DM Critical Care Medicine: Admissions, Medical Colleges, Fees, Eligibility Criteria details
DM Critical Care Medicine or Doctorate of Medicine in Critical Care Medicine also known as DM in Critical Care Medicine is a super specialty level course for doctors in India that is done by them after completion of their postgraduate medical degree course. The duration of this super specialty course is 3 years and it deals with critically ill patients who are battling with something life-threatening. This includes providing life support, invasive medical techniques, and end-of-life procedures.
The course is a full-time course pursued at various recognized medical colleges across the country. Some of the top medical colleges offering this course include- NRI Medical College- Guntur, Indira Gandhi Institute of Medical Sciences, Sheikhpura- Patna, Rajendra Institute of Medical Sciences- Ranchi, and more.
Admission to this course is done through the NEET-SS Entrance exam conducted by the National Board of Examinations, followed by counselling based on the scores of the exam that is conducted by DGHS/MCC/State Authorities.
1.1 Timely approach to the recognition, assessment and stabilization of the acutely ill patients with disordered physiology
1.2 Cardiopulmonary resuscitation
1.3 Post-resuscitation management
1.4 Triage and prioritization of patients for ICU admission
1.5 Assessment and initial management of the trauma patient
1.6 Assessment and initial management of the patient with burns
1.7 Fundamentals of the management of mass casualties
2. Diagnosis: Assessment, Investigation, Monitoring and Data: Interpretation of the acutely ill patients
2.1 History taking and clinical examination
2.2 Timely and appropriate investigations
2.3 Understanding of echocardiography (trans-thoracic/trans-oesophageal), Indications and interpretation of results
2.4 Understanding of Electrocardiography (ECG/EKG), Indications and interpretation of the results
2.5 Appropriate microbiological sampling and interpretation of results
2.6 Interpretation of results from blood gas samples
2.7 Organization and interpretation of wide range of clinical imaging including bed-side chest x- rays, ultrasound, CT scan, MRI and nuclear imaging relevant for the diagnosis and management of critically ill and injured patients.
2.8 Understanding and interpretation of physiological variables
2.9 Integration of clinical findings with laboratory, radiology, microbiology and other investigations to form appropriate differential diagnosis and management strategy
3. Disease Management Acute disease
3.1 Management of the care of the critically ill patient with following specific acute medical conditions
• Acute Myocardial Infarction
• Pulmonary Embolism
• Cardiogenic Shock
• Life Threatening Arrhythmias
• Pericardial Tamponade
• Acute Ischemic Stroke
• Intracranial Hemorrhage
• Status Epilepticus
• Head & Spine Trauma
• Acute neuromuscular failure (OPP/GBS/MG/Snakebite, etc)
• Acute severe Asthma
• Acute Exacerbation of COPD
• Severe Community acquired pneumonia
• Chest Trauma
• Acute hypoxemia Respiratory Failure including ARDS
• Acute GI Bleed
• Acute Liver Failure
• Acute Pancreatitis
• Acute Abdomen
• Acute coagulation disorders
• Sepsis and Septicemic Shock
• Meningitis
• Acute Hemorrhagic Fevers
• Severe forms of tropical infections like Malaria, Typhoid etc.
• Acute Renal Failure
• Eclampsia
• Bone marrow suppression
• Critical care of mother and child including pre-eclampsia, eclampsia, acute fatty liver of pregnancy, HELLP syndrome, meconium aspiration syndrome, respiratory distress syndrome, transient tachypnoea of the newborn etc.
