An internist trained in critical care medicine has expertise in the diagnosis, treatment and support of critically ill and injured patients, particularly trauma victims and patients with multiple organ dysfunction. This physician also coordinates patient care among the primary physician, critical care staff and other specialists.
Critical care medicine integrates a diverse group of highly trained professionals who provide care in specialized intensive care units and work toward the best outcome for seriously ill patients.
Because critical care medicine integrates so many different aspects of care, there is a broad range of training. This specialty requires additional fellowship training for those who complete their primary residency training in internal medicine, anesthesiology, pediatrics, surgery or emergency medicine. Fellowship training requirements are different for each primary specialty. (For example, individuals who have trained in anesthesiology and surgery require only one additional year of training in critical care, whereas individuals who have trained in internal medicine or emergency medicine require at least two years of critical care training. In pediatrics, three years of fellowship training are required.) Board certification in critical care medicine is available through all four specialty boards.
Many critical care medicine professionals work in the intensive care unit (ICU). While nearly all ICUs are capable of providing a spectrum of care, many have developed a focused area of excellence: care of premature or critically ill newborns in the neonatal ICU (NICU); care of critically ill and injured children in the pediatric ICU (PICU); care of adult cardiac diseases in the coronary care unit (CCU); perioperative care, trauma care and care of multiple organ dysfunction in the surgical ICU (SICU); and care of neurological and neurosurgical patients in the neuroscience ICU (neuro ICU).
Critical care medicine offers physicians the opportunity to work on a team with other critical care professionals who have diverse backgrounds and take different paths to become part of the team, including:
Respiratory therapists (RTs)
In addition, critical care physicians may work with dietitians, social workers, nursing students and dietetic students. Many ICUs incorporate medical students, residents and Critical Care Fellows on their interprofessional team.
The ICU is a unique place where so many individuals— physicians, nurses, respiratory therapists, technicians, pharmacists—pool their cognitive and technical skills. It is an environment rich in continued educational opportunity. It is a specialized environment where the staff must coordinate many disciplines (including cardiology, pulmonary, renal, neurology and infectious disease) into the care of each and every patient.