Postgraduate courses are a key aspect of continuing professional development for the junior doctor. With the myriad of courses available, it can be difficult to know which are worth your while. They also have the potential to take a significant chunk out of that JMO salary that you have just been bestowed, ranging from$300-$3000+ in some cases.
This is the first in a series of course reviews, which will aim to help you spend your time and money wisely.
What is it?
Originally developed by the Chinese University at Hong Kong, BASIC is taught in over 12 countries. The course aims to provide a beginner’s overview of key components of intensive care and critical care medicine.
How is is delivered?
A pre-course handbook is provided prior to the face-to-face component of the course. It is around 200 pages, but it’s big margins for annotation make it a much lighter read than it first appears. Also provided is a CD with interactive tutorials on ABG analysis, defibrillation, acute respiratory failure and central line insertion.
A pre-course open book MCQ exam is required to be completed prior to attending the course.
The course itself is split approximately 60% didactic lectures and 40% small group discussions and simulation stations.
The course is concluded with a final MCQ exam.
What is covered?
Everything from airway through to glucose, with a heavy focus on demystifying mechanical ventilation. A full list can be found here.
The course book manages to strike the balance between brevity and content, with each chapter building up key concepts from basic physiological principles.
The manual allows us to tap into some useful learning techniques. It forces us to space out our learning so that the face-to-face lectures act as revision, retrieving the information that has been allowed to percolate into our long-term memory. The use of pre and post-course MCQs gives us a means of active learning, and dispels the illusion that we have learnt it all simply by passive means (known as the ‘fluency illusion’, the most common cause of failure for tests of this type).
The course manages to squeeze a huge amount of content in, with sufficient chunking of information that it does not all at once feel overwhelming.
The most valuable content in the course was around mechanical ventilation. I no longer look at the screen below like a complete simpleton, drooling from the corner of my mouth.
The course runs sequentially through basic physics/physiology, common modes/settings and finally how to manage common complications of ventilation such as high airway pressures and hypotension. After the course you will be able to discuss ventilator setting intelligently, and have some idea of what to do with ventilator complications in the 10 minutes it takes for help to arrive. Even if you do not deal with ventilated patients in your daily practice, it is essential to at least be able to troubleshoot a BiPAP machine, for those patients on NIV that you get called to after hours.
The fidelity of the simulations provided can be site dependent. The CPR/ALS station had a focus on defibrillation only. While safe and early defibrillation is one of the most important part of ALS, I feel as though the opportunity was missed to teach important aspects of crisis resource management, in particular the role of the team leader. I recommend attending an ALS or rapid response course for more complete coverage of this topic, as there is only so much you can cover in a 30-minute station.
Some of the course material provided in the pre-reading felt a little outdated, and some even a bit bizarre – including feeling the iliac fossa for a transplanted kidney during CPR, as graft failure may be a cause of hyperkalaemia causing the arrest. The CPR section is also not based on Australian Resuscitations Council guidelines, with minor differences such as the inclusion of 5H’s and 5T’s rather than 4 of each.
The other courses I have attended that have included a post course exam have largely been symbolic in nature, with examiners very keen to pass you. The post course MCQs for BASIC, however, were more difficult than anticipated. If you did the pre-reading and paid attention during the lectures, then you will pass easily. It just was not the tokenistic exam that I expected it to be.
Cost is site dependent. I have seen it as cheap as $300 and as expensive as $800. Make sure you do your research and shop around. Upcoming course dates can be found here.
BASIC is almost essential for those contemplating a career in critical care. I can highly recommend it even if you have no aspirations for anaesthetics, ICU or ED, as the course will improve your assessment and management of any critically ill patient. Having an idea of what happens when your patient hits ICU will help when referring patients, as you then have some idea as to exactly what problems can be fixed/supported by the ICU.
- 2 to 3-day course for junior doctors and ICU nurses as an introduction to intensive care medicine
- Excellent coverage of mechanical ventilation
- Perfect balance between breadth and depth, with a handbook can can be re-read
- Post course MCQs were more difficult than anticipated
- ALS station is no replacement for full ALS course
- Will improve your assessment and management of any critically ill patient, even if outside the ICU