Training

Higher Specialist Training in Intensive Care Medicine

The JFICMI is the avenue through which the postgraduate training bodies (CAI, RCPI and RCSI) supervise training in ICM. In Ireland, this training is now explicitly set out as competency-based training comprising one or two years of ‘supra-specialty’ training. This is training undertaken in addition to completion of base-specialty training in Anaesthesiology, Medicine, Emergency Medicine or Surgery. Supra-speciality training is based in accredited hospitals recognised by the JFICMI. Trainees on the Specialist Division of the Medical Register who satisfy all aspects of ICM training in Ireland, including the FJFICMI examination, mandatory courses, 2 years trainee practice in accredited Irish intensive care units and all clinical competencies, will be awarded a CSCST in Intensive Care Medicine.

The following hospitals are recognised for training in intensive care medicine:

  • Beaumont Hospital, Dublin*
  • Cork University Hospital
  • Galway University Hospital*
  • Limerick University Hospital
  • Mater Misericordiae University Hospital, Dublin*
  • Our Lady’s Hospital for Sick Children, Dublin*
  • St James’s Hospital, Dublin*
  • St Vincent’s University Hospital, Dublin*
  • Tallaght University Hospital, Dublin

(*Hospitals recognised for both year 1 and year 2 ICM training)

Training is structured to maximise opportunities for learning and to provide a broad range of experience in different types of hospitals.  Details of the core curriculum and expected competencies are presented in the Joint Faculty’s Curriculum and Minimum Training Requirements document.

Postgraduate training in ICM prepares trainees for a career of lifelong learning. ICM training comprises personal study, supervised experience in clinical care, satisfactory completion of competencies and mandatory education courses. Training is overseen by consultants working in intensive care medicine as well as by Supervisors of Training. Trainees are subject to continuous competency evaluation, formal summative assessment by examination and are expected to record their clinical practice in their ICM logbook. This is located on the Kaizen platform affiliated with the College of Anaesthesiology of Ireland.

The appropriate training pathway for those interested in a career in intensive care medicine depends on their base speciality. A detailed description of training pathways for intensive care medicine in Ireland can be found in the Joint Faculty’s Higher Specialist Training in Intensive Care Medicine document. A brief outline of training pathways is shown below. The National Doctors’ Training and Planning (NDTP)  have recently released a workforce planning document for ICM that was developed with input from JFICMI. Trainees considering a career in ICM are encouraged to read this document which highlights the projected expansion of training and consultant numbers over the coming years.

Year 1 of ICM training (Intensive Care Clinical Fellow)

Completion of year 1 training is suitable for doctors contemplating a career combining ICM and their base specialty.

Anaesthesiology:

  • Year 1 can be completed during SAT years through accumulation of 12 months of modular training. To be recognised for training, ICM modules must by a minimum of 2 months duration and be in an ICU recognised for formal training. Four months of these ICM modules must be within the final 2 years of Specialist Anaesthesiology Training (SAT).
  • Trainees who complete core anaesthesiology training with less than 12 months total modular ICM training can make up the balance in a standalone ICM post (in a centre recognised for ICM training) or by applying for either a JFICMI Clinical Fellow or a SAT 7 ICM position.
  • A complementary period of training in clinical medicine (6 months) is desirable.
  • Satisfactory completion of all training requirements (including training competencies, courses, logbook and in-training assessments) is required.
  • Trainees must pass the JFICMI Fellowship examination

Medicine:

  • Year 1 can be completed during medical SpR training through accumulation of 12 months of modular training. ICM modules must by a minimum of 2 months duration and be in an ICU recognised for formal training. Four months of this ICM training must be within final 2 years of Medicine SpR training.
  • SpRs who complete core medicine training with either less than 12 months or no ICM modular time can complete year 1 of training in a standalone ICM post (in a centre recognised for ICM training) or by applying for a JFICMI Clinical Fellow position.
  • A complementary period of training in anaesthesiology training (6 months) is desirable.
  • Satisfactory completion of all training requirements (including training competencies, courses, logbook and in-training assessments) is required.
  • Trainees must pass the JFICMI Fellowship examination

