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  Training Program - Pediatric Critical Care Medicine

Description How to Apply Benefits Contracts Length of Training
   



About our Units

Fellows spend the majority of clinical time rotating though the Pediatric Intensive Care Unit and the Cardiac Intensive Care Unit. Both of these units moved to new clinical space on November 18, 2007. In the fall of 2011, the CICU will move to newly renovated space, with the PICU expanding into the current CICU space.

The PICU is a 32 bed unit, which includes a neurocritical care area (four private rooms) as well as a positive/negative isolation area (an additional four private rooms). The PICU is home to a state-of-the-art audiovisual center, the Baier Media Room. The CICU, located contiguously with the PICU, is a 13 bed unit that includes ten private rooms and a three bed pod. The unit includes telemetry monitoring from the central nursing station, an echocardiography viewing area, and a team center.  

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Clinical Experience
In the 2009-2010 academic year there were 2,300 admissions to our intensive care units, with more than 500 of those to the cardiac ICU. In the PICU the clinical team has three critical care medicine fellows as well as pediatric residents; in the CICU the team has two critical care fellows and one cardiology fellow. In both units, the physician staff is strongly supported by nursing, pharmacy, nutrition, respiratory therapy, social work, and case management. Our rounds are family centered, with family members invited and encouraged to be present for and participate in our daily work rounds. Rounds are led seven days a week by a critical care medicine faculty member. Fellows are supervised at all times by an on call attending.

A sample schedule is shown below, based on the current system of 13 four-week blocks per academic year.

First year
8 clinical blocks (to include 2 weeks of anesthesia)
4 non-clinical blocks (to include 4 weeks of vacation)
1 orientation block (to include hospital and critical care orientation, buddy calls with senior fellows, supervised procedures, and a week-long ECMO course)
Second year
6 clinical blocks
7 non-clinical blocks (to include 4 weeks of vacation)
Third year
5 clinical blocks
8 non-clinical blocks (to include 4 weeks of vacation)

NOTE: Non-clinical blocks are used mainly to participate in scholarly activity, with the expectation that each fellow submit a manuscript for peer-reviewed publication prior to the completion of his/her training. Clinical responsibilities during these blocks are limited to 3 to 4 calls, with some of the blocks being completely call free. Fellows are free to use these blocks to participate in elective rotations, provided that progress towards completion of his or her scholarly activity is satisfactory.


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Didactic Education
A brief overview of our regularly scheduled learning opportunities are listed below.

  • CICU conference: organized and led by John Berger, MD, this twice monthly conference for the critical care and cardiology fellows focuses on the pathophysiology encountered in medical and surgical patients in the CICU; various formats are utilized, including pro-con debates and topic reviews based on recent literature
  • Core content review: a fellow-led session that is held twice per month; board review type questions are written by the fellow leader, based on a reading assignment from one of the major pediatric critical care textbooks
  • Core education/clinical skills: two to three sessions per month that cover the critical elements of the American Board of Pediatrics curriculum in critical care medicine over the course of training
  • Ethics rounds: quarterly, case-based seminar that is facilitated by members of the Children’s National Ethics Committee
  • Evidence based medicine journal club: this monthly conference organized and facilitated by faculty members Tessie October, MD, and Mike Spaeder, MD, includes an in depth analysis of a recent publication relevant to pediatric critical care; the articles are reviewed based on the principles formalized by JAMA, and the discussion includes a focused review of a key statistical concept
  • Fellow/faculty research in progress conference: semi-annual presentations by members of the division engaged in clinical or basic science research; this is a key opportunity for the fellows to gain experience in presenting their work and to get valuable feedback on the progress of their research (Each fellow is expected to present once/year.)
  • Fellow core curriculum: twice monthly two-hour seminar that utilizes a three-year curriculum to cover key topics in medical professionalism and career development, including quality improvement, mentoring, risk management, and promotion/advancement and key topics in research, such as study design and statistical concepts
     
