The accreditation process in the evolving subspecialty of critical care medicine continues to be of primary importance to those in the field. During the past 15 years, the concept of an intensivist trained in the multiple subspecialty areas necessary to care for a broad range of critically ill patients has been accepted. However, disagreement still exists about whether training in a pulmonary subspecialty is sufficient background or whether a multidisciplinary critical care background is needed.
During 1985 and 1986, subspecialty board examinations in critical care medicine were given by the four major sponsoring specialties: anesthesiology, pediatrics, surgery, and internal medicine. In internal medicine, for example, physicians trained in internal medicine and one or more of its subspecialties can take the examination after completing an accredited fellowship program containing at least 12 full months of clinical critical care training in an intensive care unit (ICU) environment. Those physicians without formal fellowship