ATTITUDES OF ANESTHESIOLOGY RESIDENTS TOWARD CRITICAL CARE MEDICINE TRAINING

The number of anesthesiology residents pursuing critical care medicine (CCM) fellowship training has been decreasing in recent years. A sign ificant number of training positions remain unfilled each year. Possib le causes of this decline were evaluated by surveying residents regard ing their attitudes toward practice and training in CCM. All 38 anesth esiology programs having accredited CCM fellowships were surveyed. Fou r of these and one program without CCM fellowships were used to develo p the survey instrument. Four programs without CCM fellowships and 34 programs with CCM fellowships make up the survey group. Returned were 640 surveys from 37 (97%) programs accounting for over 30% of the poss ible residents. Resident interest in pursuing CCM training decreased a s year of residency increased (P < 0.0001). Residents in programs with little patient care responsibility during intensive care unit (ICU) r otations expressed less interest in CCM training (P < 0.012). The admi nistrative role of the anesthesiology department in the ICU also influ enced resident interest (P < 0.014). Written responses to open-ended q uestions suggested resident concerns with the following: stress of chr onic care, financial consequences of additional year of training, ICU call frequency and load, ICU role ambiguity, and shared decision-makin g in the ICU. A recurring question was, ''Are there jobs (outside of a cademics) for anesthesiologist intensivists?'' Most residents knew a C CM anesthesiologist they admired and knew that there were unfilled fel lowship positions available. Defining the job market, improving curric ulum and teaching, supporting deferment of student loans, and introduc ing residents and medical students to the ICU earlier may increase the interest in CCM practice among anesthesiology residents.