Current Practice, Demographics, and Trends of Critical Care Trained Emergency Physicians in the United States

Abstract

Objectives: Critical care medicine (CCM) is of growing interest among emergency physicians (EPs), but the number of CCM-trained EPs and their postfellowship practice is unknown. This study's purpose was to conduct a descriptive census survey of EPs who have completed or are currently in a CCM fellowship. Methods:The authors created a Web-based survey, and requests to participate were sent to EPs who have completed or are currently in a CCM fellowship. Responses were collected over a 12-month period. Physicians were located via multiple whom electronic mailing lists, including the Emergency Medicine Section of the Society of Critical Care Medicine, Critical Care Section of the American College of Emergency Physicians, and the Emergency Medicine Residents' Association. The authors also contacted CCM fellowship coordinators and used informal networking. Data were collected on emergency medicine (EM) and other residency training; discipline, duration, and year of CCM fellowship; current practice setting; and board certification status, including the European Diploma in Intensive Care (EDIC).Results: A total of 104 physicians completed the survey (97% response rate), of whom 73 had completed fellowship at the time of participation, and 31 of whom were in fellowship training. Of those who completed fellowship, 36 ⁄ 73 (49%) practice both EM and CCM, and 45 ⁄ 73 (62%) practice in academic institutions. Multiple disciplines of fellowship were represented: multidisciplinary (39), surgical (28), internal medicine (16), anesthesia (14), and other (4). Together, the CCM fellowships at the University of

Emergency Medicine: An Integral Component of the Continuum of Critical Care That is Devalued by Fellowship Programs

“…Despite these historical facts and the Intensivist shortage, emergency physicians (EPs) have traditionally been limited in CCM training and board certification in this country (2,4). In comparison, providing unimpeded access to board certification for CCM-trained EPs is standard practice in Europe and other parts of the world (2).…”

Critical Care in the Emergency Department

“…Herring et al (10) are to be commended for bringing to the fore new national data that reflects the increasing volume of critical illness in the ED. The findings of this study, which may even underestimate the volume of critically ill in the ED, highlight the need for more in-depth analysis of critical care in the ED, close coordination of the ED and ICU, enhanced CCM training of ED clinicians and opening the ICU workplace to CCM-trained ED clinicians (16). Fortunately, these initiatives are already underway, and with this study, we are better prepared to understand the changing nature of the critical care workload within the ED.…”

Training a hospitalist workforce to address the intensivist shortage in American hospitals

“…However, to meaningfully impact the intensivist shortage, the number and capacity of medical critical care fellowships, which currently train approximately 10% of the critical care workforce, would need to significantly expand (13).…”

“…Although the addition of a sanctioned EM critical care pathway is a positive development, it is unlikely to significantly impact the intensivist shortage in the near term. Between 2000 and 2007, 43 EM physicians entered nonboard sanctioned American critical care fellowships (13), while in the 2011-2012 academic year, 1957 trainees are enrolled in adult critical care medicine fellowships (surgery, anesthesia, medical critical care, and pulmonary/critical care) (14). It remains to be seen if the availability of a formal critical care pathway will significantly increase the numbers of EM physicians who pursue critical care training.…”