Critical Care Medicine Fellowship
The pediatric critical care fellowship program at Boston Children's Hospital/Harvard Medical School is fully accredited by the Accreditation Council for Graduate Medical Education (ACGME) and meets all requirements of the American Board of Pediatrics.
In addition, our program is a recognized training site by the Intercollegiate Committee for Training in Pediatric Intensive Care of the United Kingdom.
The fellowship program is designed to educate individuals interested in pursuing an academic career in pediatric critical care medicine. All of the program's professional staff have appointments at Children's with the Department of Anesthesia. In addition, all of the program's professional staff hold faculty appointments at Harvard Medical School with the Department of Anaesthesia (Pediatrics).
Children's Hospital is a 396-bed institution located in the center of the Harvard Medical School complex. Most of the fellows' clinical training takes place at the Medical-Surgical Intensive Care Unit (MSICU) and the Cardiac Intensive Care Unit (CICU). The MSICU, with approximately 2,000 admissions annually, provides all critical care services for our very active programs in medicine, general surgery, transplantation, neurosurgery, craniofacial reconstruction, orthopedics, otolaryngology and trauma. In addition, the unit serves as one of the largest extracorporeal membrane oxygenation (ECMO) centers in the United States with approximately 60 children treated annually.
In the adjacent CICU, fellows care for the full spectrum of pediatric cardiac disease, including more than 700 postoperative patients per year following cardiopulmonary bypass. This represents the highest volume of pediatric cardiac surgery utilizing cardiopulmonary bypass in the world.
The first year is designed to expose the fellow to the full range of critically ill patients. Six months are spent in the MSICU and CICU. Additional time in the first year is spent on rotations in Anesthesia (three months), and the Medicine Intensive Care Unit (MICU).
There are several months for clinical elective/establishment of a research project and twenty working days are provided for vacation. Up to five work days may be used annually for attendance at a scientific meeting.
Second Year / Third Year
The second and third years are designed to provide ongoing clinical experience while extensive research exposure is obtained. At present, this amounts to four months of clinical rotations per year with the remainder as protected research time. This is an academically-oriented fellowship and contributions to the advancement of Critical Care Medicine are expected of each fellow. Current research activities range from the scholarly delineation of ethical issues to laboratory investigation of arginine metabolism. Given the multidisciplinary nature of critical care, research in a wide variety of fields may be relevant. Strengths of the Critical Care Program which facilitate research include:
- Boston Children's Hospital is the geographic center of the Harvard Medical School Complex. There are close relationships with investigators at Harvard Medical School, the Harvard School of Public Health, the Kennedy School of Government, the Massachusetts Institute of Technology, many surgical and medical departments at Children's, the Brigham and Women's Hospital and the Beth Israel-Deaconess Hospital.
- Boston Children's Hospital is the major New England extracorporeal life support provider for neonates and children as well as the region's Level I Trauma Center for Pediatrics.
- Boston Children's Hospital has consistently been rated by physicians across the United States in the U.S. News & World Report as the best pediatric hospital in the country.
Core didactic teaching of the critical care curriculum by faculty occurs during five morning lectures a week, from 7:30- 8:15 a.m. The faculty provide additional conferences, designed especially for the critical care fellows, for one hour every Monday, Wednesday and Thursday. These include a fellows' colloquium, monthly research conference, morbidity and mortality conference, and an evidence-based medicine conference. Topics of current special interests are addressed in a monthly “Issues in Critical Care Medicine” session.
Joint conferences with the CICU staff are regularly scheduled. Members of the subspecialty divisions of the Department of Medicine and Surgery visit on a regularly-scheduled basis, providing didactic seminars and informal discussion sessions. Finally, our unit has the first and most sophisticated simulator suite for pediatrics in the United States and fellows spend considerable time learning in that environment.
Meredith van der Velden, MD
Associate Program Director, Fellowship in Pediatric Critical Care