that interests you
ensure your Foundation e-portfolio has plenty of medical evidence and that this is kept properly up-to-date
try to gain teaching and management experience
look at competition ratios (ie the number of applicants to places) critically. Find out what is happening this year and spot any regional differences in competition ratios
write case reports or make presentations (in acute medicine, for instance) with an ICM focus
ensure a good grounding in acute general medicine
speak to consultants about what the role is like
read as much information as you can on the websites of relevant professional bodies
impress interviewers by showing that your interest in the specialty is intrinsically motivated, ie you are drawn to the work and not just attracted by admiration of someone you have shadowed (You will also be happier in your career in that specialty many years later!)
be prepared to move to where the vacancies are
continue to develop your practical and academic expertise
undertake a research project
try to get some of your work published and present at national and international meetings
join or start a Journal Club (a group who meet to critically evaluate academic research)
teach junior colleagues
take on any management opportunities you are offered