  • Journal review: fellows are assigned journals to review on a rotating bases; and then briefly (3-5 minutes) present an article of interest to the group
  • Leadership and management in medicine: bimonthly seminar led by David Stockwell, MD, these sessions include topics related to professionalism, interpersonal skills, team leadership, and the business of medicine
  • Morbidity and Mortality: organized by Jen Schuette, MD, this monthly, two hour conference is a quality improvement focused and multidisciplinary discussion of all critical events occurring in the PICU and the CICU
  • PICU/ER conference: critical care and emergency medicine fellows alternate as session leaders, covering topics of interest to both groups utilizing various formats (case review, pro-con debate, journal club, etc.)
  • PICU case conference: held monthly, a PICU case is presented by the primary fellow, followed by a discussion of the differential diagnosis, appropriate work up, and potential therapeutic interventions; the discussion is guided by faculty
  • Simulation session: Lillian Su, MD, leads the fellows in a monthly session held in our hi-fidelity simulation lab focusing on clinical scenarios aimed at improving teamwork skills and expanding clinical knowledge
  • Wessel Rounds: one of our most popular sessions, this conference is open to trainees from both critical care and cardiology; David Wessel, MD, leads the fellows through a Socratic discussion of a topic or case in the CICU
  • White board sessions: led by Jen Schuette, MD, this is a semi-monthly interactive session to review physiologic principles by responding to questions individually on a white board


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Research

Children’s has become a leader among children’s hospitals in research funding. The Children’s Research Institute (CRI) is the academic home for many of our institution’s leading researchers, and both clinical and lab-based research opportunities are available to our trainees. Additionally, our division participates in both CPCCRN (the Collaborative Pediatric Critical Care Research Network, a competitive NIH-funded clinical trials network) and PALISI (the Pediatric Acute Lung Injury and Sepsis Investigators, a multi-center research consortium). With the NIH located only a few miles from Children’s National, the opportunity exists for selected fellows to participate in research.

Each of our trainees is expected to complete a minimum of one scholarly project during the course of their fellowship, resulting in the submission of a manuscript to a peer-reviewed publication. In addition, our fellows are expected to present findings at a national meeting.

A crucial first step in this process is the formation of a mentoring relationship with a faculty member (either inside or outside of our division), followed by development of a research question and specific aims and formation of a Scholarship Oversight Committee (SOC). The SOC will meet regularly with the fellow throughout his or her training to monitor the progress of the project, provide guidance, and assure that the fellow is engaging in a meaningful and educational scholarly endeavor that will meet the requirements for board certification.

Some important components of our research training include:
  • Fellow core curriculum education series and research seminar guide fellows in the development of research skills.
  • Academic Services Assistance Program (ASAP), a Wednesday noon seminar open to all Children’s faculty and fellows, offers multiple sessions focused on the development of research skills. Examples include conferences in submitting successful IRB proposals, securing funding, and poster preparation.
  • Regularly scheduled opportunities to present research work to the critical care faculty.
  • Opportunity to take courses at the George Washington University at minimal cost, including working towards a master’s degree for selected fellows.


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Our Critical Care Faculty
Children’s Critical Care Faculty members are leaders in the field. Visit the Critical Care section of the web site to meet the team and learn more about our Division.

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Past Graduates: Where are they now?

2010
Sonali Basu, MD
Children’s National Medical Center
Washington, DC
 Nana Coleman, MD
Long Island Jewish Hospital
New York, NY
 Darren Klugman, MD
 Children’s National Medical Center
 Washington, DC
 Matt Sharron, MD 
Children’s National Medical Center
 Washington, DC





2009
Mindy Dickerman, MD
St. Christopher’s Hospital
Philadelphia, PA
 Megha Fitzpatrick, MD
Georgetown University Hospital
Washington, DC
 Heidi Herrera, MD
 Florida Hospital for Children
St. Petersburg, FL
 Justin Yeh, MD
Lucille Packard Children’s Hospital
Palo Alto, CA


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2008
Eric Jarandeh, MD Georgetown University Hospital
Washington, DC


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2007
Cindy Gibson, MD
Fairfax Hospital for Children
Fairfax, VA
 Angela Hsu, MD
Tripler Army Medical Center
Honolulu, HI
 Angela Subbaswamy, MD Tripler Army Medical Center
Honolulu, HI


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2006
Anthony Lee, MD Nationwide Children’s Hospital
Akron, OH
 David Stockwell, MD Children’s National Medical Center
Washington, DC


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2005
Tom Cholis, MD
Hospital of the King’s Daughters
Norfolk, VA
 Aditi Sharangpani, MD
Sparrow Children’s Hospital
Lansing, MI
 William Tsai, MD
 Carolina Health Care System
Charlotte, NC


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2004
Michael Engel, MD
Alaska Native Medical Center
Anchorage, AK


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2003
Kimberly Fenton, MD
Stony Brook University
Stony Brook, NY


