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July 15, 1992

Critical Care Medicine

Author Affiliations

Rush-Presbyterian—St Luke's Medical Center, Chicago, Ill

JAMA. 1992;268(3):340-342. doi:10.1001/jama.1992.03490030052025

Seven years ago, in the 1985 version of the Contempo series, I raised the question about whether critical care medicine had evolved sufficiently to be designated a true medical subspecialty.1 The present statistics strongly support that it has. Critical care board certification examinations have been given since 1986 or 1987 in the four specialties of anesthesiology, internal medicine, pediatrics, and surgery. Through 1991, more than 4600 physicians have attained full certification, with the majority (>2800) coming from internal medicine.2 The total number of approved fellowship training programs has risen to 196, with internal medicine accounting for more than 100 of these programs. Within the field of internal medicine, critical care subspecialty training is represented as follows: pulmonary (70%), only critical care medicine (16%), cardiology (9%), nephrology (4%), and infectious disease (1%). As "grandfathering" accounted for most of the candidates for these examinations, this representation will probably change somewhat