PICM Medical Trainees

PICM training is accredited by the Royal College of Paediatrics and Child Health (details here).

It is overseen by the RCPCH Paediatric Intensive Care Medicine Intercollegiate Speciality Advisory Committee ‘RCPCH PICM ISAC’.

There is a route into PICM training from either Paediatric, Anaesthetic or ICM training backgrounds. Other training routes may be considered on an individual basis (e.g. PEM). PICM training consists of two years of sub-speciality training (NTN Grid) based in one or more UK PICUs. In addition to these two years, Paediatricians must gain 6 months anaesthetic experience and Anaesthetists must gain 6 months paediatric or neonatal experience.

A full description of how to apply for RCPCH PICM sub-speciality (national training grid programme) can be found on the RCPCH website.

Paediatric trainees can only become accredited as a paediatric intensivist by gaining a national grid post. You must apply for this during your ST5 or ST6 years. (This will change once ‘Shape of Training’ comes into being). There is no route to train in the UK outside the Grid and obtain at CCT in PICM.

The route for trainees from an Anaesthetic background is detailed here. You must also apply for a national grid post in PICM. You will currently, on completion of your training, NOT be recognised with dual accreditation to include ICM and PICM, but will receive a certification from PICMISAC to recognise the time spent training in PICM. To undertake Grid training and achieve a CCT in Anaesthesia requires approval of a bespoke training programme and approval from the RCoA. It will require an extension to a trainee’s predicted CCT date. A number of trainees have taken this route and this should not discourage anaesthetic trainees from pursuing a career in PICM.

The route for trainees from an ICM background is detailed here. Intensive Care Medicine trainees are eligible for PICM subspeciality recognition in their CCT. ICM trainees must have:

  • A current NTN in ICM
  • Primary FRCA, MRCEM/lntermediate FRCEM, MRCP (UK) or equivalent
  • Have completed Stage 1 of the ICM Training Programme (ST4) by the time of entry into PICM training
  • Dual CCT ICM trainees (with either AIM or EM or Anaesthesia) will need to gain approval to extend their training to complete PICM training. This does not apply to FICM single CCT ICM trainees.

The application to PICM Grid should be commenced before the end of Stage 1 of the ICM Training Programme, otherwise it might not be possible to accommodate locally without an extension to training.

Real example of ICM / PICM training pathway

You are eligible if you have done your FICM primary however would suggest all exams are done by the time you apply. I completed the PICM GRID training as an OOPE, which required some deanery negotiation.
Please link to the FICM website. We have recently redesigned this to answer your questions. There is also a link to the relative section in the FICM Trainees handbook.

Relevant article in the trainee eye (page 11)

Relevant section in the handbook

Helpful bits on the FICM website
(Down to the ‘can I subspecialise in PICM as a dual trainee?’)

1. Decide I wanted to do it. It adds a significant amount of extra training time (2 years) – well worth it.
2. Discuss with TPD. You will need to go OOPE for two years if dual training.
3. Get permission from colleges (Should now be OK with colleges (RCoA, FICM)
4. Apply to GRID and be successful. Application form and interview then national rankings.

Extended Case Studies

This document gives some more information about possible topics and marking of these summaries: Surviving-PICM-Grid-update-2021-2.pdf (pccsociety.uk) If in doubt please discuss with your Educational Supervisor or contact one of the CSAC team.

Useful documents

Case based discussions


Updated 06/2022