Department of Surgery Surgical Critical Care Fellowship

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Boston Children's Hospital Department of Surgery sponsors three two-year fellowship positions in surgical critical care with a focus in health outcomes research. The position is for individuals considering a career in Pediatric Surgery who wish to augment their clinical experience with a focus in critical care and formal training in epidemiological methods. The program begins with a 12-month clinical rotation on the pediatric critical care wards. Eligible residents must have completed three years of their general surgical training in order to be "board eligible." The fellowship is ACGME-approved, and it serves as a route to formally attain an ACQ in Surgical Critical Care through the American Board of Surgery. The second 12 months (with an option to extend this period to 24 months) is spent focusing on clinical outcomes research in one of a variety of pediatric surgical disciplines, in addition to participation in didactic learning modules.

The responsibilities of the critical care fellow during the initial clinical year include the care of patients on the Neonatal Intensive Care Unit (NICU) and the Medical/Surgical Intensive Care Units (MSICU). The care is delivered in conjunction with the Pediatric Surgery Fellows and the MSICU and NICU teams and under the guidance of the Surgery Critical Care attending physicians. The fellow will gain an understanding of the current issues and controversies surrounding the care and management of complex, critically ill pediatric surgical patients. The fellow will facilitate the interaction with and foster the support of the various related allied health care support services and gain experience relating to the administration of a multi-disciplinary pediatric intensive care unit. The fellow will also participate in the quality improvement activities of the Surgical ICU.

A broad variety of conferences occur during the week at which attendance is expected. These will include: Morbidity and Mortality Conference (Surgery and ICU); Surgical Grand Rounds; Evidence-Based Medicine conference; Research Protocol and Project Conference; ICU Core Lecture Series; Journal Club.

The second year will involve an intensive research curriculum focusing on clinical outcomes in pediatric surgery. There will be a didactic component during the summer of the first dedicated research year that will introduce the individual to clinical research methodology, including study design and implementation, data analysis and biostatistics, and manuscript preparation. If so desired, the participant will also have the opportunity to attain a formal graduate degree in health outcomes research from the Harvard school of Public Health (e.g. MPH or equivalent) if two full years of research are desired. The applicant will have the opportunity to apply their outcomes training to a variety of different pediatric surgical diseases which include, but are not limited to: vascular anomalies; fetal diagnosis and treatment; oncology; digestive diseases (short-gut syndrome); minimally invasive surgery; congenital diaphragmatic hernia and other neonatal diseases; critical care medicine; trauma; transplantation. Furthermore, fellows will also have the opportunity to focus their efforts on important health policy issues surrounding the surgical care of children, particularly those involving patient safety and qualitative assessment.

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