.

Anesthesiology

Pediatric Anesthesiology Fellowship

Introduction

The Pediatric Anesthesia fellowship at Monroe Carell Jr. Children’s Hospital at Vanderbilt attracts physicians who have a passion for learning in an environment that encourages independence, a commitment to patient care, compassion for their patients in the spirit of the anesthesia team model. You will have the opportunity to work with other fellows, anesthesia residents, CRNAs and SRNAs and the perioperative team all whose goal is to deliver the best medical and supportive care to their patients.

The VCH Pediatric Anesthesiology Fellowship Program at the Vanderbilt University School of Medicine provides 12 months of subspecialty education and training in all aspects of pediatric anesthesiology. This program is accredited by the Accreditation Council for Graduate Medical Education. Subspecialty training is at the CA-IV level and begins after satisfactory completion of an ACGME-accredited residency in anesthesiology.

Education and training concentrate on all phases of the patient’s inpatient and outpatient perioperative anesthesia care. Clinical training programs are conducted on the campus of Vanderbilt University Medical Center. Monroe Carell Jr. Children’s Hospital at Vanderbilt serves as both a primary care facility for local residents and a regional referral center. Clinical training in pediatric anesthesia ranges from brief outpatient procedures to complex neonatal, cardiovascular, and orthopedic, transplant and neurosurgical procedures.

Clinical Responsibilities and General Expectations

The clinical curriculum includes perioperative anesthetic care for pediatric patients undergoing nonoperative and operative procedures inside and remote from the operating rooms. Pain management, advanced pediatric life support and operating room management are also important aspects of the training program. The fellow will also learn to create written preoperative consultations on both complex and routine inpatients requiring surgery.

Curriculum

The clinical anesthesia program provides a broad experience, beginning with routine case assignments and progressing to increasingly complex surgical procedures and coexisting diseases. Fellows can expect to easily exceed the minimum requirements for clinical case experience recommended by the ACGME. Fellows gain experience in the management of sedation and anesthesia outside the operating room by participating in the care of patients undergoing radiation therapy, PET scanning, cardiac catheterization, MRI and other diagnostic and therapeutic procedures. The Society of Pediatric Anesthesiology Fellowship Directors committee has developed a content study guide for pediatric anesthesia fellows.

Rotations

Rotations are offered in the following areas:

  • General and Advanced Pediatric Anesthesia (up to six months)
  • Pediatric Cardiac Anesthesia (two months)
  • Pediatric Critical Care Unit (one month)
  • Neonatal Intensive Care Unit (two weeks)
  • Pediatric Pain Service (one month)
  • Perioperative Clinic (PATCH Clinic) and PACU (one month)
  • Heart, Kidney and Lung Transplants
  • Supervision (one month)

Research Opportunities - Up to 20 Non-clinical days/year

The ACGME has formulated the following policy concerning research during the pediatric anesthesia fellowship:  "The subspecialty training program in pediatric anesthesiology should provide the opportunity for active fellow participation in research projects pertinent to pediatric anesthesia”. It is difficult to become a research fellow in one year. If research will be an integral part of your career a two year fellowship is suggested that includes MPH or Masters of Clinical Research training.

Trainees are encouraged to participate in clinical projects that can be presented in abstract form at the SPA or ASA and later published in a peer reviewed journal.

International Service/Outreach

Monroe Carell Jr. Children’s Hospital at Vanderbilt is committed to providing medical services in underserved nations. This is evidenced by the number of our physicians and surgeons who travel to developing countries to offer health care services. The Shalom Foundation is an organization dedicated to providing care to those children who live in poverty. The department of pediatric anesthesia actively participates in medical mission trips sponsored by Monroe Carrell Jr. Children's Hospital and The Shalom Foundation. Fellows are encouraged and welcome to participate in these mission trips which take place at least two times per academic year.

Participation in Conferences

Journal Club

Fellows will be instructed in the conduct of scholarly activities and the evaluation of investigative methods and interpretation of data, including statistics. They should have the opportunity to develop competence in critical assessment of new therapies and the medical literature. Journal club allows the fellow to learn to use available tools and resources to evaluate scholarly works by critically evaluating investigative methods, data interpretation and statistical analysis. Each month a fellow will be assigned a medical article, and will lead journal club with a designated mentor. Each fellow will receive the book entitled Studying a Study and Testing a Test by Richard K Riegelman MD, MPH, PhD. This book will be purchased by the pediatric anesthesia division. It should be used as a guide when participating in journal club. Journal club meets monthly.

 Fellows Conference

Weekly Education Conference: Fellows attend a weekly didactic conference led by both division faculty.  Although all anesthesia providers may attend, this conference is aimed at topics appropriate for fellowship education. Included in these conferences are the discussion of competencies (ACGME Core Competencies: medical knowledge, professionalism, communication & interpersonal skills, systems/teams practice, practice-based learning & improvement, clinical care) as they affect clinical care outcomes. Together, fellows and faculty collaborate in selecting topics for discussion. Discussion is supported by evidence from the medical literature that is presented, and analyzed. Continually improving our ability (knowledge, skills, and behaviors) to deliver quality healthcare (as individuals, teams, and systems of healthcare) is the goal. Articles and other supporting data will be posted on our education web site.

Weekly Art of Anesthesia Conference: The goal of this conference is to create a round table discussion of management issues in pediatric anesthesiology.  During training, fellows are exposed to many ways of approaching unique issues in anesthesia.  Fellows decide on a topic of the week to promote discussion among the attendings during this conference. 

Division M and M

The division conducts a monthly Morbidity and Mortality (M&M) conference. This educational conference represents a forum in which unanticipated perioperative events are discussed in an open, yet, confidential forum. Attendance by all trainees (Fellows, Residents, SRNAs) is mandatory. Fellows are excused when their rotations make them unavailable to attend.

The format consists of a case presentation by a trainee, followed by a faculty or fellow facilitated discussion. Case presentation preparation should include a thorough review of the OR anesthetic and post-anesthesia care records as well as important postoperative events. In addition, a current and appropriate literature review is expected. Our administrative assistants are available and happy to assist you in preparing slides, handouts and/or Powerpoint presentations.

Society of Pediatric Anesthesiology Annual Spring Meeting

All fellows are encouraged to attend this meeting. If funding is available, the division will cover airfare and hotel for this meeting if the fellow presents an abstract, PBLD or participates in a workshop. The Program Director will discuss available options early in the academic year.

Vacation

Three weeks of vacation time are standard and should be arranged with the program director. Good-faith attempts will be made to adjust clinical schedules in order to provide the time requested as needed. The duration of leave or the timing may need to be modified depending on the clinical circumstances at hand.

Academic Leave

Fellows are granted 5 days of educational leave. If the fellow chooses to use this time for conferences other than the SPA, the fellow can still attend the SPA if they have an abstract or PBLD accepted for presentation.

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