Critical Care (also called Intensive Care, Acute Care, Intensive Therapy) is a relatively young specialty. It is not surprising, therefore, that most of the medical colleges do not expose the young trainee doctors in this aspect of Medicine.
The reality outside the medical colleges and in the ‘Real world’ is that only serious patients eventually seek hospital admissions. So every specialty (Medical, Surgical, Paediatric, Gynaecology and Obstetrics etc) deals with more and more serious cases and bolder interventions. It is logical that hospitals are giving increasing importance to the ICU/ICCU beds. In India, it is not uncommon for 25-33% of all beds in the hospital being Critical Care Beds. Many hospitals have 50-100 ICU beds and some like Amrita Institute of Medical Sciences in Kerala has more than 200 ICU beds!. So what is the problem?
The problem is that despite the increasing number of ICUs, the number of trained ICU specialists is grossly inadequate. This is a big opportunity as a career pathway for young doctors who wish to make a difference.
There are a few options for getting formal training in Critical Care Medicine in India:
Which examination to choose? Well, it’s a matter of personal choice and in reality all are good options as long as you do a proper course, so any of 1-3 options are good. Option 4 has no value and is an eye-wash as it will not prepare you for real life situation. Between the 3 top options, based on feedback for a few doctors who have given all 3 examinations, I can say the following: FNB is for post-graduates (Post MD) but is govt recognised. The ISCCM course is good but lacks the clinical bedside examination which many regard as a benchmark of training. Also, the concept on quick diagnosis with minimal data (a reality in emergencies) is not emphasised. It's an easier examination to pass than FCCCM. But if you want the ‘Mercedes’ of Critical Care Training that prepares you for real life situations, the choice, hands down, is the FCCCM exam by CCEF. Yes, it is a tougher examination and you are going to have to work harder. But once you pass out, you can handle almost any situation anywhere in the world as your foundation becomes very strong. It was setup with the help of Australian Examiners to be a world class Examination (endorsed by the fact that EDIC has recently switched to the Australian pattern of examination too!). Plus, its endorsed by the International Board of Medicine and Surgery (IBMS)-Florida, USA. The FCCCM course of CCEF is the most structured, exhaustive and fair examination you could give. I should know as I have been a teacher for all 3 examinations and the ISCCM examination was started under my guidance when I was its Founder-President.
In the end, you make a choice. As I said, any course is OK, just do some formal course. Getting a job is easy once you are well trained. In fact MBBS doctors with FCCCM are now heading ICUs in Major private hospitals and getting preferred over MDs with less stringent training.The College make efforts to guide you post FCCCM whether it is placement in India or doing advanced Fellowship abroad.
Dr. Praveen K. Jain MD., FCCCM
Chairman, Critical Care Education Foundation (CCEF)
Founder President ISCCM & Founder Editor of IJCCM
Ex-Teacher/co-ordinator for FNB Critical Care Seat (Lilavati Hospital)