Surgery and Emergency Medicine:

  • Year 1 can be completed during SpR training through accumulation of 12 months of modular training. ICM modules must be a minimum of 2 months duration and be in an ICU recognised for formal training. Four months of this ICM training must be within final 2 years of SpR training.
  • SpRs who complete core surgical/EM training with either less than 12 months or no ICM modular time can complete year 1 of training in a standalone ICM post (in a centre recognised for ICM training) or by applying for a JFICMI Clinical Fellow position.
  • A complementary period of training in anaesthesiology training (6 months) is desirable.
  • Satisfactory completion of all training requirements (including training competencies, courses, logbook and in-training assessments) is required.
  • Trainees must pass the JFICMI Fellowship examination

Mono-specialty pathway to ICM training: This is not currently applicable to ICM trainees completing training in Ireland.

Year 2 of ICM Training (Advanced Clinical Fellow)

Completion of year 2 training is suitable for doctors contemplating a career solely or mainly in intensive care medicine. This final year of ICM training can only be undertaken in ICUs registered for Advanced Clinical Fellow training. Candidates applying for these posts must satisfy the following criteria:

  • Completion of training in base specialty (anaesthesiology, medicine, surgery, emergency medicine)
  • Inclusion (or eligible to be included) in the Specialist Division of the Medical Register in Ireland in their base specialty
  • Satisfactory completion of year 1 ICM Clinical Fellow (see details above)
  • Have sat the JFICMI Fellowship examination

Certain additional training requirements for this year are specified in the training regulations. These include the completion of a research project and the acquisition of basic critical care echocardiography competence. Satisfactory completion of training will be confirmed following sign-off and an exit interview with the Joint Faculty’s Training Committee.

Applying for a Training Position

For entry into clinical fellow or advanced clinical fellow training, doctors must be registered with the Joint Faculty of Intensive Care Medicine of Ireland.

Year 1 and year 2 ICM training posts are filled each year following a central applications process under the auspices of the JFICMI. This involves a national advertisement programme, competitive interviews and post allocation process. The number of available positions varies on a yearly basis, and has increased to a total of 21 posts in late 2021.

The application process varies according to a trainee’s base specialty.

CAI trainees:

  • Modular training: Modules, of minimum 2 months duration, are negotiated locally between trainees and anaesthesiology/ICU departments during SAT years of training. All modules must be undertaken in centres recognised for training by the JFICMI.
  • Applications for SAT 7 posts in intensive care medicine are made through the annual recruitment with the College of Anaesthesiologists
  • Application for year 1 and year 2 posts can occur through annual recruitment by the Joint Faculty of Intensive Care Medicine of Ireland

RCPI trainees:

  • Modular training: Modules, of minimum 2 months duration, are negotiated locally between trainees and anaesthesiology/ICU departments in consultation with local medicine departments and the Institute of Medicine at the RCPI. All modules must be undertaken in centres recognised for training by the JFICMI.
  • Application for year 1 and year 2 posts can occur through annual recruitment by the Joint Faculty of Intensive Care Medicine of Ireland.

Surgery/Emergency Medicine trainees:

  • Modular training: Modules, of minimum 2 months duration, are negotiated locally between trainees and anaesthesiology/ICU departments in consultation with local surgery/EM departments and with the involvement of either the RCSI or the Irish Committee for Emergency Medicine Training. All modules must be undertaken in centres recognised for training by the JFICMI.
  • Application for year 1 and year 2 posts can occur through annual recruitment by the Joint Faculty of Intensive Care Medicine of Ireland.

For further details about training pathways and applications, please contact the Joint Faculty at jficmi@coa.ie or the Chair of the Training Committee. Please note that most training schemes will require up to one year of notice to accommodate a year out of programme for a trainee.