Crippen’s Law
EMCrit‘s Scott Weingart quoted David Crippen (Fearless Leader of the CCM-L listserv) in response to a Resus.ME post by Cliff Reid, which reviewed and expanded upon Weingart’s recent article on ED Intensivists and ED Intensive Care Units:
“Every well-intentioned dual-trained EP always comes out of training stating that they will split their time 50/50 ED and ICU and all of them by the 5 year mark will be spending all of their time in one area or the other.”
This is obviously important to all of us that have slogged through two grueling training schemes in the hope of contributing to both specialties. I’m familiar with Crippen’s Law, and still wonder if I will succumb to it. Unlike in the US where a 1-2 year fellowship can be tagged on to a 4 year residency (pretty intense years, but blissfully short!), in Australasia dual trainees generally clock up about 10 years of training after medical school. This is a huge commitment to both specialties, yet I know very few dual trained FACEM+FCICMs who still work in the ED. I hope that this can change. Or, perhaps, dual training might simply be an unnecessary extravagance in terms of training, time and resource utilisation.
What do you think?
Read more and contribute to the discussion at Upstairs vs Downstairs: an EPIC Conundrum on Resus.ME.
Also look out for the #FOAMed SMACC talks on the essence of critical care and the interface between emergency medicine and intensive care heading your way in the next couple of weeks. I’ll finish with two of Peter Safar’s Laws for the Navigation of Life that may go some way to explaining the predicament some of us find ourselves in:
2. When given a choice, take both.
12. When faced without a challenge, make one.
Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.
After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.
He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE. He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.
His one great achievement is being the father of three amazing children.
On Twitter, he is @precordialthump.
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