How to Maximise Your Portfolio
By virtue of being a registrar-entry training programme that accepts trainees from different. clinical backgrounds, ICM allows the development of broad clinical and non-clinical interests before applying.
My top tips are:
- Check out the self-assessment criteria on ICMNRO website early.
This will allow you to direct your activities to maximise scoring opportunities and develop your portfolio in areas where you have less experience.
- Focus on low-hanging fruit.
High scores are more achievable in some domains than others; for example, presenting a poster at a national conference or leading a local quality improvement project are easier to achieve than a Masters-level qualification, but all score the same number of points (as per 2024 guidance).
- Be mindful that you cannot use the same evidence in more than one domain.
- Maximise every project
If you have performed an audit, make sure you present it locally and as a poster at a national conference that provides a conference abstract (you generally have a high chance of acceptance!). It maximises your score in a single domain while providing valuable experience and, importantly, does not require significantly more work.
- Keep an eye out for national service evaluations that require trainees for data collection.
Apart from exposure to national projects, it will introduce you to trainee networks, you may be listed as a study collaborator for published papers, and it may spark a new interest, without demanding much of your time.
- Do what you enjoy!
The time, effort and quality of outputs reflects your passion, and while scoring points on an application is a happy by-product of this, it will also give you a strong footing in specialty interviews.
Making the Most of Your Day Job
For those without an ICM rotation, arrange a Taster Week. This shows you what the job is really like while demonstrating commitment to the specialty.
Conducting reviews of critically unwell patients in the wards, ED, or theatres uses many of the transferrable skills required for ICM. Make sure you log these cases, either through workplace-based assessments or personal reflection, and what you learned from them. Use your interactions with intensive care doctors and critical care outreach teams to understand what is involved in their criteria for acceptance to intensive care.
Stay organised: you will need to have completed exams in your parent specialty before applying for an ST3 post (MRCP, Primary FRCA, MRCEM or FRCEM Intermediate). Make sure you know when the exam and application windows are, and when is a good time for you to sit an exam (e.g., during a quieter rotation or avoiding life events like weddings or babies).
Talk to ICM trainees to understand what the training programme is really like, including exams, stages of training, special interest areas, anticipated challenges, hot topics, and life as a consultant. This provides valuable intelligence for the interviews, while outlining if the specialty is really for you.
Have a look at the FICMLearning or the Intensive Care Society Learning Portal. You will find blogs, podcasts, webinars, and other useful resources (e.g., FUSIC e-learning modules) that may be of interest to you and develop your understanding of critical care. And importantly, most of the resources are free.
Making the Most of Intensive Care Placements
Make your intention to apply to ICM clear to the whole team, who will be delighted to support you to achieve your goal.
Keep a logbook of cases that you have admitted, ward patients you have reviewed, resuscitations you have been involved with, and procedures undertaken. This demonstrates the breadth of your experience and skills achieved before entering the ICM training programme. The FICM website has some logbook options you can trial.
Complete supervised learning events (SLEs) for interesting cases you are involved with. These can be downloaded from the Faculty of Intensive Care Medicine website. Logbooks, SLEs and supervisor reports may reduce the time required to complete Stage 1 ICM, so keeping a contemporaneous record is important!
Take advantage of chances to learn and use clinical skills, for example in point of care ultrasound, echocardiography, or line placement. Some departments will have teaching programmes that support trainees to develop skills, for example FUSIC Heart or Lung. Enquire about these opportunities early and develop these during quiet periods on the Unit (avoid coming in on your days off!).
Lead or take part in an audit, quality improvement or research project while on the ICU. An intensive-care-themed project always looks impressive on an application. Share the workload by teaming up with colleagues. And remember, quality over quantity; it is better to invest in a good quality project than spread yourself too thin.
Attend an ICM conference. A good start is the ICS State of the Art conference; it’s a chance to listen to experts in the field, network, and to present a poster. If you’re looking further afield (and can get the study leave and budget), the European Society of Intensive Care Medicine Annual Congress is another option.
What About Non-ICM Placements?
Maintain enthusiasm and work to a high standard, even in specialties you don’t love; you are rewarded for demonstrating excellence in educational supervisor reports throughout your training in the “Progress through training and excellence” assessment domain, even in specialties that may not seem to have much connection to critical care.
Use the opportunities available to you to develop transferrable skills; remember, identifying fractures on an X-ray, managing complex pain patients, or managing acutely delirious patients will be useful for your intensive care career.
Keep populating those non-clinical domains; a quality improvement or research project in an unrelated specialty will score the same number of points as a critical care-themed project.
