Critical care-Addiction medicine

[drcanucktikka]

Hi everyone,

This will sound like an odd question. I wanted to see what members of this forum thought of someone pursuing a dual speciality in ICU medicine and Addiction Medicine (Australian graduate here).

In my limited experience, PGY1 in Australia here, a lot of ICU patients with substance abuse problems do not get the help they need once they leave the ICU, and even during their stay, they don't always get addiction medicine consults.

So, I thought it would be interesting pursue a career where I do ICU one week, and see the patients with addiction medicine issues during my week off over an extended period of time. I could not find any information on this area, so I assume there are good reasons behind that.

Can I get your opinion on what you think of someone pursuing this dual speciality track?

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[jdh71]

I don't know what the training set up is like in Australia, though to do that kind of thing here, would be possible (I think - psych may or may not take IM into addiction medicine fellowships - though you could always do a IM/Psych dual residency) but a reasonably long time commitment, and while training for one, you would/could lose skills in the other as there really isn't a lot of overlap.

 

[drcanucktikka]

Thanks for your insight jdh71. In Aus we do a 6 year ICU training program after a 2 year internship. There is a trend here for ICU physicians to be dual specialists (usually EM or Anesthetics).

AM training here can be done via many avenues including EM, IM, Anesthetics etc. Its 1.5 years on top of your training program.

Re: overlap. Do you think the demographic of pt with AM in ICU are too small, or perhaps their co-morbidity of having AM issues not particularly relevant in an ICU setting?

I guess thats the specific question I am hoping to get insight into.

 

[deuist]

There is an (unaccredited) American Board of Addiction Medicine that will grant certification after a one-year fellowship. The route would likely go something like:

Residency --> CC --> addiction medicine

The problem with doing AM is that practicing the specialty would be too time consuming and would distract from the ICU. When encountering addicts, the best course of action is to turn them over to the addiction docs while you focus on their medical resuscitation.