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College of Intensive Care Medicine

of Australia and New Zealand

Trainee e-news

30th April 2015

Trainee Committee Workshop
In February the trainee representatives from around Australia and New Zealand met for our annual Trainee Committee workshop. This was the first meeting in which the newly elected Paediatric Intensive Care Training Representative was also present The meeting provides not only a chance for the Trainee Reps to finally meet one another after numerous Teleconference meetings, but also a chance to meet the staff of CICM and better understand the inner workings of the college.
After brief introductions we cracked down to business and initial discussion gravitated around the issues facing each region. Common themes were issues regarding obtaining Medical, Anaesthetic and paediatric rotations in a timely fashion, jand concerns about future consultant Job Prospects (the workforce issue). Read more

Trainee Representatives
The Trainee Committee has recently elected new representatives from VIC, NSW and WA.

VIC - Sarah Yong
Sarah is a senior ICU registrar at The Alfred. She completed her basic physician then initial intensive care advanced training through St Vincent’s Hospital Melbourne and its affiliated rural centres.

Her interests include medical education, simulation and clinical research. She is a #FOAMed devotee and contributor to the Life In the Fast Lane: Critical Care Compendium and the Intensive Care Network educational websites. Sarah is also medical co-convenor for the inaugural Critical Care Collaborative, a multidisciplinary ANZICS / ACCCN continuing education symposium coming up on 8th May 2015. Outside the ICU she is a food-lover, Francophile and frequently afflicted by the travel bug. 

From a trainee perspective, Sarah is interested in trainee welfare and work-life-family balance, workforce issues for new fellows and knowledge translation in critical care education. She is keen to develop resources and networking opportunities for CICM trainees, particularly those preparing for the First Part and Second Part examinations. Follow her on twitter @drsarahyong.

NSW - Alun Ellis
Alun completed his undergraduate degree at the University of Wales, Cardiff before moving to London for his intern and residency.  His interest in ICU began after completing a term in Intensive Care as an intern.  In 2009 he moved to Sydney, starting at Westmead before commencing Intensive Care training at the Royal Prince Alfred Hospital where he spent 3 years.  He left RPA for a brief period in 2012 to undertake a stint in Cardiothoracic Anaesthesia and Intensive Care at St George’s Hospital in London before returning to continue Advanced Training at RPA.  He is currently an Advanced Trainee at St Vincent’s Hospital, Sydney and plans to undertake his Fellowship exam in 2016. 
His clinical interests are echocardiography, Cardiothoracic Intensive Care, renal replacement therapy and medical education.  At present he is working on his formal project and completing his part-time MSc.
Outside of work he enjoys traveling, fine dining and good beer.  He also enjoys painting, design, cooking and hits the slopes every ski season…
He hopes to improve opportunities for trainees to experience training both in Australia and abroad, improve interstate and international collaboration and ensure trainees can have their say in how the training programme is developed and delivered across Australia and New Zealand. 

WA - Dave Baguley
Dave has been a CICM trainee for 4 years and is currently dual training in ICU and anesthetics. He has enjoyed working in intensive care medicine in Western Australia, Victoria and the UK.
In the role of Western Australian Trainee Representative he is keen to build a much stronger network for ICU trainees than presently exists. He believes that the basis for a stronger network requires both professional and social interaction amongst trainees, and is enthusiastic about working with trainees in Western Australia and beyond in order to achieve this.

Formal Project Resources
CICM Trainees: Did you know that you can access a number of previously accepted Formal Projects from within the Members Portal?

Links to these Formal Projects can be found in the Education tab under the Resources section.

Click here to login
Trainee Perspective
Michael Purvis-Smith - ICU Training in a remote setting

I’ve worked in the Northern Territory for 7 years now, and I spent 2014 based at the ICU in Alice Springs.

Working in critical care in the Territory differs from other parts of the country in several notable ways, including patient demographics, disease epidemiology, resource limitations, cultural safety issues and geographical logistics. 

Firstly, most of the patients are indigenous. We’re all exposed to cross-cultural situations during our training. While the principles of cultural safety are broadly applicable wherever one practises, working in a primarily indigenous population probably takes this up a few notches. Read more

Course Overviews
CICM Management Skills Course - Melbourne, March 2015
Rebecca Smith - Paediatric Trainee Representative

We spend our training years learning how to be great ICU clinicians. Yet, when we finally do join the ranks of the consultants we’ll be spending a significant proportion of our time in non-clinical roles, many of us are completely unprepared. The 2015 CICM Management Skills Course was attended by not only advanced trainees but also many junior consultants, who all had harrowing tales of feeling out of their depth writing business cases, managing conflict and negotiating endless meetings and emails.

The course was efficiently run with a mixture of lectures and non-threatening interactive small group sessions and covered a wide range of important topics including managing the trainee at risk, building and presenting business cases, balancing budgets, conflict resolution, teamwork and negotiation. The faculty did an amazing job keeping everyone engaged given the nature of the topics they were presenting and there was ample opportunity to network at the course dinner and during breaks.

This course is on the compulsory training list for those who signed up for training after Jan 2014 but I would recommend it highly to all advanced trainees so when you find yourself being asked to prepare a business case on your first day as a consultant you’ll at least know where to start.
35th International Symposium of Intensive Care and Emergency Medicine (ISICEM) - Brussels, March 2015
Sarah Yong - VIC Trainee Representative

I was recently lucky enough to attend the 35th ISICEM Symposium in Brussels in March, one of the largest critical care meetings on the conference calendar.

