Emergency medicine residents seeking to broaden their expertise and tackle the most challenging cases often look towards critical care. Becoming a board-certified intensivist can significantly enhance your career, opening doors to diverse opportunities and allowing you to provide the highest level of care to critically ill patients. This guide explores the Best Critical Care Programs available to emergency medicine residents, answering key questions and outlining your path to critical care certification.
Why Choose Critical Care After Emergency Medicine Residency?
The synergy between emergency medicine and critical care is undeniable. As an emergency physician, you are already adept at managing critically ill patients in their most acute phase. You excel at rapid assessment, resuscitation, and making crucial decisions under pressure. A critical care fellowship builds upon this strong foundation, offering specialized training to manage these complex patients throughout their intensive care unit (ICU) stay.
Pursuing critical care training offers several significant career advantages:
- Develop a Niche Expertise: Specialization makes you a highly sought-after expert, enhancing your career prospects and job satisfaction.
- Expand Career Opportunities: Intensivists are in high demand in both private and teaching hospitals. Many emergency medicine trained intensivists hold positions as medical directors of ICUs.
- Combat Burnout: The combination of emergency department and ICU work provides a stimulating mix of fast-paced and cerebral environments, potentially reducing burnout.
- Lead in Early Critical Care: With increasing ED overcrowding, critically ill patients often remain in the emergency department longer. Critical care training equips you to lead and optimize the care of these patients in the crucial early hours.
Critical Care Fellowship Pathways for EM Residents
Emergency medicine residency provides an excellent springboard into critical care fellowships. You are a desirable candidate for these programs due to your unique skillset in initial resuscitation and managing undifferentiated, critical illness. Certification in critical care is attainable through various routes, primarily via fellowships in internal medicine, surgery, and anesthesiology.
Board Certification Options
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Internal Medicine: A 2-year internal medicine critical care fellowship is a well-established route to certification through the American Board of Internal Medicine (ABIM). A grandfathering track may also exist, although it’s essential to check the latest ABIM guidelines for current eligibility.
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Surgery: For residents from 2012 onwards, the American Board of Surgery (ABS) offers critical care certification after a 2-year fellowship. Note that one year will involve a surgical rotation experience. Grandfathering options are not available through this route.
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Anesthesiology: Agreements are in place allowing emergency medicine residents to pursue critical care certification through anesthesiology fellowships. Specific details should be obtained directly from the American Board of Anesthesiology (ABA) and individual program websites.
Top Recommended Critical Care Programs
Choosing the right fellowship program is crucial. The following programs are known for actively welcoming and valuing emergency medicine residents, making them excellent choices for your critical care training:
- Shock Trauma Center (Baltimore) [Surgical and Medicine tracks]
- Indiana University [Anesthesia]
- University of Pittsburgh [Anesthesia and Medicine]
- Henry Ford Hospital
- Cooper University Hospital
- Beth Israel Deaconess Medical Center (Boston)
- University of Alabama at Birmingham
- University of Michigan [Anesthesia and Medicine]
- University of Iowa Hospitals and Clinics
- Stanford University
- University of Washington (Anesthesia and Internal Medicine tracks)
- University of Nebraska Medical Center
- UC San Diego Health
- Geisinger
- Emory University
- Hennepin Healthcare
It is advisable to visit program websites for the most current information on application requirements and program focus.
Specialized Critical Care Training Options
Beyond the standard critical care fellowship, consider these specialized paths:
Resuscitation Fellowship
For those passionate about mastering resuscitation and emergency department critical care without working in the ICU long-term, a dedicated resuscitation fellowship is an excellent option. Stony Brook’s 1-year advanced training in resuscitation is a leading example.
Neurocritical Care
Neurocritical care is another area where emergency medicine physicians can excel. Certification in neurocritical care has become increasingly accessible for EM-trained physicians. While grandfathering periods may have closed, dedicated neurocritical care fellowships remain a viable path.
Preparing for Critical Care Certification
While the American boards have their certification exams, resources like this discussion on the British exam offer valuable insights into the rigor and preparation needed for critical care board exams in general.
Additional Resources
For further information and a broader perspective on critical care training, consult resources from organizations like the Society of Critical Care Medicine (SCCM) and the American College of Emergency Physicians (ACEP). The Association for Emergency Medicine-Critical Care Medicine Program Directors (AEMCCMPD) website is also an invaluable resource for EM residents interested in critical care fellowships.
Relevant References
- Tisherman S, Spevetz A, Blosser S, et al. A Case for Change in Adult Critical Care Training for Physicians in the United States: A White Paper Developed by the Critical Care as a Specialty Task Force of the Society of Critical Care Medicine. Crit Care Med. 2018;46(10):1577-1584. [PubMed]
Embark on Your Critical Care Journey
A critical care fellowship is a powerful career move for emergency medicine residents. It allows you to deepen your expertise, expand your career horizons, and become a leader in the management of critically ill patients. Explore the best critical care programs listed and take the next step towards becoming a board-certified intensivist.
