Training Capacity and Rostering
Foundation Trainees form a valuable part of the Critical Care team. Rostering of this group varies between units but care should be taken that there are sufficient training opportunities for all the trainees allocated to the unit at any one time.
Stage 1 and Stage 2 trainees
Trainees should have sufficient patient contact to provide enough clinical experience. The case mix and numbers presenting to the unit is the main determinant of this; however as a general rule an Intensive Care Medicine trainee at this level should look after a minimum of 3 level 3 patients or 6 level 2 patients and a maximum of 8 level 3 or 16 level 2 or a combination during daytime hours.
Local considerations, such as the frequency of nocturnal admissions and the degree of instability of the patients will determine appropriate ratios at night. I
nteraction with other grades influences the ratio: for example more junior grades such as Foundation programme and CT Medicine trainees may be present on the unit in varying numbers.
The tutor needs to ensure that interaction between these groups is productive, with the ICM trainee developing a supportive and supervisory role.
Stage 3 trainees
Units of eight level 3 or fewer beds should have only one Stage 3 trainee rostered to be on duty at any one time, excluding handovers.
Stage 3 trainees may be rostered to be on-call from home. This may allow additional opportunities for training appropriate to this level of trainee but it is recognised that it is increasingly common for ICM to be delivered by consultants who are resident themselves.