The three year curriculum for trainees is designed to enhance and reinforce the clinical experience and promote a culture of self-directed learning. In addition to division-level conferences, the Medical Education Department offers a fellowship core conference series covering a wide range of topics relevant to all pediatric subspecialists. Topics covered include teaching skills, contract negotiation, medicolegal aspects of pediatric care among many others. Our divisional didactics include the following conferences:
Weekly Professor’s Rounds
In this conference a recent or current ICU case is presented by the on-service fellow to the faculty and a comprehensive scrutiny of care and management is discussed. Relevant physiology topics are highlighted by participating faculty. This is a particularly popular conference with our fellows.
Weekly Cardiothoracic Surgery Conference
This multidisciplinary conference is a surgery-based teaching session including the cardiothoracic surgery team, anesthesiologists, cardiologists and intensivists. Upcoming surgical cases are discussed in detail including surgical technique, perioperative and postoperative care and common complications.
The fellow’s didactic lecture series covers the breadth of pediatric critical care medicine topics, including both basic physiologic processes as well as disease-specific states relative to the care of critically ill pediatric patients. These lectures are facilitated by both divisional faculty and outside speakers. The 18-month curriculum is designed to cover the core content of pediatric critical care training as set forth by the American Board of Pediatrics.
Bi-Weekly Journal Club:
Two studies or investigations relevant to the practice of critical care are presented by a fellow and critiqued in detail. One study is from the recent literature, while another complementary recent or “classic” article is reviewed briefly to put the primary study in context. The ability to interpret, critique and apply current evidence is quickly developed through this conference.
Bi-Weekly Morbidity and Mortality Conference:
In this conference all admissions to the ICU are reviewed with particular attention paid to elements of system-based practice and quality improvement. A “case of the week” and “save of the week” are presented by the fellows and salient features are discussed. This is a multidisciplinary conference in which colleagues in other specialties participate, including nursing, respiratory therapy, social work, child life, pharmacology and others.
Bi-Monthly Management Conference:
For this conference, senior-level fellows present a medical management question in PICO (population, intervention, comparison, outcome) format. The relevant literature is collected with guidance from the pediatric librarian and synthesized and presented by the fellow with guidance from a faculty mentor.
Quarterly Critical Care / Emergency Medicine Management Conference:
The Divisions of Pediatric Critical Care and Emergency Medicine host a joint conference four times a year to discuss a particularly interesting or challenging patient cared for by both teams. The PCCM and PEM fellows involved in the care of the patient present the case and a comprehensive discussion of the management from the perspective of both divisions ensues.
Our goal in training physicians in critical care medicine is to provide them with the clinical experience and research skills necessary for their continued productivity in the area of academic pediatrics.
As such, our program is structured so that each fellow gains the clinical expertise to run a large pediatric intensive care unit (PICU), the ability to teach medical students and residents effectively using a variety of modalities, and the skills necessary to develop and carry out a complete and meaningful clinical or basic science research program.
During the first year of fellowship training, you can expect to spend approximately 18 weeks in the PICU. This time will be split between the surgical team, which includes cardiothoracic surgery, neurosurgical and general surgery patients, and the medical team. Your day will start at 06:30 and end at approximately 18:30. An additional 7 weeks are spent in the PICU as the night fellow. You will start your shift on Monday at 18:00 and end the following morning by 09:00. You will complete 3 or 4 nights in a row during these weeks. 6 weeks are spent in the pediatric sedation unit, 4 weeks with our anesthesia colleagues in the operating room, 6 weekends and an additional 4 weeks at a neighboring hospital will complete your clinical duties for the year. The remainder of your time is devoted to your academic pursuits.
During your senior years of fellowship, as your time in the Rainbow PICU decreases, you will have the opportunity to spend time on elective rotations, and you will have additional time to complete the research and quality improvement projects of your choice.