It is well recognized that the first ICU in mainland China was set up in the Peking Union Medical College Hospital in 1982, in the form of a surgical ICU with only one bed [4,5]. Two years later, it became the first Department of Critical Care Medicine in mainland China, with a seven-bed general mostly ICU in the Peking Union Medical College Hospital, chaired by Dr Dechang Chen, the well-recognized founding father of critical care medicine in mainland China.In November 1989, the Ministry of Health issued the Regulation of Hospital Accreditation and Management, which required the establishment of an ICU as a prerequisite for accreditation as a tertiary hospital [4,5]. Many ICUs were set up in hospitals all over China following the release of this document.

Many physicians (including general surgeons, internists, emergency physicians, and anesthesiologists) were sent to other hospitals for critical care training, either abroad or domestically, before returning to practice as intensivists [4,5].Development of critical care medicine as a specialty in mainland ChinaIn mainland China, physicians of other relevant specialties were the first to be assigned to work in ICUs because of their familiarity with the necessary techniques (anesthesiologists), disease entities (surgeons and internists), and required urgency of treatment (emergency physicians). However, after years of hard work, the important role of intensivists, as a coordinator during patient evaluation and treatment, has gradually been recognized and respected by other specialties.

Junior physicians interested in critical care training can choose to be intensivists after they finish 3 or 4 years of fellowship training in surgery or internal medicine. However, the traditional specialties often still assume responsibility for or ‘ownership’ of patients, as well as have a desire to treat critically ill patients, as reflected by the fact that the proposal for setting up a critical care society under the Chinese Medical Association (CMA) was rejected in 1996.Public healthcare crises in China since 2003 have provided intensivists with an opportunity to demonstrate their knowledge and skills. Epidemics of severe acute respiratory syndrome (SARS) in 2003, of Streptococcus suis in 2005, and of avian influenza, as well as the Wenchuan Earthquake in 2008, caused extreme anxiety in the public due to the vulnerability of the general population, the high communicability of the diseases, and the high case fatality rate.

Therefore, intensivists were often convened by the government Carfilzomib to be involved in crisis management very early [6]. Their ability to coordinate, cooperate, and communicate with regard to both patient management and policy-making was well demonstrated during daily work, and recognised by the general public and healthcare authorities.