1. The JFICM supervises all advanced training in intensive care medicine. On completion of the JFICM's training program, physician trainees will be eligible for Fellowship of the JFICM and will subsequently be recommended for Fellowship of the RACP.
   
   
2. At the completion of the training program, trainees will be expected to have experience and expertise in:

• evaluation and resuscitation of critically ill patients;
• evaluation and management of patients with vital organ and system failures;
  
• physiological monitoring and clinical measurement including complex biochemical and haematological indices;
  
• cardiopulmonary resuscitation;
  
• airway management including translaryngeal intubation and tracheostomy;
  
• invasive haemodynamic monitoring including central venous, arterial and pulmonary artery cannulation and the interpretation and clinical use of derived variables;
  
• advanced respiratory monitoring (respiratory mechanics, arterial blood gases);
  
• communication with critically ill patients and their families;
  
• fibreoptic bronchoscopy;
  
• continuous renal replacement therapy;
  
• mechanical ventilation including a comprehensive range of ventilatory modes and strategies;
  
• tube thoracostomy;
  
• pleural, pericardial and abdominal paracentesis;
  
• transportation of critically ill patients;
  
• enteral and parenteral nutritional support.
  
  

3. It is desirable that trainees also acquire expertise and experience in the indications for and performance of other modalities including:

• intraortic balloon counterpulsation;
  
• echocardiography;
  
• intracranial pressure monitoring;
  
• gastrointestinal endoscopy;
• extra corporeal support techniques including cardiopulmonary bypass, ECMO, ECCO2R and ventricular assisted devices.
  

Components of Training
Core Training
Core training consists of a minimum of 2 years of full time (or pro rata part time), supervised clinical training in an advanced standing capacity in an accredited intensive care unit (ICU). It is recommended that a period of at least 6 months be spent in a 'senior registrar' capacity.

At least one year must be undertaken in an adult ICU accredited as 'C24'. At least one year of core training must be continuous. With the exception of rotations to 'S3' ICUs, core training periods must be of a minimum duration of 6 months.

It may be possible for one year of training to be undertaken in an overseas post. It is the responsibility of the trainee to ascertain relevant details and to obtain approval from the JFICM before committing to any such training position. At the time of writing, approval for overseas training is not established. If overseas training is approved, one year of continuous training must be undertaken in an Australasian unit classified as 'C24'.

Complementary Training
Training in anaesthesia is compulsory. This component may be undertaken in any hospital or post accredited for training by ANZCA. It is desirable that this component of training be undertaken prior to the final year of core training. Posts other than those accredited by ANZCA (including overseas posts) may be appropriate but prior authorisation is essential.

Effective training may be undertaken in any related medical discipline or in full time research. Elective training does not mitigate the requirement for training in anaesthesia.

Procedural Skills
These are detailed in the General Principles section above. The completion of a logbook documenting the extent of the training experience in relation to procedures undertaken and the number and case mix of patients managed is desirable. A model logbook can be down-loaded from the Faculty website.

Modules
It is likely that modules of training in specific aspects of intensive care will be introduced in the near future.

Project Report
Trainees are required to submit a satisfactory project report during the period of advanced training. Completion of training cannot be certified nor Fellowships recommended until a satisfactory report has been received and appropriately reviewed.

The report must be based on a research project in which the trainee has participated to a significant degree. The trainee must prepare the report as if for publication in a scientific journal. Although publication is not mandatory, it is encouraged and manuscripts submitted for publication may also be submitted as the project report. The project must be substantial; individual case reports are not acceptable. Presentation of the project in an appropriate forum is compulsory. The project report is to be evaluated by the trainee's supervisor. The supervisor's evaluation (including an assurance that the trainee has been a major contributor to the project, is the principal author of the report and has presented the project in a suitable forum) is to accompany the report when submitted. The JFICM will undertake final evaluation.

The relevant documents entitled Formal Project Guidelines and Supervisor's Project Evaluation Report are available from the Secretariat of the JFICM.

Research
Experience in clinical or laboratory research is an essential component of training in intensive care medicine. Knowledge of the principles of EBM is similarly essential. See Project Report for details.

Training Sites
ICUs are accredited on the basis of inspection for 6, 12 or 24 months of core training. While the entirety of core training can be undertaken in a unit classified as 'C24', training in more than one institution is encouraged. Secondment for a period of 3 months from a centre accredited for core training may be possible. Sites accredited for secondment are classified as 'S3'. Only one period of 'S3' training is allowed during the 24 months of core training.

Accreditation of Training Sites
Training site are accredited by the Hospital Accreditation Committee of the Faculty on the basis of cyclical site inspections. Factors relevant to accreditation and to the duration of accredited training in individual sites include the number and case mix of patients, available clinical and educational resources, an appropriate education program and adequate trainee supervision.

Examination
All trainees will be assessed by JFICM Fellowship Examination (the examination). The examination can be undertaken after the completion of one core year of advanced training. Successful examination candidacy and completion of the entire JFICM program is a prerequisite for admission to Fellowship of the JFICM and for support by the JFICM for admission to Fellowship of the RACP.