Continuous education in intensive care for physicians in Brazil: for whom and their needs

Introduction

The postgraduation course had been developed by the Brazilian Critical Care Society (AMIB) to be applied to physicians from all regions of Brazil since 2004. The importance of this 360-hour course is to provide continuous education and to train abilities to make decisions and start treatment. Also, for those who are in ICU practice, to qualify for application of specialist examination. The main objective of this study is to identify who are the doctors that are looking for this course.

Methods

An opinion poll was collected from the students on the first day of the class course approaching the following aspects:

• 1. Profile.

• 2. He/she is attending the course in order to: prepare for the specialist critical care examination (), improve qualification (), work at an ICU (), any other reason if they do not deal with critical care patients ().

• 3. If he/she works at an ICU: how long (years) and the role (duty, routine or leader).

• 4. Partners of AMIB (yes) (no); if they have specialist title recognized by the AMIB (yes) (no).

• 5. If he/she has other postgraduation or residency program.

• 6. Self-evaluation related to the critical patient knowledge (scales from 1 to 9, considering 9 the highest grade).

• 7. Interest in the subjects of intensive care medicine (scales from 1 to 9).

Results

From 2004 to 2005 the AMIB started eight postgraduation courses in different regions of Brazil; 250 students were enrolled; 184 had answered the survey. The average age was 35.8 years (24–57); 133 men, 51 women. One hundred and five students are attending the course in order to improve their qualification, 87 are studying for the specialist title examination, 58 to work in the ICU and 47 to acquire new knowledge. They considered their main specialties to be: internal medicine (54), intensive care (15), surgery (10) and anesthesiology (seven). Sixty-five percent work in the ICU (12.7% are leaders, 19.5% daily routine, 86.4% on duty and 6.8% play all three functions), 6% have the specialist critical care title, 15.7% are associated with the Brazilian critical care society, 49.45% have medical residence in another area, 36.4% have other postgraduations. They self-considered around grade 6 for cognitive aspects, procedural skills and competence and near grade 8 for communication and relationship (see Figure 1). Cardiopulmonary resuscitation, mechanical ventilation, haemodynamics and neurointensivism are the most desirable subjects.

Figure 1

Conclusion

Doctors are mainly from the fourth decade, want to improve their qualification, and are usually working in ICUs. The low number of specialists who works in ICU is a reality and there is a need to expand it. The self-evaluation points to problems with knowledge and ability; however, communications and relationships were well adjusted. The diversity of data will assist the AMIB to provide continuous education and qualify doctors to attend the demand of intensivists in Brazil.