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The impact of COVID-19 on Intensive Care recruitment
Journal of the Intensive Care Society ; 23(1):42-43, 2022.
Article in English | EMBASE | ID: covidwho-2043022
ABSTRACT

Introduction:

Recruitment in intensive care has long been discussed, with the pandemic bringing this into sharp focus. Most anaesthetists in training were fully redeployed into ICU rotas or provided technical expertise. As surge rotas settle and a 'new normal' is regained, the challenge of ICU consultant recruitment needs to be addressed. Historically, ICUs have been predominantly staffed by consultants trained in both anaesthetics and intensive care medicine (ICM), but the challenges of this career path have been augmented by COVID-19. Forecasts suggest a concerning supply shortage of both anaesthetic and ICM consultants.1 The latest recruitment round for ICM has been the most competitive year for applications (ratio 2.91 in 2021 compared to 1.491 in 2020).2 However, the anaesthetic/ICM dual-training contribution to this workforce has worryingly decreased from approximately twothirds to less than a half. But what factors are causing this and has COVID-19 redeployment worsened this?

Objectives:

As we emerge from the second wave of the pandemic, we assessed the attitudes of anaesthetists about future careers in intensive care.

Methods:

We performed a brief electronic survey of 100 dual-or single-specialty anaesthetists in training from four LETBs across England who were redeployed to ICU.

Results:

Our survey showed that 29% had a negative experience that dissuaded them from pursuing ICM careers or, in some circumstances, relinquish their ICM training number altogether. Promisingly, 64% had a positive experience, and of these 39% reaffirmed their desire to pursue a career in ICU and 13% developed a new interest in pursuing a career in ICU since their redeployment. Positive factors included, 'teamwork', 'complexity of patients' and 'adding variety to my anaesthetic practice'. Prominent negative factors were 'additional exams', 'two separate portfolios' and 'high risk of burnout'. Respondents suggested changes to attract more anaesthetists to dual-accredit with ICM. This included the removal of hurdles such as additional exams, separate portfolios, and duplicated assessments. The additional training time was also highlighted, particularly given that trainees already contribute significantly to ICM rotas. There was a need for more flexibility in training with dual trainees wanting to undertake advanced training modules like their anaesthetic counterparts. They also reported wanting more anaesthetic sessions in their future job plans possibly reflecting the desire for varied practice as a consultant.

Conclusion:

Although COVID-19 has had a positive effect by increasing ICM applications, this may be at the expense of dual-trained anaesthetic/ICM trainees. FFICM should consider the factors which dissuade these applicants and its future impact on skills available in ICU. Both the RCoA and the FFICM have recently announced changes to curricula and e-portfolio which may close some of these gaps. The pandemic has grabbed the attention of a few anaesthetists and presented an opportunity to work in a team that solves difficult physiological puzzles, rapidly escalates capacity, and increasingly focuses on staff wellbeing. We should capitalise on this and hope that COVID-19 will result in the conversion of some of our anaesthetic colleagues into dual-specialty ICM consultants.
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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Experimental Studies Language: English Journal: Journal of the Intensive Care Society Year: 2022 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Experimental Studies Language: English Journal: Journal of the Intensive Care Society Year: 2022 Document Type: Article