• Acute poisoning
Chronic Disease
3.2 Identifications of the implications of chronic and co morbid disease in the acutely ill patients
Organ System Failure
3.3 Management of patients with or at risk of circulatory failure
3.4 Management of patients with or at risk of acute renal failure
3.5 Management of patients with or at risk of acute liver failure
3.6 Management of patients with or at risk of neurological impairment
3.7 Management of patients with or at risk of acute gastrointestinal failure
3.8 Management of patients with or at risk of acute lung injury syndromes (ALI/ARDS)
3.9 Management of patients with or at risk of septic shock
3.10 Management of patients with or at risk of severe sepsis/septic shock with multi-organ dysfunction/failure
3.11 Management of patients following intoxication with drugs or environmental toxins
3.12 Early recognition and treatment of life-threatening complications, in mother and child, including but not limited to like eclampsia, preeclampsia, acute fatty liver of pregnancy, HELLP in mother and respiratory distress in child.
4. Therapeutic Interventions/Organ System Support in Single or Multiple Organ Failure
4.1 Principles of safe prescription
4.2 Principles of safe delivery of life-support therapies
4.3 Antimicrobial drug therapy – Fundamental principles and ICU specific issues
4.4 Transfusion therapy - Fundamental principles and ICU specific issues
4.5 Circulatory therapies - Fundamental principles and ICU specific issues pertaining to Fluid therapy including dynamic variables of fluid responsiveness and vasoactive/inotropic drugs
4.6 Mechanical circulatory assist devices
4.7 Initiation, management and weaning of the patients from invasive and non-invasive ventilatory support
4.8 Initiation, management and weaning of the patients from renal replacement therapy
4.9 Management of electrolyte, glucose and acid-base disturbances
4.10 Nutritional assessment and support
5. Peri-operative Care
5.1 Management of the pre-& post-operative care of the high risk surgical patients
5.2 Fundamentals of the management of the care of patients following cardiac surgery
5.3 Fundamentals of the management of the patients following craniotomy
5.4 Fundamentals of the management of the patients following solid organ transplantation
5.5 Fundamentals of the management of the pre and post-operative trauma care of the trauma patients
6. Critical Care of Children
6.1 Understanding of the critical care of children including but not limited to early diagnosis, initial management and life support therapies related to pediatric and neonatal emergencies
7. Transportation
7.1 Transportation of the mechanically ventilated critically ill patient outside the ICU
7.2 Understanding of the special considerations required during patient transport by air
8. Physical& Clinical Measurement Mathematical Concepts:
8.1 Relationships and graphs
8.2 Concepts of exponential functions and logarithms: wash-in and washout
8.3 Basic measurement concepts: linearity, drift, hysteresis, signal: noise ratio, static and dynamic response
8.4 SI units: fundamental and derived units
8.5 Other systems of units where relevant to ICM (e.g. mmHg, bar, atmospheres)
8.6 Simple mechanics: Mass, Force, Work and Power
Gases &Vapours:
8.7 Absolute and relative pressure.
8.8 The gas laws; triple point; critical temperature and pressure
8.9 Density and viscosity of gases.
8.10 Laminar and turbulent flow; Poiseuille's equation, the Bernoulli principle
8.11 Vapour pressure: saturated vapour pressure
8.12 Measurement of volume and flow in gases and liquids.
8.13 The pneumotachograph and other respirometers.
8.14 Principles of surface tension
Electricity & Magnetism:
8.15 Basic concepts of electricity, magnetism and Bridge circuits
8.16 Capacitance, inductance and impedance
8.17 Amplifiers: bandwidth, filters
8.18 Amplification of biological potentials: ECG, EMG, EEG.
8.19 Sources of electrical interference
8.20 Processing, storage and display of physiological measurements
Electrical Safety:
8.21 Principles of cardiac pacemakers and defibrillators
8.22 Electrical hazards: causes and prevention.
8.23 Electrocution, fires and explosions.
8.24 Diathermy and its safe use
8.25 Basic principles and safety of lasers
8.26 Basic principles of ultrasound and the Doppler effect
Pressure & Flow Monitoring:
