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Global demand for uniform critical care practice and training norms

Our Bureau, MumbaiThursday, February 12, 2004, 08:00 Hrs  [IST]

For the 2000-odd members who got together from around the world for the 10th Annual Conference of the Indian Society of Critical Care Management (ISCCM), it came as a jolt that there was no uniform global policy that could be implemented to impart education and training to several intensivists and critical care experts from around the world. Even in most developed nations like the US and Australia whose models are often replicated by other countries, it was observed that there were no definite guidelines and models. The scenario was no different with European countries with a majority of them following their own unique model for training and imparting education to their intensivists and critical care consultants. Dr Marco Reneiri, who represented the European Society for Critical Care Medicine while presenting his findings, said that in Italy close to 90 per cent of all ICUs were managed by anaesthesiologists alone while formal training was provided for just four years. Likewise varied patterns were observed in other countries like France, which had only a two-year fellowship in critical care medicine and had their ICUs managed by anaesthesiologists, pulmonologists and intensivsts. In Spain, the number of years for a Critical Care degree would take the candidate a total of 5 years. Dr Teresa Jacks from Australia who was amazed at the observation said that it was time for different critical care societies from around the world to come together and have a common programme with regards to imparting education and training. According to her, in Australia, intensive care is regarded as a super specialty, wherein it is compulsory for all ICUs in the country to have a specialist intensivist. Almost 100 per cent of all tertiary care units in Australia have a director specialist of intensive care, she said. While most of the countries have training periods for their courses in the range of 3-5 years, in India there currently is a two-year training course, which in a way has been bettered from the earlier one-year certificate course. Experts urged to increase the number of years for training to a minimum three years, with two years reserved for basic and hands on training in research and bedside ICU management. Commenting on her findings, Dr Ann Thompson from the University of Pittsburg, USA said that each country had to evolve a specific model, which could be evaluated eventually to a single universal policy for all critical care experts. According to her, it was also necessary for all consultants and critical care units to get their clinics or hospitals accredited for the purpose of super-specialty training programme.

 
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