This study surveyed 111 emergency medicine (EM) trainees to identify factors influencing their choice of critical care (CC) fellowship pathways, particularly surgical critical care (SCC). Respondents included 42 fellows and 69 residents, with most pursuing anesthesiology or medicine CC; only 15 intended SCC.
Key determinants of pathway selection were:
exposure to specialty units
geographic considerations
multidisciplinary team experience.
Limited exposure to EM-SCC during residency was noted—only 28% had access to such fellowships, and 42% interacted with surgical intensivists, despite 41% envisioning SCC practice.
Intellectual appeal ranked highest for entering CC, above job prospects or lifestyle.
Fellowship components most valued were:
CC knowledge
Institutional support for EM/CC
ECMO exposure
While descriptive, the authors noted many respondents cited the "preliminary surgical year" as a reason that the Surgical Critical Care pathway is less attractive.
The authors conclude that respondents pursued a career in CC for "intellectual appeal and desire for additional expertise" and that improving EM-SCC matriculation requires targeted interventions.
References
Hynes AM, Carver TW, Owodunni OP, et al. Attracting Emergency Medicine-Trained Residents to Surgical Critical Care: The Implications From a Nationwide Survey of Emergency Medicine Trainees Interested in Critical Care. Crit Care Med. 2025 Oct 31. doi: 10.1097/CCM.0000000000006935.
