Pediatric Critical Care Fellowship Curriculum
Clinical Training Heading link
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Where you'll train
Primary inpatient service location for PCCM fellows includes the following:
- 32 bed critical care floor (16 PICU beds + 16 intermediate care beds)
- Mixed cardiac/med-surgical unit with 2 teams (1 CVICU team + 1 PICU team)
- All children requiring cardiovascular surgery (including neonates) managed by CVICU team
- A patient and family-centered focus
Pediatric surgical services commonly admitting to PICU include:
- cardiothoracic surgery
- general/trauma surgery
- neurosurgery
- orthopedic surgery
- otolaryngology
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Team breakdown
- 11 board certified (or eligible) pediatric intensivists
- 7 specialty-trained, full-time advanced practice providers
- 4 fellows (2 first year, 2 second year)
- A multidisciplinary team of:
- critical care nurses
- respiratory therapists
- residents
- students,
- pharmacists
- registered dieticians
- physical, occuppational, and speech therapists
- social workers
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Resource details
- Extracorporeal membranous oxygenation
- Renal replacement therapires
- Intracranial pressure monitoring
- Negative-pressure ventilation
- Paced diaphragmatic stimulation
- Continuous hemoglobin monitoring
- Non-invasive cardiac output monitoring
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Fellows can expect the following
- Fellows are directly involved in management of all PICU patients with increasing independence and autonomy as training program progresses.
- 13 four-week blocks per year with service time split between general PICU and CVICU services (weighted more heavily towards general PICU).
- Longitudinal exposure to cardiac intensive care as fellows manage both general and cardiac ICU patients during overnight call
- Weighted with clinically heavy 1st year to cement critical care concepts early while providing ample time for scholarly activities during latter 2 years
Example of rotations Heading link
| Block | Year 1 | Year 2 | Year 3 | Dates |
|---|---|---|---|---|
| 1 | General PICU | Research | General PICU | 7/17/23-8/13/23 |
| 2 | Anesthesia | Research | Research | 8/14/23-9/10/23 |
| 3 | General PICU | Research | CV ICU |
9/11/23-9/24/23 10/23/23-11/5/23 |
| 4 | Research | General PICU | Research | 9/25/23-10/22/23 |
| 5 | CV ICU | Research | Research | 11/6/23-12/3/23 |
| 6 | CV Surgery/Cath Lab | CV ICU | General PICU | 12/4/22-1/2/24 |
| 7 | General PICU | Elective* | Research | 1/3/24-1/28/24 |
| 8 | Elective* | General PICU | Research | 1/29/24-2/25/24 |
| 9 | CV ICU | Research | Elective* | 2/26/24-3/24/24 |
| 10 | General PICU | Research | CV ICU | 3/25/24-4/21/24 |
| 11 | Research | General PICU | Research | 4/22/24-5/19/24 |
| 12 | Research | Elective* | “Pre-Tending” PICU | 5/20/24-6/16/24 |
| 13 | General PICU | Research | Research | 6/17/24-7/14/24 |
Research Heading link
Fellows conduct research
More than 40% of the 3-year program is dedicated to scholarly activities. This amounts to 17 four-week research blocks over 3 years.
With mentorship, fellows are expected to:
- Develop hypothesis-driven research questions
- Test hypotheses in academically appropriate ways
- Analyze collected data
- Present and publish results
Current fellow scholarly focused include
- Anticoagulation on extracorporeal membranous oxygenation
- Resident education X+Y schedule system
Faculty research
Department faculty hold division membership in Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) research collaborative. PCCM faculty are engaged in scholarly work in:
- Clinical research
- Patient safety and quality improvement
- Medical education and curriculum development
- Simulation
- Basic science
Fellows open to pursue mentorship outside of PCCM division, if appropriate.
Multicenter trials
Faculty are involved in the following current trials:
- SHIPPS (Stress Hydrocortisone in Pediatric Septic Shock)
- P-ICECAP (Pediatric Influence of Cooling Duration on Efficacy in Cardiac Arrest Patients)
Collaboration with other units
PCCM faculty have recently collaborated with faculty from the following units:
- Hospitalist medicine
- Cardiology
- Hematology
- Emergency medicine
- General surgery
- Cardiothoracic surgery
- Procedural sedation
- Simulation
Education Heading link
The educational component of the fellowship program combines bedside teaching with various didactic opportunities. Some didactic experiences are designed specifically for PCCM fellows, others incorporate faculty in the division of critical care, while some include pediatric fellows from other disciplines within the institution. In addition to their own learning experiences, fellows have ample opportunities to teach other learners, whether in clinical situations, through didactic lectures, or in a simulated environment.
The formal lecture series designed specifically for PCCM fellows incorporates a variety of formats focused on topics relevant to critical care. The curriculum includes the following:
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What is it?
This is an in depth discussion of recent PICU cases.
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What is it?
This is a high level discussion of critical care physiology (e.g., ventilator management, renal replacement therapy, cardiopulmonary interactions, etc.).
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What is it?
This is a review of landmark publications in pediatric critical care in addition to appraisal of recent relevant publications with focus on evidence-based concepts.
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What is it?
We practice questions to help prepare fellows to pass ABP PCCM board exam.
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What is it?
The morbidity and mortality conference for the pediatric intensive care unit
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What is it?
These are periodic updates from faculty and fellows of ongoing scholarly work, particularly in preparation for regional, national, or international presentations.
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What is it?
This is the shared curriculum among all pediatric fellowship programs at the institution to cover elements of care that share commonalities across specialties.
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What is it?
A discussion of upcoming surgical and cath lab cases for that week.
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What is it?
This is the morbidity and mortality conference for the congenital heart program.
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What is it?
This is a multidisciplinary discussion of recent ECMO outcomes, literature updates, etc.
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What is it?
This is a resident-led Department of Pediatrics morbidity, mortality, & improvement conference.
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What is it?
Grand Rounds is a weekly presentation covering wide variety of topics hosted by the Department of Pediatrics.
Additional Educational Opportunities Heading link
In addition to required educational experiences, there are additional optional opportunities available for fellows, such as:
- Stanford Faculty Development Core Curriculum for Clinical Teaching program
- Pediatric Fundamental Critical Care Support, a Society of Critical Care Medicine-led program designed to improve the skills of those who care for critically ill children
- Specialized training in point-of-care ultrasound (POCUS), including certification in POCUS through a program offered through the Department of Emergency Medicine
- Simulation certification through a training program offered at Jump Simulation