Kadri Sameer S, Rhee Chanu, Fortna Gregory S, O'Grady Naomi P
Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, Maryland.
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts.
Clin Infect Dis. 2015 Aug 15;61(4):609-14. doi: 10.1093/cid/civ360. Epub 2015 May 5.
The recent rise in unfilled training positions among infectious diseases (ID) fellowship programs nationwide indicates that ID is declining as a career choice among internal medicine residency graduates. Supplementing ID training with training in critical care medicine (CCM) might be a way to regenerate interest in the specialty. Hands-on patient care and higher salaries are obvious attractions. High infection prevalence and antibiotic resistance in intensive care units, expanding immunosuppressed host populations, and public health crises such as the recent Ebola outbreak underscore the potential synergy of CCM-ID training. Most intensivists receive training in pulmonary medicine and only 1% of current board-certified intensivists are trained in ID. While still small, this cohort of CCM-ID certified physicians has continued to rise over the last 2 decades. ID and CCM program leadership nationwide must recognize these trends and the merits of the CCM-ID combination to facilitate creation of formal dual-training opportunities.
近期,全国传染病(ID)专科培训项目中未填补培训岗位数量的增加表明,在内科住院医师毕业生中,传染病作为职业选择的吸引力正在下降。用重症医学(CCM)培训来补充传染病培训,可能是重新激发对该专业兴趣的一种方式。实际的患者护理和更高的薪资显然很有吸引力。重症监护病房中高感染率和抗生素耐药性、免疫抑制宿主群体的扩大,以及近期埃博拉疫情等公共卫生危机,都凸显了重症医学与传染病培训相结合的潜在协同效应。大多数重症医学专家接受的是肺病医学培训,目前获得委员会认证的重症医学专家中只有1%接受过传染病培训。尽管这一获得重症医学与传染病联合认证的医生群体规模仍然较小,但在过去20年里一直在持续增长。全国范围内的传染病和重症医学项目负责人必须认识到这些趋势以及重症医学与传染病相结合的优点,以便推动创建正规的双重培训机会。