Pediatric Emergency Fellowship Program - Rotations
Pediatric Emergency Department (PED)
The fellow's responsibilities include precepting residents and medical students, running surgical trauma’s and medical resuscitations, answering EMS medical control, as well as performing procedures and caring for patients. In the first 2 years fellows are paired with an attending PEM physician and function with progressing independence. In year 3 fellows act as attendings, working independently in a single coverage role.
Adult Emergency Department
Boston Medical Center has an exceptionally busy and high acuity adult emergency department with a strong emergency medicine residency. For 3 months of fellowship our fellows work as residents under the supervision of emergency medicine attendings. In year one and two fellows function as the “Resuscitation Resident” and in year three they act as the “Trauma Resident.”
AED- Resuscitation Resident
In the resuscitation resident role, the fellows act as code leader for all medical resuscitations and have first priority for all procedures in the department. This role serves as an excellent opportunity for fellows to practice their ACLS and code leadership skills as well as to obtain repetitions with procedures which are less common in pediatric emergencies such as chest tubs, central lines, and ultrasound guided IVs.
AED- Trauma Resident
In the third year the fellows return to the AED as the Trauma Resident where they lead all traumas at one of the busiest trauma centers in the United States. They are responsible for performing primary and secondary surveys and managing the activities of the trauma team. The trauma resident also receives priority for all intubations in the emergency department.
Ultrasound training is a strength of our fellowship. Fellows complete a month rotation in point of care ultrasound in the first year and participate in a longitudinal ultrasound curriculum with dedicated PEM and EM ultrasound faculty throughout the remainder of fellowship. We aim for our graduating fellows to complete enough scans for independent credentialing.
During the first year, each fellow spends time with Boston EMS gaining a hands-on understanding of the work of emergency medical services personnel. Fellows are assigned to an ambulance and ride with that ambulance to emergencies. Also included in this experience is a visit to the medical control center and meetings with the leadership of Boston EMS.
Fellows spend one month at the Regional Center for Poison Control and Prevention. They participate in toxicology rounds and provide telephone coverage for the poison control center. This is typically a second-year rotation.
Pediatric Intensive Care
In their first year, our fellows spend one month at Boston Children's Hospital (BCH). They act as PICU fellows in the Medical Surgical ICU. This challenging rotation provides excellent exposure to concepts in tertiary critical care. Fellows are responsible for codes and ICU consults within BCH and act as medical control for the BCH Critical Care Transport Team.
Fellows rotates in their first and third years with the Anesthesia Department at Massachusetts Eye and Ear Infirmary (MEEI). This rotation is focused exclusively on developing airway management and intubation skills. Fellows perform a minimum of 50 intubations during each of these high yield months.
There are numerous electives available. They include: trauma, sports medicine, orthopedics, radiology, ENT, anesthesia, dermatology, international electives and others. We are happy to arrange almost any elective if it is pertinent to the fellow's education.
Fellows are strongly encouraged to spend time throughout their fellowship working internationally in an underserved country as volunteer physicians. The program protects time for such work and covers travel expenses. This unique opportunity is newly offered in response to fellows' interests in gaining exposure to global medicine. Recent fellows have traveled to Lesotho, Colombia, Cambodia, and Haiti. This opportunity is available to fellows in their third year.
In July, our fellows participate in a curriculum under the guidance of the Adult Emergency Department designed to teach the basics in a wide variety of surgical and nonsurgical techniques commonly used in emergency medicine. This course includes a lab to learn placement of central lines, chest tubes and cricothyroidotomy splinting and suturing workshops, introduction to slit lamp use as well as ultrasound experience.
We have a structured curriculum with weekly educational meetings designed to meet the educational needs of our fellows. In addition, we have regular simulation activities for faculty and fellows. The fellows take part in our teaching series for residents and medical students.
Throughout the year, regular educational meetings in the Department of Pediatrics and the Adult Emergency Department afford multiple opportunities for cooperative learning, teaching and case discussion.
Once a month fellows participate in a Fellowship Academy with fellows from the Department of Emergency Medicine. These sessions are aimed to provide professional development. They cover topics such as CV writing, grant applications, and contract negotiations.