Key Facts in Clinical Training | Overview
Boston Children’s Hospital is a 396-bed institution located in the center of the Harvard Medical School complex. Clinical training occurs in four distinct areas: the Medical-Surgical Intensive Care Unit (MSICU), the Cardiac Intensive Care Unit (CICU), the Medicine Intensive Care Unit (MICU), and the Operating Room. The Division of Critical Care is led by Dr. Jeffrey Burns, Chief of Critical Care and Chair of the Governance Committee of the Intensive Care Units at BCH, who oversees clinical care across all ICU domains.
The MSICU, with approximately 2,000 admissions annually, provides critical care services for very active programs in medicine, general surgery, transplantation, neurosurgery, craniofacial reconstruction, orthopedics, otolaryngology and a Level I Trauma Center. Fellows in the MSICU also provide medical control for the hospital’s transport team, and lead the hospital’s code team, or emergency response team. In the adjacent CICU, fellows care for the full spectrum of pediatric cardiac disease, including more than 900 postoperative patients per year following cardiopulmonary bypass. This represents the highest volume of pediatric cardiac surgery utilizing cardiopulmonary bypass in the world. In addition, the MSICU/CICU serves as one of the largest extracorporeal membrane oxygenation (ECMO) centers in the United States with approximately 60 children treated annually. Finally, the MICU is a 12 bed unit where fellows care for critically ill medical patients with a full range of pediatric diagnoses.
The majority of clinical training for pediatric critical care fellows occurs in the first year of fellowship. This year is designed to expose the fellow to the full range of critically ill patients in all three intensive care units and progressively increase supervisory experience and responsibility in the clinical setting. In addition, first year fellows spend three months in the operating room to intensify their airway, procedural and peri-operative experience. In the second and third years of training, fellows assume progressively more responsibility and autonomy for guiding work rounds and monitoring the function of the unit throughout the day. Additionally, third year fellows are also expected to serve in a senior fellow role as a manager of all care delivered in the intensive care unit.