Postgraduate Training in Intensive Care Medicine is under the remit of the JFICMI.
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.
The following hospitals are recognised for training in intensive care medicine:
- AMNCH Tallaght Hospital, Dublin
- Beaumont Hospital, Dublin
- Cork University Hospital
- Mater Misericordiae Hospital, Dublin
- Our Lady’s Hospital for Sick Children, Dublin
- St James’s Hospital, Dublin
- St Vincent’s University Hospital, Dublin
- University College Hospital, Galway
- University Hospital, Limerick
Training is structured to maximise opportunities for learning and to provide a broad range of experience in different types of hospitals. Details of the the core curriculum and expected competencies are presented in the Joint Faculty’s Curriculum and Minimum Training Requirements document.
Postgraduate training is an example of lifelong learning which comprises personal study, supervised practical experience in clinical management areas as well as satisfactory completion of competencies and other mandatory elements including education courses. Training is supervised by consultants in ICM and Supervisors of Training. Trainees are subject to competency assessment and formal examination throughout their training and are expected to record their clinical practice through the JFICMI logbook.
This summary is taken from the Joint Faculty’s Higher Specialist Training in Intensive Care Medicine document. Recognised modules of training are of a minimum of 2 months duration, with the accumulated modular training addressing the training pathways defined below.
The NDTP have recently released a workforce planning document for ICM that was developed with input from JFICIMI and it would be useful reading for prospective trainees with regards to expansion of training numbers over the coming years.
Year 1 of ICM ‘Supra-Specialty’ training
An individual doctor’s training pathway will depend on his/her base specialty background
Anaesthesia: 1 year of formal training in ICM which may be taken within the total standard (6 -7 years) of Anaesthesiology CST training – usually termed Special Interest Year (SIY) in ICM, or acquired via modules of training (minimum 2 months each). 6 months ICM training to be within final 2 years of Specialist Anaesthesiology Training (SAT). Complementary training (6 months medicine) is desirable during the totality of ICM training. If not completed at Special Interest year (SIY) level, it may be considered and undertaken at post CST (Year 2) level – see below
Medicine: 1 year of formal training in ICM which may be taken within the total standard (usually 6 years) of medicine CST training. 6 months ICM training to be within final 2 years of Medicine SpR training. Complementary Anaesthesiology training (6 months or equivalent) is required prior to JFICMI exam – see below. FJFICMI examination to be completed at the end of year 1.
Surgery and Emergency Medicine: 1 year of formal training in ICM which may be taken within the total duration (usually greater than 6 years) of Surgical training. 6 months ICM training to be within final 2 years of Surgery SpR specialist training. Complementary Anaesthesiology training (6 months or equivalent) is required prior to JFICMI exam – see below. FJFICMI examination to be completed at the end of year 1.
Mono-specialty pathway to ICM training: (Not applicable to ICM training in Ireland.) A minimum training time of
- 2 years full time ICM,
- 1 year medicine,
- 1 year anaesthesia,
- 1 year analogous to post CST (supra-specialty year 2) training for defined specific ‘pre-consultant’ or complementary training e.g. additional anaesthesia or medicine (depending on specialty background of the trainee), echocardiography, research and competency development in professionalism, leadership, management or other as would be relevant to a ‘pre-consultant / transition’ year. A total of 5 years required to attain the competencies specified in the Joint Faculty’s competency document.
- Please note that the precise requirements for monospecialty training will be those specified and utilised by the JFICMI Credentials Committee in assessing applications for equivalence of training – See Credentials Committee criteria
Rostered on-call training time
Rostered on-call duties in JFICMI-accredited centres shall have structured consultant ward rounds and supervision. Where a trainee has completed 6 months of modular training in JFICMI accredited centres, a period of 18 months on-call to intensive care medicine in all JFICMI-accredited centres (ie. within or outside of modular time) shall be recognised as an additional 2 months modular training time, supported by log-book and sign-off by the local JFICMI supervisor of training.
Year 2 of ICM ‘Supra-Specialty’ Training
This is the final year of ICM postgraduate training which is undertaken after success at 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. In general terms, this training year helps the trainee to develop the skills and professionalism which will prepare them for consultant practice. Satisfactory completion of training will be confirmed following sign-off and an exit interview with Joint Faculty’s Examination and Training Committee.
Applying for a Training Position
For entry into the Special Interest Year / Year One ICM Training / Modular Training – Candidates must be a registered trainee with the College of Anaesthesiologists of Ireland or the Royal College of Physicians of Ireland or the Royal College of Surgeons in Ireland – including Emergency Medicine.
Special Interest Year or Year One of Intensive Care Training is an option within the base specialty training scheme. Entry currently within the College of Anaesthesiologists’ SAT programme is by response to a formal call from the Training Department for expressions of interest approximately one year in advance of commencing the Special Interest Year. Shorter modular periods of two months or more are allocated by the JFICMI accredited training hospitals.
Access to Special Interest Year / Year One ICM Training / Modular Training for RCPI candidates is via the year out-of-programme option available to candidates of the RCPI and is approached by application to the Irish Committee for Higher Medical Training (ICHMT) Higher Specialist Training Office RCPI. Once approved and funded within the RCPI, the JFICMI will seek placement with an accredited training hospital. Shorter modular periods of two months or more are allocated by the JFICMI accredited training hospitals as a component of a number of accredited RCPI specialty training posts.
Access to Special Interest Year / Year One ICM Training / Modular Training for Emergency Medicine Trainees is also via the year out-of-programme option available to these candidates and is approached by application to the The Irish Committee for Emergency Medicine Training, RCSI. Once approved and funded, the JFICMI will seek placement with an accredited training hospital. Shorter modular periods of two months or more are allocated by the JFICMI accredited training hospitals as a component of a number of accredited emergency specialty training posts.
Advice of the above process is available through the Chair of the Training Committee, JFICMI and candidates are encouraged to seek such advices. Most training schemes will require up to one year of notice to accommodate a year out of programme for a trainee.
Applications for Post CSCST Programme. Trainees are appointed to supervised training posts through a central applications process under the auspices of the JFICMI. Currently there is an annual intake of trainees, with variable training numbers contingent on the numbers of applicants for special interest year posts and those eligible for Post-CSCST appointment. In 2017 for example, the numbers of each was 8 at special interest year and 4 at post CSCST year.
To apply, a candidate submits:
- An up to date Curriculum Vitae – Statement of interest
- Confirmation of CSCST date in base specialty.
- Evidence of current entry on the Register of Medical Specialists Medical Council of Ireland
- Confirmation of award of Fellowship of JFICMI
- The names of 2 referees who can be contacted to support the candidate’s application with particular reference to clinical competencies and professionalism.
- Application process is advertised in October, interviews are in November / December, and appointments generally commence in July of the following year.