I strongly believe that all students, no matter what level, should be allowed to take part in all ITU treatments. The principles of assessment are the same as for non- ventilated patients. The manual skills are not difficult- obviously they need to know the indications and contra-indications. I would never leave them to treat a ventilated patient unsupervised. As you say this may be their only respiratory placement before graduation and then we expect them to take part in the on call rota. We should be giving them every opportunity to learn in a supportive environment as under- graduates. Let's not turn ITU into some elitist speciality!!