https://jficmi.anaesthesia.ie/wp-content/uploads/2020/09/Brain-Death-Guidelines-September-2020.pdf
This will be held in September. It is hoped that there will be a significant turnout for the Faculty’s Honorary Conferring of Professor Martin Tobin – only the second ever Honorary Conferring by the Faculty. Professor Tobin will be speaking on a topic on which he is world leader: “How to be successful in weaning mechanical ventilation” and he will also deliver the key-note address: “Medicine: Art of Science”. Martin is from Kilkenny and always relishes the opportunity to come home.
Both John Bates and Maria Donnelly finish their terms on the board having served with distinction as Vice Dean and Treasurer respectively. Dr Ruth Aoibheann O’leary is stepping down as the trainee’s elected representative as she is destined for Melbourne to pursue her interests in ICU Medicine. New Elections by online voting will be announced shortly.
Dr Rory Dwyer (President of the ICSI) and Dr Michael Power (Clinical Lead of Critical Care Programmes) recently met with Minister Simon Harris and outlined the difficulties and challenges facing Intensive Care Medicine in Ireland at present. ICU bed numbers have have fallen despite the recommendations of the Prospectus report that there should be an increase in bed capacity. The minister was reported to be very positive about the submission, particularly given that it was a joint submission from the ICSI and the Irish Association for Critical Care Nurses. This is a component of the ongoing work of the Critical Care Programme.
This course was reactivated and run on April 25th by Dr Ian Conrick-Martin. It is a required course for JFICMI trainees. Based upon feedback, future courses are likely to feature greater emphasis on role-play and simulation scenarios. The performance of BSD testing is one of the key competencies in ICM training, and while the theory of BSD is a frequent examination question, formal conduct of BSD testing is an important learning opportunity for all trainees. Based upon feedback, all supervisors of training should afford maximum exposure of all trainees to each BSD testing situation.
The issue of achieving Medical Council recognition for the JFICMI’s training programme in Intensive care Medicine remains a pressing and immediate issue and the JFICMI is concerned inter alia that the status of the trainees who are undertaking this training does not seem to be getting due recognition. The Joint Faculty is reviewing the current position with others including its constituent colleges (CAI, RCPI and RCSI) and will shortly be writing again to the Medical Council ahead of its next council meeting in July.
The Joint Faculty’s AGM will be held at the time of its next refresher course meeting on Thursday, Sept 21st. Donal Ryan is convenor for the Refresher Course. Elections for Board positions (ordinary and elected trainee representative) will be called by the Hon Secretary (Dr Vida Hamilton) before then. They will conducted on-line as before with a planned prior notification from the JFICMI.
Eight of the ten candidates passed the exam. Post exam counselling was provided for the unsuccessful candidates. Our congratulations to the successful candidates: Drs Immanuel Hennessy, John Fitzgerald, Aoife Quinn, Michelle O’Mahony, Laura Flood, Bill Walsh, Bairbre McNicholas and Aoife Lavelle.
Exam course feedback and Training subgroup: The feedback was useful and the Chair of the Examination: Andrew Westbrook plans tabling the feedback at the planned examiners’ workshop in the Autumn – with a view to updating the website ‘Guide to the Fellowship clinical examination’, if necessary. There is also a provisional plan to do this workshop in conjunction with the new Training subgroup which will incorporate all of the Supervisors of Training nationally under the Chairmanship of Brian Marsh
Splitting of the exam: Further to a matter raised by the Trainee representative, there was general agreement that the written and clinical components of the current exam will be split so that there will be two exams – a written and a clinical. Regulations will be drawn up by the E and T committee. There was general agreement that there should be some limited ability for a candidate to ‘carry’ success at the first exam if he / she happened to be unsuccessful at their first attempt of the second part.
There is significant concern given the shortage of ICU beds and other limitations, that the capacity of Ireland to deal with a major casualty incident (MCI) is an increasingly relevant issue. This issue had been outlined by Dr Marsh and others at the ICSI Meeting in Belfast. Collaboration between the Dublin ICU network and national networks via the the hospital groupings framework is proposed as a way of achieving improved coherence to the advocacy in this respect.
Recently approved ICSI guidelines governing the process of DCD
The JFICMI shall provide for recognition of Basic CCE at defined training sites. Certification at such sites shall support the ability of a candidate to progress to advanced CCE training and accreditation. The attached document outlines the prerequisites for trainees, mentors and supervisors together with the expected knowledge and skills essential to accreditation at this level. The approved logbook is also attached.
JFICMI Basic Critical Care Echo
Dr Marsh, as Chair of Training, had a meeting with the JFICMI Supervisors of Training(SOTs) which was successful and many aspects of training now clarified. There is a reasonable awareness of the new 2-part exam structure and the specific regulations will be written by the Chair of the Examination, Dr Andrew Westbrook in conjunction with website personnel and published shortly. There is also increasing awareness of the facilities and advantages of the new website logbook format among trainees and SOTs.
It was agreed that the JFICMI SOTs would conduct the end-of-module assessments for the post-CST (post FJFICMI) trainees, the Special Interest Year (SIY) trainees (including those doing 6-mths modules in one institution) and for the 2-mth modular trainees in Intensive Care. The JFICMI Training sub-committee will collate the assessments.
Noted also that the CAI Training Committee is conducting a review of the Intensive Care component of its overall training and any potential for interaction will be addressed once outcome known. JFICMI plans this year to conduct interviews for SIY candidates (when the post CST interviews are being held) and will liaise with the CAI Training committee in this respect.
