Intensive Care Curriculum

The curriculum for ICM ('CCT in Intensive Care Medicine') is defined by the Intercollegiate Board for Training in Intensive Care Medicine (IBTICM) and is competency based, the documents for which can be found below. The CCT curriculum is divided into Basic (3 months at ST 1/2 level), Intermediate (6 months normally at ST3 or above) and Advanced (12 months at ST4/5 or above) levels and on successful completion allows application for the joint CCT.

The curriculum for ACCS trainees in ICM is divided into a preliminary syllabus (basic level competencies) for use over the initial three months of ICM training. ACCS trainees completing more than three months in ICM will also complete the core syllabus competencies (covering part of the intermediate curriculum). However the IBTICM and national ACCS committee have stated that trainees will need to complete further ICM training at intermediate level (ST3 and above) in order to gain Intermediate ICM accreditation.

The curriculum for training in adult ICM is categorised in domains, each of which is presented as Knowledge, Skills, Attitudes and behaviour, and Workplace training objectives, in addition to basic sciences. The acquisition of these competencies should be recorded in the educational training record during the module with formal assessment of competence required. The documentation for this can be found below. The generic work place assessments as required for completion of the ACCS programme are additional to the ICM competency documents and should be used to support development.

Preliminary (Basic) syllabus

Trainees will be expected to demonstrate a level of knowledge and skills which permit them to identify acutely ill patients, initiate appropriate emergency management, stabilise them for transfer, plan their care for the first hour in ICU, and identify serious complications which may arise during intensive care. The assessments will be conducted in the workplace, usually during the third month. The trainee will be assessed in the following:

CPR skills
Airway management
Initial assessment of competence in the management of the acutely ill patient
Organ support and practical procedures
Communication skills, clinical judgement, attitudes and behaviour

The clinical skills that are to be assessed must be supported by knowledge of the presentation, identification and management of common medical and surgical conditions which may result in critical illness. The focus is on first-point-of-contact, and the initial stabilisation of a sick patient. This will include knowledge of applied physiology and pharmacology, and an understanding of appropriate methods for basic organ system support and their potential complications.

Core (Intermediate) syllabus

The trainee will be assessed in the following areas:

Practical procedures, comfort care and organ system support
Patient management: assessment, investigation, monitoring and diagnosis
Outreach and Transport care
Communication Skills, Attitudes and Behaviour
Cardiopulmonary Resuscitation

Object: After completing Core training the trainee will be expected to have acquired the clinical ability to manage the majority of patients on a general intensive care unit and to recognise the need and appropriateness of intensive care admission and to manage safe transport of the patient. In these assessments, the trainee will be expected to support the demonstration of clinical skills with knowledge of the relevant areas as described in the syllabus. This will include establishing a safe environment for critically ill patients inside and outside the ICU, and one in which patient suffering is minimised by an humanitarian approach to patient care and the judicious use of drugs to relieve distress. The trainee should be able to develop clinical management plans for several hours of intensive care, and to modify those plans according to changes in the patient's condition. The trainee should be able to support junior or less experienced colleagues, and to prioritise work based on competing clinical needs.

Case Summaries: Core (Intermediate) syllabus

During Core Training it is a requirement that each trainee compiles ten case summaries. (See Part II, the Educational Training Record). The purpose of this exercise is to educate in the specific disease state and process described, to train in the arts of searching for information and writing medical text coherently, and to permit reflection on practice.