Guidance for anaesthetic trainees wishing to pursue a career in PICM

This sub-specialty is looked after by the Paediatric Intensive Care Medicine Intercollegiate Specialty Advisory Committee (PICMISAC), a joint committee of the following organisations:

The PICMISAC, encourages trainees from an anaesthetic background to pursue a career in Paediatric Intensive Care Medicine (PICM). It believes that a Paediatric Intensive Care Unit (PICU) benefits from the mixture of skills and experience brought by having consultants from both a paediatric and an anaesthetic background. There is a relative paucity of anaesthetists in PICM training and it is likely that anaesthetists trained in PICM will continue to be in demand.

The Royal College of Paediatric and Child Health administer a higher training scheme in Paediatric Subspecialties (Grid Training), which includes PICM, and is open to trainee anaesthetists holding a National Training Number. However as there is no specific CCT in PICM, trainees must fulfil the training requirements for a CCT in their parent specialty.  Trainees appointed to the Grid Training scheme will spend an indicative period of two years in approved PICU training units in the UK. It is possible that a trainee might achieve the appropriate competencies in less than this time, depending on their previous experience and rate of progress. This is likely to be the exception rather than the rule.

In August 2010 the Royal College of Anaesthetists published the Curriculum for CCT in Anaesthetics. This curriculum details the requirements for training at core, intermediate, higher and advanced level. PICM training can be part of advanced level training however it remains  necessary to complete the requirements for anaesthesia training..'

To undertake Grid training and achieve a CCT in Anaesthesia requires approval of a bespoke training programme  and approval from the RCoA. It will require an extension to a trainee’s predicted CCT date. A number of trainees have taken this route and this should not discourage anaesthetic trainees from pursuing a career in PICM.

Alternative options for anaesthetists pursuing a career in PICM are to undertake some of the training post CCT or as Out of Programme Experience (OOPE  – time not counted towards training). Anaesthetists may also wish to have advanced training in paediatric anaesthesia in addition to PICM training,   so again a bespoke programme must be agreed. This requires either an extension to CCT or a portion of the training occurring after CCT in Anaesthesia. In practice there are relatively few post CCT posts in Paediatric Anaesthesia in the UK therefore unless intending to undertake a post overseas it is generally easier to arrange post CCT training in PICM.

Early discussion and approval of individual training programmes is vital for trainees wishing to pursue a career in PICM whether applying for a Grid post or placing part of their training post CCT in Anaesthetics. Trainees seeking further advice should contact an Educational Supervisor or a member of the CSAC in PICM through the RCPCH.