Abstract
Undergraduate education on the intensive care unit

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The Intercollegiate Board for Training in Intensive Care Medicine has recommended that medical students should be exposed to a period of structured training in intensive care.1 The importance of training in the management of the critically ill patient has also been emphasized by the General Medical Council.2 The current state of medical student training in intensive care is not known. We performed a questionnaire study to investigate the level of undergraduate experience of intensive care nationally.

A questionnaire was sent to the director of each intensive care unit (ICU).3 The questionnaire asked about the number of medical students attached to the ICU, the duration of the attachments, teaching and assessment procedures and satisfaction with the present situation. It also asked about potential problems experienced by medical students. Another questionnaire was piloted to groups of first and fourth year medical students. This questionnaire asked about the usefulness of undergraduate intensive care training, the students experience of such training and possible problems.

The response rate for the ICU questionnaire was 155/267 (58%). Medical students were attached to 79 (51%) of responding ICUs, 26 (33%) of attachments were for one day and 73 (92%) for a month or less. Of the units offering attachments, 50 (63%) receive 10 students or fewer each year and 15 (19%) receive more than 25 students annually. One unit offered a first year attachment; 53 (68%) offered final year attachments. During the attachments, 57 (72%) of units gave up to 5 h of teaching each week and 42 (43%) assessed the students during the module, usually by a written report. Of the respondents 39 (49%) were dissatisfied with the level of intensive care experience gained by students and most thought intensive care was a vital part of undergraduate training. The technical atmosphere and clinical complexity of intensive care were thought to be potential problems by 40% and 36% of respondents. Twenty-five first year and 25 fourth year medical students completed the student questionnaire. Of these, 46 (92%) thought it should be possible to spend some time on the ICU before graduating and 47 (94%) thought the third year the most appropriate time. More students (41 (82%)) believed that the technology and complexity of intensive care were important problems in intensive care teaching.

Few medical students are exposed to intensive care during their undergraduate training and then for only a short time. There is dissatisfaction from students and intensivists with the current level of undergraduate intensive care experience. The technology of intensive care and the complexity of the clinical problems are perceived as problems by students but not by clinicians. The ICU is a valuable resource for training knowledgeable, skilful doctors; at present that resource is underused.

Keywords

education, medical students
intensive care

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