Clinical Experience

By the completion of training, our fellows are proficient in the management of acutely ill and injured children of all ages with a broad spectrum of illnesses and injuries.

Our Emergency Department

Children's Hospital of Pittsburgh of UPMC signThe Emergency Department at Children’s Hospital of Pittsburgh of UPMC is a level I trauma center and has an annual volume of more than 80,000 visits; 19% of these patients are admitted, including approximately 1,700 annual admissions to the Trauma Service. We have 43 ED beds, including 3 trauma resuscitation suites and 7 critical care rooms. The Children’s Hospital of Pittsburgh is the major referral site for western Pennsylvania, northeastern Ohio and northern West Virginia for ill and injured children. We have a busy in-hospital transport team and a large regional air and ground transport service. The catchment area and census expose fellows to a wide variety of clinical problems and disease states.

Our Division currently has twenty-seven pediatric emergency medicine faculty, six general pediatrician faculty and twenty-two advanced practice providers on our staff. We have nine pediatric emergency medicine fellows, three per year. Our faculty and fellows teach pediatric residents from Children’s Hospital of Pittsburgh, emergency medicine residents from the University of Pittsburgh Department of Emergency Medicine, and visiting residents from area programs in Family Medicine and Emergency Medicine. All our faculty members have scholarly interests and a long history of academic productivity and mentorship.

Clinical Pediatric Emergency Medicine Experience

Pediatric Emergency Medicine StaffOur clinical PEM experience was designed to create a robust early clinical training followed by a focused research and graduated clinical autonomy experience. Our PEM fellows have a targeted progression to precepting patients and leading our ED teams. An additional unique aspect of our program is our “Coach Month” clinical mentoring experience. Each month during a clinical PEM rotation, fellows are paired with a PEM faculty mentor with who they have 3-5 coach shifts fostering focused guidance and allowing continuity in fellow development and mentorship.

Sample block schedule for Pediatric Graduate (PDF)
Sample block schedule for Emergency Medicine Graduate (PDF)

 

1st year

Fellows, during their first year, receive advanced training in pediatric emergency medicine, anesthesia, critical care medicine, emergency medical services, toxicology, point of care ultrasound, adult emergency medicine and trauma.

During PEM clinical rotations in the first year of fellowship, fellows have supervised shifts in the Emergency Department (ED). During these shifts, fellows see patients in their assigned team area, and see other interesting and challenging cases throughout the ED. Fellows will see patients on their own and will supervise students and residents in patient care and procedures, including sedations. In addition, fellows have dedicated procedure and ultrasound shifts.

2nd year

Fellows, during their second year, receive advanced training in pediatric emergency medicine, anesthesia, adult emergency medicine, including education in women’s health and burn emergencies, and dedicated training in the evaluation and management of the abused child. Fellows have graduated autonomy taking on a supervisory role during pediatric ED rotations. Second year fellows will also have assigned procedure and ultrasound shifts.

Pediatric Emergency Medicine Staff

3rd year

After their second year of PEM clinical training is successfully completed, fellows will serve in a supervisory role in the pediatric ED during their third training year. Fellows will supervise trainees in the ED, and be responsible for all evaluation and management decisions during clinical shifts.

* Vacation time= 3 weeks per year, plus 1 week for conferences

Point of Care Ultrasound (POCUS) PEM Experience

Point of Care UltrasoundThe POCUS experience is longitudinal and begins in the first year of fellowship. Fellows receive didactics and on-on-one sessions with our POCUS directors, Drs. Jennifer Marin and Desiree Neville, and dedicated scanning time is scheduled during clinical PEM months. Fellows are exposed to various indications and technique for POCUS, and learn the appropriate use of and gain competence in emergency ultrasound. Second year fellows participate in scholarship in emergency ultrasound by either preparing a case report for publication or developing a 45 minute lecture on emergency ultrasound to be given at the PEM divisional conference. During their third year of fellowship, fellows have an additional academic role teaching POCUS.

 

PEM Fellowship Didactic and Simulation Curriculum

Point of Care Ultrasound Staff

The PEM fellowship didactic curriculum is designed to teach a comprehensive set of PEM core topics. Each Wednesday morning, fellows have dedicated, protected conference for these sessions. Some highlights of the sessions include annual series by local experts on toxicology, child abuse, and emergency radiology, EKG review and PEM procedure curriculum workshops. As a part of learning evidence based medicine, fellows critically review current literature thorough our mentored journal club and journal scan series. In addition to our weekly didactics, fellows participate in a monthly board review curriculum. Our program hosts a PEM Academic Skills Curriculum, which is focused by year in training, and is complemented by our hospital’s United Fellows Conference series for all pediatric sub-specialty fellows to cover topics such as work-life balance, mentoring, teaching, leadership and career planning.

Pediatric Emergency Medicine Simulation ProgramSimulation is an important part of our PEM fellows curriculum. We have a long-standing, outstanding PEM Simulation Program, which is affiliated with WISER, The Peter M. Winter Institute for Simulation, Education, and Research, a world class multidisciplinary training and research facility. We have a dedicated simulation room located in our ED, which allows just-in-time training throughout fellowship. First year fellows begin their fellowship with a simulation boot camp covering core clinical PEM scenarios, critical procedures and procedural sedation. All first year fellows become Pediatric Advance Life Support instructors, and are Advanced Trauma Life Support certified. Fellows participate in an annual PEM emergency procedure and airway simulation course. We have two mock codes series, one based on a 24-month PEM critical case curriculum and one focused on leadership skills. Mock codes are held twice per month, are team based with nursing and patient care technicians, and are held in-situ in our ED trauma/resuscitation rooms.