Critical Care Medicine and why it's important for a future dermatologist
They say the "lifestyle" of dermatology is better because there are no "Dermatologic Emergencies". There are a few exceptions to this rule and certain dermatologic diseases can be acute and/or life threatening. Despite this knowledge. I wanted to do a month in the intensive care unit (ICU). Partly for self-motivate reasons - my residency requires an intern year where I will be rotating through medical ICUs, and partly out of curiosity.
My ICU month taught me the importance of basic physiology, vital signs, and attention to detail. On the floor, our vital signs are generally stable and when they start to fluctuate, those patients end up in the ICU. It was also neat to see how interventions and procedures can assist in patient recovery. I was able to see people intubated, extubated, and even transitioned over to longterm tracheostomies for airway management. I feel a lot more comfortable.
Always considering the fluid balance… Lessons from the ICU!
In addition to the science of medicine, I learned even more about the art of medicine in the approach to prioritizing interventions and aligning healthcare delivery within goals of care. Patient and family desire for quality of live was at the forefront of each daily plan and we frequently checked in on wellbeing of their advocates including spouses, adult children and more. It was a powerful reminder to keep patient preferences in perspective with the daily decisions of care.
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Why is it important to do a critical care month as a future dermatologist? I firmly believe that if you have an MD after your name, you need to be a generalist in addition to a specialist. While I do not expect to be an expert in ICU medicine - I do think it's important to have familiarity and to understand what your ICU colleagues are faced with. Additionally, how will you know when your patient needs ICU level care if you've never seen ICU level care?
Finally, I'll have you know that we did consult dermatology for a rash of unknown significance, in a patent with high cell counts because we were curious if they two were linked. So on that day, there were almost as many dermatologists as there were ICU fellows!
I would highly recommend that you do an ICU month as a medical student or trainee. The experience may not come again, and I learned so much from my month. I look forward to working as a part of an ICU team in the future!