16 - Charles Gomersall - Training junior doctors in the BASIC practice of intensive care

How did you feel the first day you worked in ICU? Was it like walking on the moon? So foreign, because you didn't understand much about the machines, the techniques, or even the words that were being used. That's what it felt like for me, all those years ago. Thanks to one of my consultants who really "held my hand" on that first day, I was OK, but I wish I could have completed a BASIC course like most resident doctors in Australia (and many other countries) do today when they start their term in intensive care.

The BASIC course that those resident doctors now complete is mostly due to the efforts of Charles Gomersall. Over a decade ago, he realised the difficulties these junior doctors had in understanding what the Intensive Care consultants were both talking about and doing, so with a bunch of friends he set up BASIC (The Basic Assessment & Support in Intensive Care) course with the aim to teach participants, over 2 days, to rapidly assess seriously ill patients and provide initial treatment and organ support. Topics like airway management, acute respiratory failure, mechanical ventilation, haemodynamic monitoring, management of shock, interpretation of arterial blood gases, transport of critically ill patients, severe trauma, neurological emergencies, oliguria & acute renal failure, cardiopulmonary resuscitation, arrhythmias, nutrition, sedation and analgesia, etc.

This week my guest is Charles who is Professor in the Department of Anaesthesia & Intensive Care at The Chinese University of Hong Kong. In his words, his minor claims to fame are persuading some friends to write the BASIC course and denying a British prime minister entry to a London Intensive Care Unit, and his remaining ambition is to become a professional chef. That's all he wanted me to say about his background but let me say that having resident doctors rapidly brought up to speed on basic intensive care skills and practice, mostly so that they can feel comfortable at the ICU bedside in their first few weeks, is something I think is hugely valuable, not only to them, but also to me as a consultant and especially our patients. So that makes Charles a hero in my eyes. Of course, BASIC has gone on to now consist of many other courses, which now help up-skill nurses, medical students, advanced trainees, consultants (by providing refresher courses) in many countries, including in the developing world.

So I think Charles is a legendary educator, an inspiring leader and an outstanding clinician. He is softly spoken, humble, unassuming but incredibly well considered. He powerfully helps the patients in his own ICU and dramatically helps patients all around the world by providing BASIC. What a master.

In this week's episode you will hear all about the BASIC course, how it came to be, and where it is right now in amongst the other work of the BASIC Collaborative. You'll also hear Charles speak about:

• How he became both a doctor and an intensivist by accident
• How difficult it is to objectively judge the value of education
• The prime importance of putting the patient first in clinical, academic and educational practice
• Understanding the good and bad that surrounds us in our Intensive Care department culture
• How ICU specialists are like the hotel concierge of the hospital
• How paying back the support we received as trainees to our upcoming trainees is vital to the system of ICU education
• His views on sleep, cycling to work and listening to music
• The story of being on duty in a London hospital after a train crash people
• The benefits of communicating humanely to our patient's families when things are not going well
• And, how there is compulsory retirement at age 60 in Hong Kong

With this podcast, and the previous episodes, please help me in my quest to improve patient care, in ICUs all round the world, by inspiring all of us to bring our best selves to work to more masterfully interact with our patients, their families, ourselves and our fellow healthcare professionals so that we can achieve the most satisfactory outcomes for all. It would be much appreciated if you could help to spread the word by simply emailing your colleagues or posting on social media.

If you have a comment or a question, let's engage. Whilst my primary goal is to improve patient outcomes by helping us all get better thanks to the inspiring messages of my guests, I also have the goal of building community through Mastering Intensive Care, so people can share their thoughts and their own skills. So leave a comment (on the LITFL episode page or on twitter using #masteringintensivecare), send me an email at andrew@masteringintensivecare.com or engage in the facebook page Mastering Intensive Care.

Thanks for listening. Do the best you can for those unfortunate people in our ICUs we call patients, and strive to get better at what you do, whilst looking after yourself.

Show notes (people, organisations, resources or links mentioned in the episode)

Prof Charles Gomersall: https://www.cuhk.edu.hk/med/ans/prof_gomersall.htm

BASIC course: https://www.aic.cuhk.edu.hk/web8/BASIC.htm