Critical care medicine education in Middle East, FCCS/BASIC course, common purpose, different method

Sir,

Fundamental Critical Care Support (FCCS) course was started in 1990s by the society of critical care medicine (SCCM)[1]; it is now active in more than 100 countries. So far, it has been presented in several countries in Middle East such as Iran, Iraq and Jordan with plentiful participants.[2] Basic Assessment and Support in Intensive Care (BASIC) is a course, which was originally developed by Charles Gomersall and his colleagues at the Chinese University of Hong Kong, and since has been endorsed by European society of intensive care medicine (ECISM) and the intensive care society (ICS). While, the courses have been developed by two completely different systems[3], however, the aim of both courses is to teach non-intensivists to rapidly assess seriously ill patients, identify and respond to significant changes in the unstable patients, and provide initial treatment and organ support. The BASIC course is run worldwide in over 30 different countries mostly in East Asia and Middle East. There are assumptions regarding the content, modules and expansion of these courses.

The FCCS has costs for both traditional and online formats; however, instructors do not ask for money in many cases[4] such as Professor Janice Zimmerman instructing in Iran (Tehran) in 2010. Besides, pricing options are tiered, based on the country in which FCCS course is held. In BASIC course, information is supplemented with a free course manual and CD sent out prior to course commencement (approximately four weeks prior to the course start date). Basic collaboration has some educational resources as Very BASIC, BASIC, Pediatric BASIC, Beyond BASIC and BASIC Developing Healthcare Systems (DHS). Basic course supposed to be free registration, while it is not cost free in some instances. In BASIC course held in Iran (Shiraz) 2013, Dr Hussain Al Rahma (| head of Emirates, Intensive Care Society) instruct with no charge. Moreover, FCCS do not get any sponsors from private companies in courses, lecture slides, and textbooks; thus, have no conflict of interests. BASIC course do get sponsors for its courses use them in their slides, textbooks and in the course meeting.

Both FCCS and BASIC courses consist of lectures, skills stations and workshops, Pre-and post-course multiple-choice questions (MCQs) to assure mastery of the participants in educational content (Achieve a score >70% in FCCS and >75% in BASIC). FCCS has 3 types: Traditional, online and self-directed. Textbooks and slides are well-established materials in traditional and online FCCS. On the other hand, BASIC course materials are more diverse and slides are more figurative. Sessions and lectures are more flexible for instructors and contain open question and answers in BASIC course.

Although, online lectures and learning management system is presented only in FCCS not BASIC courses at the moment; however, online courses is not well received in Middle East or resource-limited countries, which demonstrate preference of physicians for traditional courses.

The mainstay of FCCS and BASIC courses are mainly fundamental management principles of intensive care; however, BASIC course presents some aspects of advanced intensive care such as subclavian vein catheterization, which seems overwhelming for such basic course. FCCS course is more restricted to only fundamental and instructors mostly stick to the slides and textbook content instead of open discussion in BASIC course.

In conclusion, FCCS and BASIC courses are both well received among physicians in Middle East. Although, these two courses have some differences in content and method, both have common purpose and a great value in countries, in which there are not enough number of intensivists. It seems that FCCS course are well designed and more standard path to learn critical care medicine with less conflict of interest.