Speciality status for intensive care medicine?

Today, ICM has a multidisciplinary approach in many countries. A survey of the European Society of Intensive Care Medicine (ESICM) [1] showed that in 10 out of 19 European countries there is a multidisciplinary approach to intensive care training with a common core curriculum. Only in eight countries is training in ICM available solely through anaesthesia (ie as a subspeciality of anaesthesia). Seventeen countries out of the 19 offer an official registration (accreditation) for special competence in ICM, and in 16 countries out of these 17 this accreditation is combined with a base or major speciality, such as anaesthesia, internal medicine, surgery and paediatrics; in these countries ICM can be described as a 'supraspeciality'. Only in Spain is ICM considered a speciality in its own right (monospeciality) without a second or a base speciality; however, even in Spain the national society of Intensive Care Medicine (SEMICYUC) recommends open, multidisciplinary access.Outside Europe, the multidisciplinary access has also been established in the USA where ICM training programmes are available through the common major specialities.Considering its multidisciplinary appearance, ICM seems vague to many professionals. ICM even seems to be subject to professional covetousness sometimes, in that some societies claim sole representation of ICM.In view of this, I can well understand those intensivists who long for ICM to become a speciality in its own right; in my view, though, this is not a desirable objective at present. My vision for ICM is that of the 'supraspeciality' with a multidisciplinary access.My reasoning for this is that ICM provides a multidisciplinary spectrum of actions that cannot be compared to most of the other specialities. ICM obviously represents a crosssection of medicine for acute situations. Thus, ICM has to unite various influences and experiences from many different specialities. It represents a highly active synapsis in clinical medicine where the in