Training in critical care medicine: a personal perspective

Over the past several years, there has been growth in the number of training programs in the new subspecialty of critical care medicine. The adoption of subspecialty certifying examinations in critical care medicine has added momentum to the growth of the subspecialty. A personal experience in a critical care medicine fellowship training program is detailed and contrasted with a year of clinical pulmonary fellowship training. The clinical training programs differed primarily in scope. Technical expertise in intensive care unit procedures and therapy was stressed during the critical care medicine fellowship, whereas the year of clinical pulmonary training was of greater scope, encompassing comprehension of pulmonary pathophysiology, diagnostic procedures, and therapy. "Hands-on" intensive care unit training was limited during the pulmonary fellowship, though didactic instruction and the conceptual approach to critical illness was stronger. Research training opportunities were largely equivalent. From this experience, I present suggestions for selecting fellowship training in critical care medicine.