Dr. Guillermo Domínguez-Cherit Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”. México.

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Dr. Guillermo Domínguez-Cherit Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”. México

Private hospitals Teaching hospitals * closedopen 95% affiliated ICU Models (Mexico) * <5% owned by University 22 critical care residency programs Government system

ICU Physicians Background Mexico Internal Medicine (at least 2 years) Anesthesia Surgery + 2 or 3 years in Critical Care

Internal medicine 80% Anesthesia 10% Pulmonary 5% Others 5%

ICU Mexico Medical students rare Residents in anesthesia, internal medicine and surgery 3 months total

ICU CLINICAL DECISION ICU STAFF PRIMARY PHYSICIAN CONSULT SERVICES

ICU CLINICAL DECISIONS ICU STAFF CONSULT SERVICES PRIMARY PHYSICIANS ICU STAFF + PRIMARY PHYSICIANS CONSULT SERVICES Government modelPrivate model

Mexican educational needs Homogeneous high technology availability Increased number of research programs Better access to medical information More opportunities of attendance to the major Critical Care meetings