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2002
Glenn Stryjewski, MD
DuPont Hospital for Children
Wilmington, DE
 Matthew Kapklein, MD
Pediatric Residency Director
New York Medical College
Valhalla, New York


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2001
Noreen Crain, MD Fellowship Director
University of Virginia
Charlottesville, VA
 Mark Sorrentino, MD CMO, H.A.S. Physicians
Laytonsville, MD


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2000
Saumitra Biswas, MD Pediatric Critical Care Specialists
Springfield, MO
 Enrique Carrion, MD University of Puerto Rico SOM
San Juan, PR


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1999
Ralph Vardis, MD
St. Vincent Hospital
Green Bay, WI
 Anthony Slonim, MD, PhD
Chief Medical Officer
Shady Grove Adventist Hospital
Rockville, MD
 Bradford Harris, MD
University of North Carolina
Chapel Hill, NC


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1998
James Marcin, MD, MPH University of California, Davis
Sacramento, CA
 Anne Naclerio, MD Division Chief, Pediatric Critical Care
Tripler Army Medical Center
Honolulu, HI


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1997
Robert Pretzlaff, MD
Division Chief, Pediatric Critical Care
University of California, Davis
Sacramento, CA
 Allyson Goodman, MD
St. Johns Children’s Hospital
Springfield, MO
 Vinay Vaidya, MD
Chief Medical Information Officer
Phoenix Children’s Hospital
Phoenix, AZ
Thomas M. Berger
Kinderspital Luzern
Lucerne, Switzerland


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1996
John Berger, MD CICU Medical Unit Director
Children’s National Medical Center
Washington, DC


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1995
Jeannean Carver, MD
Division Chief, Pediatric Critical Care
University of Virginia
Charlottesville, VA
Rodrigo Mejia, MD
MD Anderson Cancer Center
Houston, TX
Ann Marie Levine, MD
Fellowship Director and Research
Director, Pediatric Critical Care
University of Florida
Gainesville, FL


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1994
Jacqueline Williams-Phillips, MD Robert Wood Johnson Hospital
New Brunswick, NJ
Brian Jacobs, MD Chief Medical Information Officer
Children’s National Medical Center
Washington, DC


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1993
Christi Corriveau, MD
Children’s National Medical Center
Washington, DC


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1992
Ido Yatsiv, MD
Division Chief, Pediatric Critical Care
Hadassah University Hospital
Jerusalem, Israel


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1991
Constance Houck. MD
Children’s Hospital Boston
Boston, MA


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1990
Joseph Stambouly, MD
Division Chief, Pediatric Critical Care
Winthrop University Hospital
Mineola, NY
Koteswara Chundu, MD Maricopa Medical Center
Phoenix, AZ


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1989
Stephen Klem, MD
Children’s Mercy Hospital
Kansas City, MO
Richard Mink, MD Division Chief, Pediatric Critical Care
Harbor-UCLA
Torrance, CA


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1988
Gabriel Hauser, MD
Division Chief, Pediatric Critical Care
Georgetown University
Washington, DC


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1987
Joseph Carcillo, MD
Pittsburgh Children’s
Pittsburgh PA
David McKinley, MD Geisinger Medical Center
Danville, PA


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1986
Patrick Kochanek, MD
Director, Safar Center
Pittsburgh Children’s
Pittsburgh, PA
Steven Lucking, MD Penn State Hershey Medical Center
Hershey, PA


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1985
James Wilkinson, MD, MPH
University of Miami School of Public Health
Miami, FL
Joseph Costello, MD Costello and Associates Pediatrics
Swansea, IL


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1984
Jerry Zimmerman, MD
Division Chief, Pediatric Critical Care
Seattle Children’s
Seattle, WA


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1983
Aaron Zucker, MD
Division Chief, Pediatric Critical Care
Connecticut Children’s Medical Center    
Hartford, CT


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1981
Tim Yeh, MD
St. Barnabas Medical Center
Livingston, NJ
Robert Katz, MD Vice President of Clinical Affairs
New Mexico Children’s Hospital
Albuquerque, NM


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1980
Thomas Reed, MD
Children’s Hospital Oakland
Oakland, CA
Robert Kanter, MD Division Chief, Pediatric Critical Care
SUNY Upstate
Syracuse, NY


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1978
Murray Pollack, MD
Chief Medical Officer and Vice
President of Medical Affairs    
Phoenix Children’s Hospital
Phoenix, AZ


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