About the Intensive Care Training Program

Intensive Care Training

Training in intensive care medicine is undertaken via the Joint Faculty of Intensive Care Medicine.  Conjoint training programs are available to trainees also undertaking anaesthesia and physician training.  Other conjoint programs are available for emergency medicine and surgical trainees.  At the completion of training, an intensive care specialist will have experience and expertise in:

• evaluation and resuscitation of critically ill patients;

• evaluation and management of patients with vital organ and system failures;

• the use of relevant, organ support and replacement systems;

• physiological monitoring and clinical measurement.

Trainees are expected to gain experience and expertise in the indications for and performance of a variety of investigational, therapeutic and monitoring modalities including:

• cardiopulmonary resuscitation

• airway management including translaryngeal intubation

• tracheostomy

• invasive haemodynamic monitoring including central venous, arterial and pulmonary artery cannulation and the interpretation and clinical use of derived variables

• fibreoptic bronchoscopy

• continuous renal replacement therapy

• mechanical ventilation including a comprehensive range of ventilatory modes and strategies

• tube thoracostomy

• intraaortic balloon counterpulsation.

• echocardiography.

• intracranial pressure monitoring.

• gastrointestinal endoscopy.

• biopsy of various organs and tissues.

• extracorporeal support techniques including cardiopulmonary bypass, ECMO, ECCO2R and ventricular assist devices.
  

Components of Training

The training requirements of the JFICM training program in General Intensive Care includes 12 months General Hospital Experience post graduation plus 36 months of basic training and 36 months of advanced training. 

See attached training sequence diagram.

The Basic and Advanced training program in intensive care must include:

• 24 months training in intensive care in units approved by the Board for core training which must be undertaken during advanced training.  One core year of intensive care training must be continuous.  The second core year of intensive care training may be spent discontinuously in two periods of six months each. At least 12 months must be undertaken in a unit or units accredited as C24, and only one rotation to a unit classified as C6 is permitted without prior approval of the Censor.  In-Training Assessments for this period of training are required.  At least 6 months of intensive care training must be undertaken as a Senior Registrar. 
•  12 months  approved clinical internal medicine post, at least 6 months of which must be undertaken as a Registrar.
•  12 months exclusively in clinical anaesthesia, not necessarily continuous.
•  24 months in any combination of General Medicine, Specialist Medicine, Emergency Medicine, Surgery, Research, Intensive Care, Clinical Anaesthesia, other disciplines related to intensive care.
• Success at the JFICM Primary Examination, or a Primary Examination approved by the Joint Faculty
• Success at the Joint Faculty’s Fellowship Examination in intensive care
• Successful completion of a Formal Project
• Successful completion of a Medical ADAPT Workshop
• An approved Part I or Primary Examination must be successfully undertaken prior to the commencement of advanced training.
  

The JFICM Fellowship Examination may be undertaken following the successful completion of at least 12 months of Advanced Core Intensive Care training.  This Examination is conducted twice a year, with the written sections held in any capital city in Australia, and some cities in New Zealand and Hong Kong.  The oral/clinical sections of the Examination are held alternatively in Adelaide, Brisbane, Melbourne and Sydney.

Please note that, in order for Advanced training to be recognised, trainees must register within three months of commencing in an approved post. 

 A separate endorsement is available in Paediatric Intensive Care, based on the above training program.

Procedural Skills

These are detailed above. The completion of a logbook documenting the extent of the training experience in procedures undertaken and the number and casemix of patients managed is desirable in ensuring that the trainee’s experience has been appropriately broad and complete. The supervisor will review logbook(s) when preparing the supervisor’s report.

Formal Project

Trainees are required to submit a satisfactory project during the period of advanced training. Completion of training can not be certified nor Fellowship recommended until a satisfactory report has been received and appropriately reviewed.

The report must be based on a research project in which the trainee has participated to a significant degree. The report must be prepared by the trainee as if for publication in a scientific journal. Although publication is not mandatory, it is encouraged, and manuscripts submitted for publication may also be submitted as the project report. The project must be substantial; individual case reports are not acceptable. Presentation of the report at a scientific meeting is encouraged.

The project report is to be evaluated by the trainee’s supervisor and the evaluation (including an assurance that the trainee has been a major contributor to the project and the principal author of the report) is to accompany the report when submitted. Final evaluation will be undertaken by the Training Committee.

Medical ADAPT Course

Trainees must also successfully complete the Medical ADAPT Course during their six years of training.  It is recommended that this takes place during Basic Training.

Training Posts

The suitability for training of a clinical post will depend upon the facilities available in the unit; the staffing of the unit; the level of functioning of the trainee within the clinical structure; the level of supervision of the trainee; and the number and casemix of patients treated within the intensive care unit. It is desirable that experience in more than one intensive care unit be obtained during the period of core training. Not all Australasian intensive care units are suitable for the entirety of core training although it is likely that most would be suitable for six or twelve months of core training.  Trainees are advised to determine the suitability of training sites before undertaking employment, especially if this involves a smaller highly specialised intensive care unit.