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Through a combination of clinical experiences, didactics and case conferences, fellows become thoroughly knowledgeable and competent in managing various critical-care situations, including single- and multiple-organ failure in both previously healthy and extremely medically complex infants, children and adolescents. Critical Care fellows learn the theoretical and practical aspects of invasive and non-invasive monitoring and support, as well as the complexities of working with a variety of medical and surgical subspecialists. Our fellows also serve as medical directors for our busy transport team.
Our program provides three hours of didactics, case conferences or journal club per week to review the pathophysiology of organ failure in a variety of contexts and to review the state-of-the-art evidence-based care for these problems. The Graduate Medical Education Committee at Cincinnati Children’s also provides an excellent core curriculum addressing many aspects of the ACGME core competencies.
During the three-year fellowship, fellows complete 13 months of clinical service in the PICU, one month with anesthesiology and four months in the CICU with the remaining 18 months of the fellowship dedicated to research and scholarly activity and elective time, if desired.
Residents serve on in-house call every fourth night when “on service” and every seventh night when “off service.” The ICU is covered by two teams, consisting of one attending, two fellows, four residents and a full complement of social work, nutrition, pharmacy, Child Life and pastoral care support. Each night and weekend is covered by two fellows and two residents.
During the first year, three months are devoted to fellows’ research interests. In the second year of training, fellows spend three to four months on clinical service in the PICU/CCU, with the remainder of time spent in research pursuits.
The third year is tailored to the individual needs of each fellow, but includes at least eight to nine months of research and two months as a junior-level attending in the PICU. A strong emphasis is placed on independent decision making by the fellows, especially as they gain experience.
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