NCC working in MICU?

[spacegun]

This might be a dumb med student question, sorry if it is, I have heard of IM/CCM working in NCC, but is it possible for NCC to work in the MICU?

---

Members don't see this ad.

 

[typhoonegator]

There is a difference between working in a unit and being board-certified in a specialty. There are many, many more ABIM-certified critical care physicians than UCNS-certified neurocritical care physicians. So you'll definitely see them in neuroICUs that don't have NCC faculty, or don't want them. But unless they're grandfathered in or get more training, they can't sit for the UCNS certification. I don't think many of them are losing sleep over that.

Much rarer to see NCC people in MICU or SICU, except in a cross-covering situation like overnight and etc. This is for the same reason -- there are plenty of MICU people out there and far fewer NCC people to fill those spots. Also, depending on where you do fellowship, some NCC people are trained to be more consultative and less focused on managing non-neuro issues day-to-day, which would make for a pretty steep learning curve in the MICU when you have someone on VA ECMO and you're trying to keep the boat afloat.

 

[spacegun]

There is a difference between working in a unit and being board-certified in a specialty. There are many, many more ABIM-certified critical care physicians than UCNS-certified neurocritical care physicians. So you'll definitely see them in neuroICUs that don't have NCC faculty, or don't want them. But unless they're grandfathered in or get more training, they can't sit for the UCNS certification. I don't think many of them are losing sleep over that.

Much rarer to see NCC people in MICU or SICU, except in a cross-covering situation like overnight and etc. This is for the same reason -- there are plenty of MICU people out there and far fewer NCC people to fill those spots. Also, depending on where you do fellowship, some NCC people are trained to be more consultative and less focused on managing non-neuro issues day-to-day, which would make for a pretty steep learning curve in the MICU when you have someone on VA ECMO and you're trying to keep the boat afloat.

Thanks typhoonegator! That makes sense.

About the bold part, why wouldn't a neuroICU want a UCNS-certified NCC physician instead of an ABIM-certified critical care physician? Wouldn't a UCNS-certified NCC physician be more qualified for the neuroICU? I must be missing something here?

 

[typhoonegator]

Yes, hospitals should want to hire neurocritical care faculty to staff their neuroICU. But some units, like Pitt's neurotrauma unit, have existed since before neuroICU was a developed specialty, and for many reasons never came around to hiring neurocritical care-trained and boarded faculty members (until recently for Pitt's example). Or at some hospitals all the units are run by a critical care department/division, and they'd rather hire pulm-CC and anesthesia-CC people because they can be more easily plugged in to other units than a NCC person where the training in general critical care is less homogeneous.