8.27 Principles of pressure transducers
8.28 Resonance and damping, frequency response
8.29 Measurement and units of pressure.
8.30 Direct and indirect methods of blood pressure measurement; arterial curve analysis
8.31 Principles of pulmonary artery and wedge pressure measurement
8.32 Cardiac output: Fick principle, thermodilution
Clinical Measurement:
8.33 Measurement of gas and vapour concentrations, (oxygen, carbon dioxide, nitrous oxide, and volatile anaesthetic agents) using infrared, paramagnetic, fuel cell, oxygen electrode and mass spectrometry methods
8.34 Measurement of H+, pH, pCO2, pO2
8.35 Measurement CO2 production/ oxygen consumption/ respiratory quotient
8.36 Colligative properties: osmometry
8.37 Simple tests of pulmonary function e.g. peak flow measurement, spirometry.
8.38 Capnography
8.39 Pulse oximetry
8.40 Measurement of neuromuscular blockade
8.41 Measurement of pain
9. Research Methods Data Collection:
9.1 Simple aspects of study design (research question, selection of the method of investigation, population, intervention, outcome measures)
9.2 Power analysis
9.3 Defining the outcome measures and the uncertainty of measuring them
9.4 The basic concept of meta-analysis and evidence-based medicine
Descriptive Statistics:
9.5 Types of data and their representation
9.6 The normal distribution as an example of parametric distribution
9.7 Indices of central tendency and variability
Deductive & Inferential Statistics:
9.8 Simple probability theory and the relation to confidence intervals
9.9 The null hypothesis.
9.10 Choice of simple statistical tests for different data types
9.11 Type I and type II errors
9.12 Inappropriate use of statistics
10. Applied Anatomy Respiratory System:
10.1 Mouth, nose, pharynx, larynx, trachea, main bronchi, segmental bronchi, structure of bronchial tree and differences in the children's airway
10.2 Airway and respiratory tract, blood supply, innervation and lymphatic drainage
10.3 Pleura, mediastinum and its contents
10.4 Lungs, lobes, microstructure of lungs
10.5 Diaphragm, other muscles of respiration, innervation
10.6 The thoracic inlet and 1st rib
10.7 Interpretation of a chest x-ray
Cardiovascular System:
10.8 Heart, chambers, conducting system, blood and nerve supply
10.9 Congenital deviations from normal anatomy
10.10 Pericardium
10.11 Great vessels, main peripheral arteries and veins
10.12 Foetal and maternal-foetal circulation
Nervous System:
