Pediatric Surgery Fellowship

The goal of the advanced residency training in Pediatric Surgery at UPMC Children’s Hospital of Pittsburgh is to develop the specialized knowledge and skills required to care for surgical disease in infants and children. At the conclusion of the two-year training program, residents will be competent pediatric surgeons, qualified for certification in Pediatric Surgery by the American Board of Surgery, and able to assume responsibility for the pre-operative, operative, and post-operative management of surgical problems in infants and children. During the training program, residents will demonstrate mastery of the six competencies set forth by the Accreditation Council of Medical Education (ACGME) and be afforded increased responsibility and independence according to their skill.

Essentials

1. Demonstrate appropriate oversight of the pediatric surgery service, both on the general wards and in the various intensive care units
2. Participate in the emergency and outpatient evaluation of infants and children with surgical disease and trauma. Participation in all phases of care including the pre-operative and post-operative evaluation as well as in-hospital course is required.
3. Develop the technical skills required for complex surgical procedures in infants and children.  Residents will be facile with advanced techniques in laparoscopy, thoracoscopy, and endoscopy, as well as open surgical procedures.
4. Understand the multi-disciplinary nature of today’s medical environment and effectively work with all members of the patient care team to achieve the best outcome for the patient.
5. Be an active participant in the educational process, both during the residency and beyond. Residents are to consult the literature and perform self-study during the training, as well as participate in scholarly activities.

Selection and Opportunity

Qualified applicants are selected through the Electronic Residency Application Service (ERAS), invited to interview at UPMC Children's, and matched through the National Resident Matching Program (NRMP). Having completed five years of general residency, PGY VI and above are eligible to apply for the Pediatric Surgery two-year fellowship at UPMC Children's.

• Year 1 is a junior fellowship working alongside the chief fellow and 13 faculty in the Division of Pediatric General and Thoracic Surgery.
• Year 2 is in the chief fellow role, which requires management and delegation of responsibilities amongst various members of the care team.

Residents primarily remain on the core pediatric surgery service during their two years of training, although there will be a targeted experience in neonatology.

Residents identify a research mentor early in their tenure and develop a research plan. It is the expectation that the project will be clinically based, and suitable for presentation/publication.

Learning Objectives

Patient Care

From the start of the residency program the first and second year residents must work together to insure the smooth functioning of the patient care team. The chief resident is ultimately responsible for the service, with the junior resident (1st year) providing assistance.

Medical Knowledge

During the course of residency, the pediatric surgery resident is expected to attain foundation of knowledge regarding surgical conditions, including trauma, in infants and children.

Practice-Based Learning

Practice-based learning is the basis for life-long learning habits. The pediatric surgery residents are to actively participate in the evaluation of their patient care skills, as well as appraise and assimilate the evidence from the surgical literature. They also have an important role as teachers on the service.

Interpersonal and Communication Skills

It is imperative that the pediatric surgery resident demonstrate competency in communication and in teamwork. It is expected that the resident: effectively interact with colleagues in allied disciplines, demonstrate effective and compassionate communication skills with parents, and age appropriate methods of communicating with children, actively participate in the teaching and supervising of junior house staff, provide timely and accurate documentation of the plan of care through the medical record.

Professionalism

The pediatric surgeon is a leader in care delivery to children with surgical disease. It is therefore imperative that the surgical resident develop strong skills in professionalism. These are evident by a demonstration of the commitment to patient care, an adherence to the policies that regulate the medical environment, from both a health care regulatory agencies and the ACGME, with sensitivity to issues of race, gender, and culture as they relate to medical practice. As the resident progresses through the program, there is an increasing emphasis on administrative activities, such as team leadership and conference preparation.

Systems-Based Practice

Pediatric surgery is a sub-specialty in the pediatric health care system. It is required that the pediatric surgery residents learn the tools to functioning effectively in this environment. They need to be able demonstrate effective coordination of patient care, considerations of cost-containment, risk-benefit analysis, patient advocacy, and inter-professional teamwork.

Specific areas that the resident is involved in these issues include discharge planning for the complex neonate, coordination of care in patients who are the victims of non-accidental trauma, outpatient care of children with surgical disease, and in the MAC meeting for trauma. The residents also participate in the development of practice-guidelines.

Scholarly Activity

It is the expectation that pediatric surgery residents at UPMC Children's are interested in academic careers. It is therefore important for them to participate in scholarly activities during their fellowship. The first year fellow should identify a research mentor early in their tenure and develop a research plan. It is the expectation that the project will be clinically based, and suitable for presentation/publication.