ANESTHESIOLOGY CRITICAL CARE MEDICINE FELLOWSHIP TRAINING

Anesthesiology critical care medicine (ACCM) fellowship training was a ccredited in 1989, and a small number of graduating anesthesiology res idents pursue this additional training. Considering the flexible progr am guidelines of the American Board of Anesthesiology (ABA), we hypoth esized that ACCM fellowship training programs varied significantly amo ng the 42 institutions accredited to offer this program. This study of ACCM fellowship programs used a six-part, 57-item questionnaire compl eted by 36 program directors to describe six aspects of the program: i nstitution size, program director, attending staff, fellowship applica nts, curriculum, and the role of the American Society of Critical Care Anesthesiologists (ASCCA). Ninety-four percent of ACCM fellowships ar e in facilities with more than 400 beds; 81% of these institutions hav e more than 20 intensive care unit (ICU) beds as the basis for fellows hip teaching. Eighty-three percent of ACCM program directors have prac ticed critical care for more than 5 yr. All programs had more than one attending physician, with the majority having a multidisciplinary att ending staff. During two academic years (1990-1992), 12 (33%) of 36 pr ograms did not have a fellow, resulting in an average of less than one fellow for each program. ACCM fellow involvement in patient care was characterized as ''primary'' in medical and pediatric ICUs and ''coope rative'' in surgical ICUs. Fellowship curricula had varied requirement s for research, intraoperative anesthesia, and ICU procedures performe d by the fellow. In general, program directors believe that salary and on-call responsibility are not important issues for applicants. Ninet een percent of program directors train ACCM fellows longer than the 12 mo required by the ABA and believe that ACCM training should be lengt hened.