10.13 Brain and its subdivisions
10.14 Spinal cord, structure of spinal cord, major ascending & descending pathways
10.15 Spinal meninges, subarachnoid & extradural space, extradural space-contents
10.16 Cerebral blood supply
10.17 CSF and its circulation
10.18 Spinal nerves, dermatomes
10.19 Brachial plexus, nerves of arm
10.20 Intercostal nerves
10.21 Nerves of abdominal wall
10.22 Nerves of leg and foot
10.23 Autonomic nervous system
10.24 Sympathetic innervation, sympathetic chain, ganglia and plexuses
10.25 Parasympathetic innervation.
10.26 Stellate ganglion
10.27 Cranial nerves: base of skull: trigeminal ganglion
10.28 Innervation of the larynx
10.29 Eye and orbit
Vertebral Column:
10.30 Cervical, thoracic, and lumbar vertebrae
10.31 Interpretation of cervical spinal imaging in trauma
10.32 Sacrum, sacral hiatus
10.33 Ligaments of vertebral column
10.34 Surface anatomy of vertebral spaces, length of cord in child and adult
Surface Anatomy:
10.35 Structures in antecubital fossa
10.36 Structures in axilla: identifying the brachial plexus
10.37 Large veins and anterior triangle of neck
10.38 Large veins of leg and femoral triangle
10.39 Arteries of arm and leg
10.40 Landmarks for tracheostomy, cricothyrotomy
10.41 Abdominal wall (including the inguinal region): landmarks for suprapubic urinary and peritoneal lavage catheters
10.42 Landmarks for intrapleural drains and emergency pleurocentesis
10.43 Landmarks for pericardiocentesis
Abdomen:
10.44 Gross anatomy of intra-abdominal organs
10.45 Blood supply to abdominal organs and lower body
11. Physiology & Biochemistry General:
11.1 Organisation of the human body and homeostasis
11.2 Variations with age
11.3 Function of cells; genes and their expression
11.4 Mechanisms of cellular and humoral defense
11.5 Cell membrane characteristics; receptors
11.6 Protective mechanisms of the body
11.7 Genetics & disease processes
Biochemistry:
11.8 Acid base balance and buffers, Ions e.g. Na, K, Ca, Cl, HCO3, Mg, PO4,
11.9 Enzymes and Cellular and intermediary metabolism
Body Fluids:
11.10 Capillary dynamics and interstitial fluid
11.11 Oncotic pressure
11.12 Osmolarity: osmolality, partition of fluids across membranes
11.13 Lymphatic system
11.14 Special fluids: cerebrospinal, pleural, pericardial and peritoneal fluids
Haematology & Immunology:
11.15 Red blood cells: haemoglobin and its variants
11.16 Blood groups
11.17 Haemostasis and coagulation; pathological variations
11.18 White blood cells
11.19 Inflammation and its disorders
11.20 Immunity and allergy
Muscle:
11.21 Action potential generation and its transmission
11.22 Neuromuscular junction and transmission
11.23 Muscle types
11.24 Skeletal muscle contraction
11.25 Motor unit
11.26 Muscle wasting
11.27 Smooth muscle contraction: sphincters
Heart & Circulation:
11.28 Cardiac muscle contraction
11.29 The cardiac cycle: pressure and volume relationships
11.30 Rhythmicity of the heart
11.31 Regulation of cardiac function; general and cellular
11.32 Control of cardiac output (including the Starling relationship)
11.33 Fluid challenge and heart failure
11.34 Electrocardiogram and arrhythmias
11.35 Neurological and humoral control of systemic blood pressures, blood volume and blood flow (at rest and during physiological disturbances e.g. exercise, haemorrhage and Valsalva manoeuvre)
11.36 Peripheral circulation: capillaries, vascular endothelium and arteriolar smooth muscle, autoregulation and the effects of sepsis and the inflammatory response on the peripheral vasculature
11.37 Characteristics of special circulations including: pulmonary, coronary, cerebral, renal, portal and foetal
Renal Tract:
11.38 Blood flow, glomerular filtration and plasma clearance
11.39 Tubular function and urine formation
11.40 Endocrine functions of kidney
11.41 Assessment of renal function
11.42 Regulation of fluid and electrolyte balance
11.43 Regulation of acid-base balance
11.44 Micturition
11.45 Pathophysiology of acute renal failure
Respiration:
