Assessment of the College of Intensive Care Medicine's capacity to train: a survey of trainees and directors.

BACKGROUND: In Australia and New Zealand, the numbers of intensive care medicine trainees have increased significantly over the past 15 years. This has implications for supervision, clinical and procedural experience, and availability of rotations. The College of Intensive Care Medicine of Australia and New Zealand (CICM) decided to estimate the current training resources using several domains. METHODS: An online survey was sent to all CICM trainees (n = 528) and all directors of intensive care units (ICUs) (n = 106), using the SurveyMonkey tool. RESULTS: The overall response rate for the survey was 44% (trainees, 38%; directors, 72%). Most trainees had a 1:1 day-night roster system. Experience among trainees with common ICU procedures appeared limited. Fifty-six per cent of trainees reported spending more than 20% of their time attending medical emergency team calls. Difficulty accessing anaesthesia, medicine, paediatric and rural terms were reported by 35%, 26% 46% and 40% of trainees, respectively. Thirty-seven percent of trainees reported having to wait at least 1 year and 10% waited up to 2 years over and above their required training time to secure an anaesthesia term. Owing to gaps in experience in certain modules, one-third of final-year trainees felt underprepared to take on a role as a specialist, an observation shared by 15% of directors. CONCLUSION: This report has provided an assessment of the available resources within Australia and New Zealand for training doctors in intensive care medicine, and has identified significant limitations and concerns among trainees and ICU directors regarding the capacity to train. The findings call for a review of the training program, including a determination of optimal numbers of training positions.

Prevalence of bullying, discrimination and sexual harassment among trainees and Fellows of the College of Intensive Care Medicine of Australia and New Zealand.

BACKGROUND: Anecdotal reports about bullying behaviour in intensive care emerged during College of Intensive Care Medicine (CICM) hospital accreditation visits. Bullying, discrimination and sexual harassment (BDSH) in the medical profession, particularly in surgery, were widely reported in the media recently. This prompted the College to formally survey its Fellows and trainees to identify the prevalence of these behaviours in the intensive care workplace. METHODS: An online survey of all trainees (n = 951) and Fellows (n = 970) of the CICM. RESULTS: The survey response rate was 51% (Fellows, 60%; trainees, 41%). The overall prevalences of bullying, discrimination and sexual harassment were 32%, 12% and 3%, respectively. The proportions of Fellows and trainees who reported being bullied and discriminated against were similar across all age groups. Women reported a greater prevalence of sexual harassment (odds ratio [OR], 2.97 [95% CI, 1.35-6.51]; P = 0.006) and discrimination (OR, 2.10 [95% CI, 1.39-3.17]; P = 0.0004) than men. Respondents who obtained their primary medical qualification in Asia or Africa appeared to have been at increased risk of discrimination (OR, 1.88 [95% CI, 1.15-3.05]; P = 0.03). Respondents who obtained their degree in Australia, New Zealand or Hong Kong may have been at increased risk of being bullied. In all three domains of unprofessional behaviour, the perpetrators were predominantly consultants (70% overall), and the highest proportion of these was ICU consultants. CONCLUSIONS: The occurrence of BDSH appears to be common in the intensive care environment in Australia and New Zealand.