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Indian J Crit Care Med. 2017 Nov;21(11):733-739. doi: 10.4103/ijccm.IJCCM_268_17.

Critical Care Junior Doctors' Profile in a Lower Middle-income Country: A National Cross-sectional Survey.

Author information

1
National Intensive Care Surveillance, Ministry of Health, Sri Lanka.
2
Intenisve Care National Audit and Research Centre, London, United Kingdom.
3
Network for Improving Critical Care Systems and Training, Colombo, Sri Lanka.
4
Paediatric Neurology Unit, Lady Ridgeway Hospital, Colombo, Sri Lanka.
5
Faculty of Medicine, University of Rajarata, Anuradhapura, Colombo, Sri Lanka.
6
Sri Lanka Government Medical Officers Association, Colombo, Sri Lanka.
7
Education, Training and Research Unit, Ministry of Health, Colombo, Sri Lanka.
8
Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
9
Direcotr General's Office, Ministry of Health, Colombo, Sri Lanka.
10
Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand.

Abstract

Background and Aims:

Retention of junior doctors in specialties such as critical care is difficult, especially in resource-limited settings. This study describes the profile of junior doctors in adult state intensive care units in Sri Lanka, a lower middle-income country.

Materials and Methods:

This was a national cross-sectional survey using an anonymous self-administered electronic questionnaire.

Results:

Five hundred and thirty-nine doctors in 93 Intensive Care Units (ICUs) were contacted, generating 207 responses. Just under half of the respondents (93, 47%) work exclusively in ICUs. Most junior doctors (150, 75.8%) had no previous exposure to anesthesia and 134 (67.7%) had no previous ICU experience while 116 (60.7%) ICU doctors wished to specialize in critical care. However, only a few (12, 6.3%) doctors had completed a critical care diploma course. There was a statistically significant difference (P < 0.05) between the self-assessed confidence of anesthetic background junior doctors and non-anesthetists. The overall median competency for doctors improves with the length of ICU experience and is statistically significant (P < 0.05). ICU postings were less happy and more stressful compared to the last non-ICU posting (P < 0.05 for both). The vast majority, i.e., 173 (88.2%) of doctors felt the care provided for patients in their ICUs was good, very good, or excellent while 71 doctors (36.2%) would be happy to recommend the ICU where they work to a relative with the highest possible score of 10.

Conclusion:

Measures to improve training opportunities for these doctors and strategies to improve their retention in ICUs need to be addressed.

KEYWORDS:

Critical care; junior doctors; lower middle-income country; resource-limited setting; training

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