11.46 Gaseous exchange: O2 and CO2 transport, hypoxia and hyper- and hypocapnia, hyperandhypobaric pressures
11.47 Functions of haemoglobin in oxygen carriage and acid-base equilibrium
11.48 Pulmonary ventilation: volumes, flows, dead space.
11.49 Effect of IPPV and PEEP on lungs and circulation
11.50 Mechanics of ventilation: ventilation/perfusion abnormalities
11.51 Control of breathing, acute and chronic ventilatory failure, effect of oxygen therapy
11.52 Non-respiratory functions of the lungs
11.53 Cardio-respiratory interactions in health & disease
Nervous System:
11.54 Functions of nerve cells: action potentials, conduction, synaptic mechanisms and transmitters
11.55 The brain: functional divisions
11.56 Intracranial pressure: cerebrospinal fluid, blood flow
11.57 Maintenance of posture
11.58 Autonomic nervous system: functions
11.59 Neurological reflexes Motor function: spinal and peripheral
11.60 Senses: receptors, nociception, special senses
11.61 Pain: afferent nociceptive pathways, dorsal horn, peripheral and central mechanisms, neuromodulatory systems, supraspinal mechanisms, visceral pain, neuropathic pain, influence of therapy on nociceptive mechanisms
11.62 Spinal cord: anatomy and blood supply, effects of spinal cord section
Liver:
11.63 Functional anatomy and blood supply
11.64 Metabolic functions
11.65 Tests of function
Gastrointestinal:
11.66 Gastric function; secretions, nausea and vomiting
11.67 Gut motility, sphincters and reflex control
11.68 Digestive functions and enzymes
11.69 Nutrition: calories, nutritional fuels and sources, trace elements, growth factors
Metabolism and Nutrition:
11.70 Nutrients: carbohydrates, fats, proteins, vitamins, minerals and trace elements
11.71 Metabolic pathways, energy production and enzymes; metabolic rate
11.72 Hormonal control of metabolism: regulation of plasma glucose, response to trauma
11.73 Physiological alterations in starvation, obesity, exercise and the stress response
11.74 Body temperature and its regulation
Endocrinology:
11.75 Mechanisms of hormonal control: feedback mechanisms, effect on membrane and intracellular receptors
11.76 Central neuro-endocrine interactions
11.77 Adrenocortical hormones
11.78 Adrenal medulla: adrenaline (epinephrine) and noradrenaline (norepinephrine)
11.79 Pancreas: insulin, glucagon and exocrine function
11.80 Thyroid and parathyroid hormones and calcium homeostasis
Physiology and Metabolism Unique to Pregnancy, Child Birth and Neonates:
11.81 Physiological changes associated with a normal pregnancy and delivery
11.82 Materno-foetal, foetal and neonatal circulation
11.83 Functions of the placenta: placental transfer
11.84 Foetus: changes at birth
11.85 Metabolism unique to pregnant mother and neonates
12. Pharmacology
Principles of Pharmacology:
12.1 Dynamics of drug-receptor interaction
12.2 Agonists, antagonists, partial agonists, inverse agonists
12.3 Efficacy and potency
12.4 Tolerance
12.5 Receptor function and regulation
12.6 Metabolic pathways; enzymes; drug: enzyme interactions; Michaelis-Menten equation
12.7 Enzyme inducers and inhibitors.
12.8 Mechanisms of drug action Ion channels: types: relation to receptors.
12.9 Gating mechanisms.
12.10 Signal transduction: cell membrane/receptors/ion channels to intracellular molecular targets, second messengers
12.11 Action of gases and vapours
12.12 Osmotic effects 12.13pH effects
12.14 Adsorption and chelation
12.15 Mechanisms of drug interactions:
12.16 Inhibition and promotion of drug uptake.
12.17 Competitive protein binding.
12.18 Receptor inter-actions.
12.19 Effects of metabolites and other degradation products.
Pharmacokinetics & Pharmacodynamics
12.20 Drug uptake from: gastrointestinal tract, lungs, nasal, transdermal, subcutaneous, IM, IV, epidural and intrathecal routes
