DICM - The ETR and Case Reports

The ETR and Case Summaries

This is the first bit of the Diploma to get started on, and the easiest if you start it early. If you are registered as an Intensive Care Trainee, you should already have received the paperwork for your Educational Training Record - if not, write off to the IBTICM as soon as you start to consider writing the Diploma. It will save you some hassle to fill it in as you go along, rather than doing it retrospectively. The ETR consists of:

A list of your ICU placements for Basic, Intermediate and Advanced levels (you only need to complete 'Intermediate' to sit the DICM).
A record of courses, meetings, research and audit you've taken part in.
Your case summaries (a sample is included in the paperwork).
Several pages of 'core curriculum' topics to be ticked off at Basic, Intermediate and Advanced levels. You don't need to tick off every topic at every level, but this will serve as a record of what you've covered and hopefully make you aware of any gaps in your experience.
A list of relevant Basic Science topics, 'for information only'.

While working on ICU, keep an eye out for interesting cases. If you collect one each month you work in ICU, that's all you need do. Even if you don't write them up fully at the time, at least collect the clinical details - reading, literature searching and writing-up can be done later if you must. A few suggestions to guide your selection of cases:

Choose a wide selection of cases - don't focus too many reports on one organ system.
The examiners are keen to see that you've learnt something from each case. In particular, look out for cases where in retrospect you think management could have been different.
Topical or new modalities form a useful focus for discussion or reading. Examples might include a patient who received therapeutic hypothermia; a patient who was monitored by pulse-contour analysis (or any other 'new' monitor); a patient in whom you used activated Protein C (or any other 'new' drug).
Do not pick anything too obscure. I resisted the temptation to include my infant with intracranial haemorrhage due to alpha-1-antitrypsin deficiency. Although you don't want cases that are too 'run-of-the-mill', you do want cases that will be of relevance to your future ICU practice.
It sounds obvious, but only submit a case if you would be happy to be viva'd on it.
With good selection of cases, and wide reading around them, you can probably cover about 20% of the core of intensive care medicine. This overlap could save you time in your general swotting!

If you're interested to see the list of case reports I submitted, click here. Further examples of case reports can be downloaded from the ICS Trainees Page. A summary of the requirements of the ETR appears in the DICM Regulations, and more detail on the requirements for the Case Summaries can be found on the last page of the Calendar. The ETR itself can be downloaded here (same link as at the top), including a sample Case Summary.