EM critical care fellowship vs pulm crit

[SevenSummitz]

Hi!
I am interested in applying to critical care and am a PGY2 EM resident. What are the advantages / disadvantages / differences between doing a CCM fellowship vs a PCCM?
Do either CCM or PCCM programs have access to or require you to report your ITE scores when applying like ACCM and SCCM programs do?

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[CCM-MD]

Hi!
I am interested in applying to critical care and am a PGY2 EM resident. What are the advantages / disadvantages / differences between doing a CCM fellowship vs a PCCM?
Do either CCM or PCCM programs have access to or require you to report your ITE scores when applying like ACCM and SCCM programs do?

You cannot do pulmonary after EM. So your options are either IM, anesthesia or surgery based 2 year fellowships.

 

[ShockIndex]

Like @CCM-MD said, you are eligible for all of the 2-year CCM fellowships as an EM resident, but not the 3-year PCCM fellowships that lead to additional certification in pulmonary medicine. The only way that you could do PCCM is if you are a PGY2 in a 5-year EM/IM combined residency which makes you eligible for all IM fellowships. If that is the case - have fun with 8 years of post-graduate training. I thought that EM grads from 4-year programs were gluttons for punishment with 6 years of training...

To answer your other question, yes. You will have to report your in-service exam scores. FWIW, IM-CCM is quickly becoming among the most competitive IM fellowships. I think that they had something like 1.5-2 applicants per spot this past year.

Also, you are late to the game for ACCM if you are a PGY2 in a 3-year EM program unless you plan to practice for a year before starting fellowships (not a bad idea for some on the fence). ACCM programs began accepting applications last month and are already interviewing for 2021 positions...

 

[gro2001]

You cannot do pulmonary after EM. So your options are either IM, anesthesia or surgery based 2 year fellowships.

And also neurocritical care

 

[deleted547339]

Like @CCM-MD said, you are eligible for all of the 2-year CCM fellowships as an EM resident, but not the 3-year PCCM fellowships that lead to additional certification in pulmonary medicine. The only way that you could do PCCM is if you are a PGY2 in a 5-year EM/IM combined residency which makes you eligible for all IM fellowships. If that is the case - have fun with 8 years of post-graduate training. I thought that EM grads from 4-year programs were gluttons for punishment with 6 years of training...

To answer your other question, yes. You will have to report your in-service exam scores. FWIW, IM-CCM is quickly becoming among the most competitive IM fellowships. I think that they had something like 1.5-2 applicants per spot this past year.

Also, you are late to the game for ACCM if you are a PGY2 in a 3-year EM program unless you plan to practice for a year before starting fellowships (not a bad idea for some on the fence). ACCM programs began accepting applications last month and are already interviewing for 2021 positions...

That’s not necessarily true. Lots of ACCM programs go unfilled. You will likely still find a spot if you want it.

 

[CCM-MD]

And also neurocritical care

Ehh. That’s not really the same thing.

 

[ShockIndex]

That’s not necessarily true. Lots of ACCM programs go unfilled. You will likely still find a spot if you want it.

I believe that most, if not all, of those unfilled ACCM spots are funded and approved 1-year spots that can only be filled by anesthesiologists, surgeons, and obstetricians. I explored this option a couple of years ago when I wanted to begin fellowship a year early by filling an open spot - every program was a no-go because they were all approved for just 1-year.

Bottom line, the math is very different for EM applicants who are applying to a much smaller pool of 2-year funded/ACGME accredited spots. Programs would need to go through the process of converting a 1-year spot to a 2-year spot (and come up with the funding) before the applicant began training. Apparently, it’s a lot more complicated for the program than just drumming up another year’s funding.

For example, my program has 6 ACGME/SOCCA-approved spots per year. However, only one per year is funded and accredited for an EM applicant. This seemed to be the norm at most of the programs that interviewed me - just 1 spot for an EM applicant out of 4-7 total spots. Meanwhile, about 1/3 of the applicants were EM...

 

[CCM-MD]

Interesting. I thought being EM trained, you can only apply to EM-CC programs.

Does it work the same for IM/Anesthesia docs? For example, can someone IM trained apply for EM-CC or Anesthesia-CC?

Technically speaking there is no such thing as a EM-CCM fellowship from an accreditation standpoint. All fellowships are accredited as either IM-CCM, anesthesia-CCM or surgical critical care. You can look this up on the ABMS, ABEM or ACGME websites if you are interested in all the nitty gritty details relating to CCM fellowship accreditation and specialty certification. EM is unique to be able to apply to the 3. An internist can’t do a surgical critical care fellowship and a surgeon can’t do an IM-CCM fellowship.

How the fellowship is accredited is less important than the kind of training it provides. If your goal is to be a strong well rounded intensivist, the key is multidisciplinary training with training that allows you to gain experience in a role in which you have primary responsibility of various types of ICU patients. Obviously if one’s goal is to only work in a MICU or SICU or neuro ICU then a pigeonholed focused fellowship could be a good choice.

 

[ShockIndex]

Interesting. I thought being EM trained, you can only apply to EM-CC programs.

Does it work the same for IM/Anesthesia docs? For example, can someone IM trained apply for EM-CC or Anesthesia-CC?

Fellowships for EPs are accredited and administered by the American Boards of IM, Surgery, Anesthesiology, and Psychiatry and Neurology (neurocrit). These organizations develope and administer the subspecialty certification examination in Critical Care Medicine for EPs, while ABEM is responsible for credentialing its candidates and notifying them of their examination results.

 

[deleted547339]

Fellowships for EPs are accredited and administered by the American Boards of IM, Surgery, Anesthesiology, and Psychiatry and Neurology (neurocrit). These organizations develope and administer the subspecialty certification examination in Critical Care Medicine for EPs, while ABEM is responsible for credentialing its candidates and notifying them of their examination results.

This. It’s more semantics, but what ShockIndex says is how it works (in spite of what a lot of people say/think).

I did an ABIM 2y CCM fellowship. I took the same exam as ABIM administers, but my board is technically ABEM/CCM cosponsored by ABIM.

Now how were going to recert is anyone’s guess.

 

[SpacemanSpifff]

This. It’s more semantics, but what ShockIndex says is how it works (in spite of what a lot of people say/think).

I did an ABIM 2y CCM fellowship. I took the same exam as ABIM administers, but my board is technically ABEM/CCM cosponsored by ABIM.

Now how were going to recert is anyone’s guess.

Semi-related question, not worth a new thread - are there any IM-CCM programs other than the ones listed on the EMRA CCM site (Critical Care Fellowships) that are known to accept EM applicants, either routinely or on a case-by-case basis?

 

[deleted547339]

Semi-related question, not worth a new thread - are there any IM-CCM programs other than the ones listed on the EMRA CCM site (Critical Care Fellowships) that are known to accept EM applicants, either routinely or on a case-by-case basis?

Florida hospital is starting one. Don’t know much beyond that.