Career Story: Single Specialty ICM in Wales

We have a co-located Long term Ventilation with long stay complex weaning service. Six consultant Intensivists, out of a total of 28 ICM consultants provide the continuity of service to this patient cohort. Around one third of my clinical sessions goes to provide the consultant sessional in-put. I find this very rewarding. The work is very multi-disciplinary team (MDT) focused with a weekly goal planning MDT meeting. The relationship between patients, their families and the MDT is very different from the acute ICM service. 

I am also one of three consultants who provide the medical in-put into our Follow Up and rehabilitation clinic which aims to see those patients who have been through our critical care service with a length of ventilated stay of more than 72 hours. We see patients every other week. Each clinic sees 6 patients and is a 2 session (PA) day. I find this provides a good link with other specialties and I really enjoy medical clinics - appreciating that this is not every Intensivists idea of enjoyment. 

My current job plan is around 50% acute ICM and 50% lower acuity ICM which still requires a good working knowledge of critical care medicine in a broader sense. I will be coming off the consultant resident night shift from aged 55 years. This means picking up more day time sessions (PAs) at weekends and weekdays. Our sessions (PAs) are all annualised. This allows periods away from clinical work provided the total annual sessions are worked. 

The career timeline to my current job included undergraduate medical training in London, a medical rotation in Bristol through to registrar level, anaesthetic core training in West London and then ICM and anaesthetic training in north central London. During this period I did a year as a cardiothoracic ICM/Anaesthetic fellow and also did training and an examination in TOE. 

The expectation at that time was to be a consultant in London covering ICM and anaesthesia for cardio-thoracic surgery. I did this for a year as a locum consultant in UCLH. However with young children came the realisation that we did not want to live and work in London. I had also come to the conclusion that I only wanted to do Intensive care medicine. The opportunity arose to move to Cardiff as an Intensivist and I took this up. 

After 6 years in this consultant post I decided to move to a neighbouring Health Board where I worked in a large DGH as one of three full time Intensivists. In time I was the Lead clinician for the large DGH and following a merging process also the cross site lead clinician for a small DGH unit. I was also the lead clinician for the south east Wales critical care network. 
I was offered the chance to return in a split ICM consultant job in Cardiff which I took. After several years working in two Health Boards I decided to consolidate my sessions in Cardiff. 

I am not sure if ‘variety is the spice of life’ but refreshing career changes have been very important to me. The ICM consultant post we are appointed into does not need to be the same as the one we retire from. Flexible job planning which takes into account changes in our interests and lifestyle have been very important as is the support of our consultant colleagues. 

Role Summary

Direct Clinical Time (PAs) = 7.5
DCC divided into 50% acute and 50% lower acuity + Follow Up
SPAs 2.5 including FICM role
All PAs are annualised