Intensive Care Medicine
Intensive Care Medicine involves the management of patients who are critically-ill with life-threatening conditions. Specialists commonly work in an ICU.
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Entry Route into Intensive Care Medicine
Applicants must have completed the two-year Foundation Programme to be eligible to apply for a core training programme. Training in Intensive Care Medicine (ICM) takes at least seven years on the single training pathway and eight and a half years if trainees chose dual training. The three training pathways for core training are:
Trainees need to complete the speciality examination for the relevant Royal College – such as the Royal College of Emergency Medicine, the Royal College of Anaesthetists, or the Royal College of Physicians.
Job Progression as an ICM Specialist
Entry into higher speciality training is at ST3, and it takes at least five years to complete ST3-7. In ST5 and ST6, trainees work in subspeciality areas including paediatric ICM, and neuroscience. They also complete a special skills year, during which they can develop an interest in a specific area of ICM – such as pre-hospital medicine, echocardiography, or academic ICM. To continue training to the final year, trainees must pass the Final Fellowship of the Faculty of Intensive Care Medicine (FFICM) examination. Finally, ST7 is spent solely in Intensive Care Medicine.
Dual certification is possible in ICM, with dual programmes for Acute Medicine, Anaesthesia, Emergency Medicine, Renal Medicine, and Respiratory Medicine. This extends the training programme to at least eight and a half years.
Trainees enter the first speciality and then compete for posts in the second speciality in the following year. If more than 18 months elapses before the trainee enters the second speciality, the GMC will award them a Certificate of Eligibility for Specialist Registration (Combined Programmes) in the second speciality, rather than a CCT. Trainees who are on the dual-CCT programme will work in their partner speciality during their special skills year.
Competition for ICM Posts
The competition ratio in 2017 at ST3-level was 1.42, with 231 applications for 163 posts.
In December 2017, there were
- 558 consultants,
- 4 associate specialists,
- 29 speciality doctors,
- 669 speciality registrars,
- 276 core trainees,
- 82 F2 trainees, and
- 30 F1 trainees.
Salaries in Intensive Care Medicine
The salary for NHS consultants ranges from £76,000 to £102, 500, and for speciality doctors from £37,500 to £70,000. The salary for doctors in training ranges from £26,350 to £45,750.
A Day on the ICU
A typical day starts with a ward round on the ICU, with duties including teaching, supervising junior colleagues, and performing practical procedures such as endotracheal intubation, intercostal drain insertion, and pulmonary artery catheterisation. There is often a second ward round in the late afternoon where treatment plans are reviewed for the evening. The on-call rota for consultants is typically one-in-five, or one-in-eight. Some consultants may see patients in follow-up clinics after they are discharged from the ICU.