ICM training West Midlands

To outsiders, the West Midlands evokes an image of the decaying Victorian industrial landscape which inspired the ‘Twin Towers’ of J.R.R. Tolkien fame. Tolkien grew up in Birmingham and many locations in his books are said to be inspired by there. However, the reality is far from Mordor!

With a population of nearly six million, the West Midlands covers a vast and varied geographical area. It ranges from Shropshire and Herefordshire to Staffordshire, Warwickshire and Worcestershire as well as the well-known cities of Birmingham, Coventry and Stoke. With convenient transport links to other parts of the country, including London, the West Midlands is literally in the heart of the country.

The region encompasses three major teaching and several district general hospitals, offering a varied and enriched ICM training, lifestyle and culturally diverse experience.

Training Variety

The region prides itself in providing high quality training offering a robust and comprehensive programme. Whilst the majority of the trainees are Dual CCT trainees with anaesthesia and acute medicine, we also have trainees who are single and dual with ED. We appreciate that each trainee’s training and goals are different. In this respect, we are fortunate to have strong ties with ICM linked specialties and can individualise training to a greater degree.

We now have a collaborative, established ICM academic training programme with NIHR funded posts, supported by Professors Bion, Whitehouse, Veenith, Yeung, Gao and Perkins. Several ICM trainees are pursuing an academic career in ACF and ACL posts whilst continuing to participate in clinical management.

Our trainees have access to PICU training at the Birmingham Childrens Hospital and University Hospital North Midlands NHS trust.

The region has several Trusts where the Advanced Critical Care Practitioner (ACCP) programme is embedded and ACCPs are employed to support services whilst offering additional mutual training and educational opportunities.

ICM Training Programme

Care of the critically ill patient requires the cooperation and integration of care across of multiple specialties. The West Midlands benefits from a breadth of ICM programmes that provide exposure to complex critical care and foster the acquisition of skills compatible with helping trainees develop into leadership roles.

Over the last few years, with the help of enthusiastic educators, we have expanded our regional educational programme, beyond the established monthly teaching for FFICM, to ensure that the skills essential to delivering excellent critical care are provided. We now have a regular local FFICM exam preparation course established by Nehal Patel and now delivered by Ingy Elsayed at UHNM which attracts trainees locally as well as nationally. In addition, we are establishing ICM themed regional teaching days in ACCS and ICM. Some trusts regularly run ICM courses for the trainees which are enthusiastically received. These courses also enable the senior ICM trainees to cultivate their skills as teachers and course organisers. Additionally, as part of complimentary specialty training, Airway Management and Adult Transport courses are provided at UHCW.

Special Skills Years undertaken to date include ECMO, echocardiography, cardiac, neurointensive care, quality improvement, research, and Pre-Hospital Emergency Medicine (PHEM). We have several accredited mentors offering training in FICE. Additionally, Ashley Miller (West Midlands lead for ICM echocardiography training) has set up a multifaceted, echocardiography/ultrasound fellowship training programme adaptable for ICM specialist skills training in echocardiography. One of our former trainees has successfully completed a Chief Medical Registrar placement.

After considerable negotiation, we have increased placements in the district general hospitals, offering advanced training and flexible management opportunities to ensure that Stage 3 trainees procure the experience to prepare for life as an ICM consultant.

Consultant Numbers

In National ICM recruitment, competition for West Midlands ICM posts is substantial and we are fortunate to have an occupancy rate of 100%. Despite this, we remain significantly short of the numbers required for the region in terms of ICM consultants. This was the conclusion of the West Midlands Regional Workforce Engagement meeting organised by the Faculty and the Midlands Critical Care Network endorsed this. Increasing our trainee posts is one way of addressing this. Within the School of Anaesthesia, we are negotiating with HEE to increase ICM post numbers.

The Future

The challenges facing the West Midlands mirror those across the country:

• Recovering from the recent setbacks to training in the wake of the Covid-19 Pandemic including resultant service reconfigurations,

• Lifting trainee morale and

• Expanding trainee numbers to equip the region with a sustainable consultant workforce to elevate patient care and meet GPICS standards.

Overcoming these are key to promoting the ICM programme and retaining our trainees through to the consultants we need. Come and experience the excellent training first hand in the not so stereotypical West Midlands!