HST in Intensive Care Medicine
Curriculum and Minimum Requirements
The winners of the ICSI Kate Flynn Prize 2018 are Dr Maeve McAllister and Dr Teresa Sweeney of Our Lady of Lourdes Hospital, Drogheda, Co Louth. The case submitted was Acute Intermittent porphyria leading to posterior reversible encephalopathy syndrome (PRES): a rare cause of abdominal pain and visual disturbance. The authors of the case are T Sweeney, M McAllister, and D Divney.
The Irish National ICU Audit was established by NOCA in 2013 and focuses on the care of patients in adult Intensive Care Units (ICUs) and Paediatric Intensive Care Units (PICUs). This audit was led by Dr Rory Dwyer and Dr Martina Healy
The objectives of the Irish National ICU Audit include the following:
Irish_National_ICU_Audit_Annual_Report_2017_FINAL
While it is not a requirement to be on the new (ICM) section of the specialist register to practise Intensive Care Medicine in Ireland, the Faculty is encouraging all eligible doctors to register. Consultants with ICM practice and those doctors who have recently completed JFICMI training in Ireland are strongly encouraged to apply. This will help to regularise the current situation with regard to Intensive care Medicine in Ireland.
You may apply at https://www.medicalcouncil.ie/Contact-Details/Registration-Contact/. Select “Request Application Pack” from the dropdown menu and indicate in the free text area that you require the Intensive Care Medicine Application pack. The fee is normally €4037.00 but to encourage the above, there is a reduced fee for one year for Fellows of the JFICMI (in good standing), as the JFICMI is foregoing any fee for this work. The reduced fee of €490 pertains until 30April2020.
The annual retention fee is fixed at €605 per practitioner i.e. you do not have to pay twice for inclusion on two sections of the specialist register. Holders of the FJFICMI who do not wish to apply for specialist registration in ICM may retain their base specialty registration and apply to have their additional qualification (FJFICMI) registered.
In line with the new phase in the development of ICM in Ireland (opening of the ICM specialist register and formal commencement of the JFICMI training programme), the Joint Faculty is offering a subscription amnesty which is intended to encourage Intensive Care doctors to join (or maintain membership of) the JFICMI. The Joint Faculty is the Training, Examination and will soon be the PCS body for Intensive Care Medicine in Ireland and in conjunction with the ICSI and its parent colleges, it is actively working on behalf of Intensive Care Consultants, Trainees and Training hospitals in Ireland. Now is an excellent time to take part in its activities.
Detail of subscription amnesty:
JFICMI Fellowship Ad Eundem
Doctors who have attained comparable competence in ICM with a doctor holding the FJFICMI (by examination and specified training) are eligible to apply for Ad Eundem fellowship. See website for updated eligibility criteria [create link].
Updated national standards for Intensive Care Units
These have been finalised in conjunction with the ICSI and taking advice from other associated professional bodies and are now Board-approved and available on the website (https://jficmi.anaesthesia.ie/wp-content/uploads/2019/09/National-Standards-for-Adult-Critical-Services-2019.pdf).
Committees
Training: Ongoing matters being addressed are
– Meeting with National Doctors Training Programme (NDTP), in conjunction with CAI, RCPI and EM, to address consultant manpower deficit and secure an ongoing funding mechanism for postgraduate training posts in Intensive Care Medicine.
– Liaison with CAI Training Committee continues. Mechanisms are being discussed which might recognise appropriate, supervised ICM training achieved during base specialty training
– Accreditation Visitations programme continues – this is done in conjunction with CAI visitations where possible.
– The Faculty’s Supervisors of Training are completing the competency assessments on the website facility.
– Trainees are encouraged to interact with the Training Committee either individually, via their SOTs or via the two Trainee representatives on the Board.
Education: The pre-exam course, the IDAP, the echocardiography and refresher course continue. Dr Donal Ryan is requesting input on a re-vitalisation of the Refresher Course, please.
Echocardiography: Dr Catherine Nix presented a submission to the Board on developing and standardising ongoing Echocardiography education and training opportunities in Ireland. It included a proposal to incorporate a Point of Care Ultrasound (PoCUS) and Focussed UltraSound for Intensive Care (FUSIC) Interim Credentialing Pathway into Critical Care training. Discussion will continue with the JFICMI Training Committee (Chair Dr Brian Marsh) regarding the optimum manner to marry such developments with the JFICMI / Cobatrice requirement for basic critical care echocardiography competence.
Exams: The JFICMI is facilitating the holding EDIC Part 2 in Dublin on October 24th. Examiners who may be available to help are requested to contact Dr Andrew Westbrook, Chair of Exams.
Credentials: Work on Ad Eundem applications and in assessing Specialty applications as referred by the Medical Council is continuing.
Website
The transition of the JFICMI site to the CAI mainframe is largely complete. The transfer of the Training logbooks and competency assessment facility has worked and other adjustments are ongoing. The new arrangement is facilitating better invoice management being organised by Dr Alan Gaffney, Treasurer and new, improved website features including possible emailed updates are planned.
Paediatrics The new standards document for Paediatric ICUs is finalised and available on the website (https://jficmi.anaesthesia.ie/standards-documents/wp-content-uploads-2019-02-national-standards-for-paediatric-critcal-care-2018-07-02-2019-pdf/)