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VOLUME 21 , ISSUE 11 ( 2017 ) > List of Articles


Critical care junior doctors' profile in a lower middle-income country: A national cross-sectional survey

Ambepitiyawaduge De Silva, D. D. S. Baranage, Anuruddha Padeniya, Ponsuge Sigera, Sunil De Alwis, Anuja Abayadeera, Palitha Mahipala, Kosala Jayasinghe, Arjen Dondorp

Keywords : Critical care, junior doctors, lower middle-income country, resource-limited setting, training

Citation Information : De Silva A, Baranage DD, Padeniya A, Sigera P, De Alwis S, Abayadeera A, Mahipala P, Jayasinghe K, Dondorp A. Critical care junior doctors' profile in a lower middle-income country: A national cross-sectional survey. Indian J Crit Care Med 2017; 21 (11):733-739.

DOI: 10.4103/ijccm.IJCCM_268_17

License: CC BY-ND 3.0

Published Online: 01-01-2019

Copyright Statement:  Copyright © 2017; The Author(s).


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.

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  1. Kelley MA. Critical care medicine – A new specialty? N Engl J Med 1988;318:1613-7.
  2. Dorman T, Angood PB, Angus DC, Clemmer TP, Cohen NH, Durbin CG Jr., et al. Guidelines for critical care medicine training and continuing medical education. Crit Care Med 2004;32:263-72.
  3. Fuchs RJ, Berenholtz SM, Dorman T. Do intensivists in ICU improve outcome? Best Pract Res Clin Anaesthesiol 2005;19:125-35.
  4. Husain T, Gatward JJ, Hambidge OR, Asogan M, Southwood TJ. Strategies to prevent airway complications: A survey of adult Intensive Care Units in Australia and New Zealand. Br J Anaesth 2012;108:800-6.
  5. Astin J, King EC, Bradley T, Bellchambers E, Cook TM. Survey of airway management strategies and experience of non-consultant doctors in Intensive Care Units in the UK. Br J Anaesth 2012;109:821-5.
  6. Riviello ED, Letchford S, Achieng L, Newton MW. Critical care in resource-poor settings: Lessons learned and future directions. Crit Care Med 2011;39:860-7.
  7. Turner EL, Nielsen KR, Jamal SM, von Saint André-von Arnim A, Musa NL. A review of pediatric critical care in resource-limited settings: A Look at past, present, and future directions. Front Pediatr 2016;4:5.
  8. Gajic O, Afessa B. Physician staffing models and patient safety in the ICU. Chest 2009;135:1038-44.
  9. Bhagwanjee S. Critical care in Africa. Crit Care Clin 2006;22:433-8, viii.
  10. Haniffa R, De Silva AP, Iddagoda S, Batawalage H, De Silva ST, Mahipala PG, et al. Across-sectional survey of critical care services in Sri Lanka: A lower middle-income country. J Crit Care 2014;29:764-8.
  11. Friends and family test. Nurs Manage 2012;19:13. [RCN Publishing Ltd.]. Available from: [Last accessed on 2016 Dec 01].
  12. Sigera PC, Tunpattu MU, Jayashantha TP, De Silva AP, Athapattu PL, Dondorp A, et al. National profile of physiotherapists in critical care units of Sri Lanka: A low-middle income country. Phys Ther 2016;96:933-9.
  13. Kellerman SE, Herold J. Physician response to surveys. A review of the literature. Am J Prev Med 2001;20:61-7.
  14. Judson JA, Fisher MM. Intensive care in Australia and New Zealand. Crit Care Clin 2006;22:407-23, vii-viii.
  15. Poalillo FE, Jimenez EJ, Falk J. Critical care in the United States of America. Crit Care Clin 2006;22:447-55, ix.
  16. Offenstadt G, Moreno R, Palomar M, Gullo A. Intensive care medicine in Europe. Crit Care Clin 2006;22:425-32, viii.
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