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Understanding MOC Requirements
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Critical care medicine encompasses the diagnosis and treatment of a
wide variety of clinical problems representing the extreme of human
disease. Critically ill patients require intensive care by a
coordinated team. The critical care specialist (intensivist) may be
the primary provider of care or a consultant. The intensivist needs
to be competent not only in a broad range of conditions common
among critically ill patients but also with the technological
procedures and devices used in the intensive care setting. The care
of critically ill patients raises many complicated ethical and
social issues, and the intensivist must be competent in areas such
as end-of-life decisions, advance directives, estimating prognosis,
and counseling of patients and their families.
Important procedural skills for the critical care medicine
specialist include advanced cardiac life support, arterial blood
gas sampling and interpretation, bedside pulmonary function,
mechanical ventilation, placement of arterial and central venous
lines, insertion of temporary pacemaker, endotracheal intubation,
placement of pulmonary artery catheter, and interpretation of
Training (via Internal Medicine)
Training in critical care medicine is most commonly pursued as part
of a combined 3-year subspecialty fellowship in pulmonary and
critical care medicine, after which the trainee is eligible for
subspecialty certification in both pulmonary medicine and critical
care medicine. In addition, a physician interested in critical care
medicine can pursue training by alternative routes besides linking
critical care with pulmonary medicine training. Such alternative
routes include: (1) a two-year accredited fellowship in critical
care medicine after internal medicine residency; (2) two years of
fellowship training in advanced general internal medicine (that
include at least six months of critical care medicine) plus one
year of accredited fellowship training in critical care medicine;
or (3) two years of accredited fellowship training in a
subspecialty of internal medicine (three years for cardiovascular
disease or gastrointestinal disease) plus one year of accredited
clinical fellowship training in critical care medicine.
For the 2010-2011 academic year, there are 33 "stand-alone"
ACGME-accredited training programs in Critical Care Medicine with
194 active positions. Thirty-two percent of the trainees are female
and 25% are U.S. medical graduates. There are also 134 programs
that offer combined training in Pulmonary Medicine and Critical
The American Board of Internal Medicine, ABIM, offers certification in critical
care medicine. Certificates of Added Qualifications are also
awarded from the American Board of Surgery, American Board of
Pediatrics, and the American Board of Anesthesiology.
Major Professional Societies
Society of Critical Care Medicine
701 Lee Street, Suite 200
Des Plaines, IL 60016
Phone: (847) 827-6869www.sccm.org/sccm
American Thoracic Society
New York, NY 10006-2755
Phone: (212) 315-8600www.thoracic.org
American College of Chest Physicians
3300 Dundee Road
Northbrook, Illinois 60062-2348
Phone: (847) 498-1400www.chestnet.org
American Journal of
Respiratory and Critical Care Medicine
Back to June
2011 Issue of IMpact
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