In his welcome, Jean-Louis Vincent noted that over the last 35 years in ICU we have come to appreciate that in some circumstances, “less is more”: for example in fluid administration, blood transfusions, ventilation. Despite this paradigm shift, mortality has overall remained static but our patient population is actually older and more complex. He cautions on the endless pursuit of randomised controlled trial evidence, highlighting the heterogeneity of the ICU patient population and that "intelligent care" rather than "protocolised care" is the way to go.
Australia's Simon Finfer followed with highlights from the Surviving Sepsis round table discussion. Despite sepsis mortality reducing in Australia and New Zealand, lets not forget the global burden of sepsis remains, particularly in developing countries. For example, maternal deaths put the neonate at 80% risk of dying within the first year: a sobering statistic. Additionally morbidity post sepsis is high, with increased risk of cognitive impairment and long-term functional disability amongst survivors. Still much work to do. Next was the great reveal - Kathryn Rowan on ProMISe, completing the trifecta of the Early Goal-Directed Therapy trials, showing that in adults presenting to ED with septic shock, haemodynamic management with an EGDT protocol did not lead to improvement in outcomes compared with usual care. Read more
CICM QRC Formal Project Workshop - Brisbane, March 2015

The CICM QLD Regional Committee recently held a Formal Project Workshop designed to assist trainees in completing their Formal Project requirements. The workshop was well attended by CICM trainees as well as a number of CICM Fellows and Supervisors who were on hand to provide advice and mentoring to the group.

The workshop featured presentations from a number of ICU research experts including John Fraser, Bala Venkatesh, Dan Mullany, Jeremy Cohen and Jeff Lipman, and included sessions on statistics, data collection and ethics approval.

Feedback from the workshop has so far been positive, and the College is now planning to run the workshops in the other regions.

Fellowship Profiles
Wade Stedman - Sunnybrook Hospital, Toronto, Canada
Does this sounds familiar: “There’s no jobs!”.
With the stress of the fellowship exam behind me it was time to kick-back, relax, socialise and spend some time with family.  After all it felt well earned.  In fact, I enjoyed the exam so much I thought I better sit it twice!  However, like many of you I approached the final year of training with some trepidation.  What next?  Will there be a job?  What other string can I add to my bow?
I soon realised the stress of the exam was replaced by the uncertainty of the job market.  After chatting with a mentor of mine I contacted Sunnybrook Hospital in Toronto, Canada and never looked back. Read more
James Moore - Papworth Hospital, Cambridge, UK

Which Fellowship are you completing and where?
I’ve been doing a fellowship at Papworth Hospital in Cambridge, UK. I dual trained with anaesthesia, so my job has been a mix of cardiothoracic anaesthesia and ICU. The plan had been to come over here for 18 months as a fellow, but about halfway through I got offered a locum consultant job in the same department, so I’ve now shifted into doing that.
What were the major challenges in arranging your fellowship? Approximately how long did the process take? 
Actually finding the job wasn’t too difficult. The Australiasian training programme is well respected here (and I was also lucky that the Clinical Director of the department was a Kiwi!). 
More difficult was the process (and expense) of moving countries. I could get a UK work visa fairly easily through having British grandparents, but as you’d expect there were a lot of forms to fill in (including having to post your passport off to Manila)! Registration with the GMC was surprisingly straightforward, although I did have to haul my original medical degree across the world for them to view (you’d think these things would be electronic nowadays)?
Setting up life in the UK was a bit more of a challenge; there are a lot of one-off expenses incurred and I burned through most of my ‘setup’ money within the first month. Setting up a bank account and getting some mail delivered to wherever you’re staying (so you have proof of address) is essential early on. And things you’d expect to be simple like getting car insurance or organising a lease on a flat can turn into multifaceted ongoing dramas….
I only started organising my fellowship about a year before I left, and a lot of the logistical issues like visas etc can only be done in the immediate months before you leave. Read more

Courses and Events
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Visit the ASM Website to register

Join the conversation on Twitter - #CICM2015ASM

NSW Trainee Education Days
The next TED session will be held at St George Hospital on Thursday 18 June. The session topic will be Neurointensive Care.

To register your attendance, or for more information please email megang@cicm.org.au
Paediatric BASIC Course

14 & 15 July **Limited Spaces Available**

24 & 25 November
email stephg@cicm.org.au to register interest.

Click here for more information
1 - 3 March 2016
Contact stephg@cicm.org.au to be placed on a registration list as course numbers are limited.
Critical Care Collaborative: Keeping it Real
8 May 2015
Albert Park, Melbourne, VIC
For more information and to register click here
Sydney Short Course in Intensive Care Medicine
29 June - 2 July 2015
Concord Hospital, NSW
For more information and to register click here
Critical Care Imaging Course 
**FREE Registration for ICU trainees**
17 - 21 August 2015
Queenstown, NZ
For more information click here

Beyond BASIC - Advanced Airway Management
27 August 2015
Liverpool Hospital, NSW
For more information and to register click here
Brisbane Intensive Care Medicine Courses
29 September - 1 October 2015
The Wesley & Princess Alexandra Hospitals, Brisbane, QLD
For more information and to register click here
All content within the Trainee e‐news reflects the views of individual contributors only and do not necessarily represent the views held by the College of Intensive Care Medicine of Australia and New Zealand as an organisation.