12.21 Bioavailability
12.22 Factors determining the distribution of drugs: perfusion, molecular size, solubility, protein binding.
12.23 The influence of drug formulation on disposition
12.24 Distribution of drugs to organs and tissues:
12.25 Body compartments Influence of specialised membranes: tissue binding and solubility
12.26 Materno-foetal distribution
12.27 Distribution in CSF and extradural space
12.28 Modes of drug elimination:
12.29 Direct excretion
12.30 Metabolism in organs of excretion: phase I & II mechanisms
12.31 Renal excretion and urinary H
12.32 Non-organ breakdown of Drugs
12.33 Pharmacokinetic analysis:
12.34 Concept of a pharmacokinetic compartment
12.35 Apparent volume of distribution
12.36 Orders of kinetics
12.37 Clearance concepts applied to whole body and individual organs
12.38 Simple 1 and 2 compartmental models:
12.39 Concepts of wash-in and washout curves
12.40 Physiological models based on perfusion and partition coefficients
12.41 Effect of organ blood flow: Fick principle
12.42 Pharmacokinetic variation: influence of body size, sex, age, disease, pregnancy, anaesthesia, trauma, surgery, smoking, alcohol and other drugs
12.43 Effects of acute organ failure (liver, kidney) on drug elimination Influence of renal replacement therapies on clearance of commonly used drugs
12.44 Pharmacodynamics: concentration-effect relationships: hysteresis
12.45 Pharmacogenetics: familial variation in drug response
12.46 Adverse reactions to drugs: hypersensitivity, allergy, anaphylaxis, anaphylactoid reactions
Systemic Pharmacology
12.47 Hypnotics, sedatives and intravenous anaesthetic agents
12.48 Simple analgesics
12.49 Opioids and other analgesics; Opioid antagonists
12.50 Non-steroidal anti-inflammatory drugs
12.51 Neuromuscular blocking agents (depolarising and non-depolarising) and anti cholinesterases
12.52 Drugs acting on the autonomic nervous system (including inotropes, vasodilators vasoconstrictors, antiarrhythmics, diuretics)
12.53 Drugs acting on the respiratory system (including respiratory stimulants and bronchodilators)
12.54 Antihypertensives
12.55 Anticonvulsants
12.56 Anti-diabetic agents
12.57 Diuretics
12.58 Antibiotics
12.59 Corticosteroids and other hormone preparations
12.60 Antacids. Drugs influencing gastric secretion and motility
12.61 Antiemetic agents
12.62 Local anaesthetic agents
12.63 Immunosuppressants
12.64 Principles of therapy based on modulation of inflammatory mediators, indications, actions and limitations
12.65 Plasma volume expanders
12.66 Antihistamines
12.67 Antidepressants
12.68 Anticoagulants
12.69 Vitamins and trace elements
Career Options
After completing a DM in Critical Care Medicine, candidates will get employment opportunities in Government as well as in the Private sector.
In the Government sector, candidates have various options to choose from which include Registrar, Senior Resident, Demonstrator, Tutor etc.
While in the Private sector the options include Resident Doctor, Consultant, Visiting Consultant (Critical Care Medicine), Junior Consultant, Senior Consultant (Critical Care Medicine), Critical Care Medicine Specialist.
Courses After DM in Critical Care Medicine Course
DM in Critical Care Medicine is a specialisation course which can be pursued after finishing a Postgraduate medical course. After pursuing specialisation in DM in Critical Care Medicine, a candidate could also pursue certificate courses and Fellowship programmes recognised by NMC and NBE, where DM in Critical Care Medicine is a feeder qualification.
Frequently Asked Question (FAQs) –DM in Critical Care Medicine Course
Question: What is the full form of DM?
Answer: The full form of DM is a Doctorate of Medicine.
Question: What is a DM in Critical Care Medicine?
Answer: DM Critical Care Medicine or Doctorate of Medicine in Critical Care Medicine also known as DM in Critical Care Medicine is a super specialty level course for doctors in India that is done by them after completion of their postgraduate medical degree course.
Question: What is the duration of a DM in Critical Care Medicine?
Answer: DM in Critical Care Medicine is a super specialty programme of three years.
Question: What is the eligibility of a DM in Critical Care Medicine?
Answer: Candidates must be in possession of a postgraduate medical Degree (MD/MS/DNB) from any college/university recognized by the Medical Council of India (now NMC)/NBE.
Question: What is the scope of a DM in Critical Care Medicine?
Answer: DM in Critical Care Medicine offers candidates various employment opportunities and career prospects.
Question: What is the average salary for a DM in Critical Care Medicine candidate?
Answer: The DM in Critical Care Medicine candidate's average salary is between Rs. 11,00,000 to Rs. 26,00,000 per year depending on the experience.
Question: Can you teach after completing DM Course?
Answer: Yes, candidate can teach in a medical college/hospital after completing DM course.
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