Intensive Care

The Imperial school offers a wide variety of intensive care experience, from general medical/surgical through to specialist trauma, neurological/neurosurgical and cardiology/cardiothoracic centres

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Intensive care medicine is an exciting speciality that complements many core skills of anaesthesia. This is reflected in the anaesthesia training programme and curriculum; as a minimum, trainees will complete a three month block of intensive care medicine at both core, intermediate and higher levels. 

Trainees interested in becoming a consultant in intensive care medicine will need additional training to achieve a separate CCT or equivalence via a CESR. The equivalence process is not covered here and more information can be found on the Faculty for Intensive Care website.

The ICM CCT 

Prior to July 2013, anaesthesia trainees could apply locally to be entered to a joint CCT programme with ICM. However a review in 2010 by PMETB (since absorbed into the GMC) identified the need for a separate ICM training programme and a separate ICM CCT in 2012, trainees now apply for a speciality training post in ICM as they would for any other training programme. 

Trainees can apply for ICM as a single CCT or alongside another speciality in order to obtain dual CCTs. Only certain other CCTs - anaesthesia, emergency medicine and selected medical specialities (respiratory, renal and acute medicine) - have agreed dual training programmes with ICM. This means that competences can be cross counted and the two CCTs (usually seven years each in duration) can be achieved in a shorter time frame. Based on 2016 application data, almost two thirds of trainees entering an ICM CCT wish to dual accredit with anaesthesia.

Application

As there is no core training programme in ICM, trainees can apply from core medical, core anaesthetic or ACCS training. You must have achieved the associated examination for that level (ie MRCP, primary FRCA, or MCEM) prior to application.

The application window is open once per year and is coordinated nationally by Health Education West Midlands. This is an online process and usually occurs in February for each August start date. In 2016 there were 158 posts available of which 30 were in London schools.

If you wish to undertake a single CCT in ICM then you can apply for any national post. Things are more complicated for those wishing to obtain a dual CCT - the key points being:

  • Recruitment is "stepped" and you can only be appointed to one CCT at each recruitment episode; for example, if you are a CT2 trainee and want to dual accredit, you are eligible to apply for both ST3 anaesthesia and ST3 ICM - but even if you are successful in both interviews, you can only accept one offer. If you still wished to dual accredit you would need to reapply for the other CCT in the next recruitment episode
  • If you have already being appointed to anaesthesia (or another CCT) and wish to dual accredit with ICM, you can only apply for posts in the same training area/LETB; for example, if you are an Imperial School ST3 anaesthetic trainee, you can only apply for London ICM posts. 
  • If you have already being appointed to anaesthesia (or another CCT), you cannot apply to dual accredit with ICM if you are beyond ST5 or at the time of your expected ICM CCT start date

Structure of dual training with anaesthetics

This section is being updated, please refer to the FICM website in the interim and check back soon.

Once appointed to both CCTs, trainees will meet with both training programme directors to agree a training programme to provide opportunities to achieve the required competences for both CCTs. For trainees applying from a background of core anaesthetic training, this will usually mean an additional 12 months training in acute or emergency medicine.

ICM training is broadly split into three stages:

  • Stage 1 - covers core training up until the end of ST4
  • Stage 2 - covers ST5/6, during which time the FFICM examination must be completed
  • Stage 3 - an advanced year of ICM training

Examinations

The ICM CCT now has its own final examination - the FFICM. A primary examination may be introduced at some point, but currently the primary FRCA, MRCP or MCEM examinations fulfil the entry criteria to ST3 application.

The FFICM examination can be taken at any point from the start of stage 2 training, although the Faculty may make exceptions for dual trainees appointed to the ICM CCT later in their parent specialty progression to allow them to enter prior to being signed off for stage 1.

The FFICM comprises a written MCQ examination, which must be passed before the trainee can apply for a viva and OSCE. In similarlity to the primary FRCA, both the viva and OSCE are taken together at the first sitting and in the event of failing either, are only required to resit the component they failed.

More information on the FFICM is available on the FICM website.

ICM Training Programme directors 

Please see the key people page for contact details of the TPDs for both the previous joint and current dual CCT programme.

Research in ICM 

The Imperial school has a strong reputation in the field of ICM research. If you are interested in doing research in Intensive Care Medicine then please take a look here.

North West London Critical Care Network 

The vast majority of the intensive care units in the Imperial School are part of the North West London Critical Care Network (NWLCCN). The NWLCCN is key in developing training and policy for critical care service provision in the area.

The NWLCCN run a regular, free transfer training course and have developed a free smartphone app called the Safer Transfer App (STrApp) to provide support, advice and information for anyone involved in transferring the critically ill patient. Their website contains several training videos and other useful information.

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