Training in additional areas of expertise has been a common feature of ICM training programmes, such as the acquisition of experience in echocardiography, bronchoscopy or upper GI endoscopy. These types of activities encourage new developments on intensive care units and should be strongly encouraged. The acquisition of relevant experience by attachment to other areas such as microbiology or radiology should also be facilitated and count towards intensive care training. This should not normally exceed 1 half day per week and may overlap with Educational Development Time. However, pure service attachments outside intensive care will not be permitted during any time of day or night. For example, a doctor in training with an Anaesthesia background will not be permitted to be involved in anaesthesia daytime or out of hours provision, or a doctor from a medicine background will not be permitted to conduct clinics or out of hours provision.
The opportunity to be involved in research, quality improvement and service review should be provided, as they are HiLLO requirements. However, it may be difficult for non-academic doctors in training to do original research and that “research awareness” may be easiest to obtain via an established research programme. Therefore, this should be part of an existing programme of research rather than individual projects specifically developed for doctors on the programme and should be identified as early as possible. An ICM consultant with responsibility for coordinating allocation to these projects should be identified. It is possible that this coordinator could be the Faculty Tutor or another individual; whatever the arrangement, close liaison should occur between the Tutor and coordinator/researcher at an early stage to avoid delays and missed opportunities.
Doctors are expected to complete smaller worthwhile quality improvement projects as well as contribute to programmes with a longer timescale for completion and dissemination.