Pediatric Surgery

  • Extracorporeal Membrane Oxygenation (ECMO) Fellowship Training Program

    The Division of Pediatric Surgery at Cincinnati Children’s Hospital Medical Center offers a Pediatric Extracorporeal Membrane Oxygenation (ECMO) Fellowship Training Program.
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    Program Demographics

    Name of Host Institution: Cincinnati Children’s Hospital Medical Center

    Program Specialty / Subspecialty: Extracorporeal Membrane Oxygenation (ECMO) Fellowship Training Program

    Program Mailing Address:
    Cincinnati Children’s Hospital Medical Center
    MLC 2023
    3333 Burnet Ave.
    Cincinnati, OH 45229-3039

    Program Phone Number: 513-636-4371

    Program Fax Number: 513-636-7657

    Program Email: jason.frischer@cchmc.org

    Program Director: Jason Frischer, MD

    Alternate Program Contact: Julie Ludwig, residency coordinator, julie.ludwig@cchmc.org

    Introduction

    History

    This program was approved by the Graduate Medical Education Committee in September 2010. The first trainee began in October 2010.

    Duration

    One to two years.

    Prerequisite Training / Selection Criteria

    The trainee would need to be a general surgery resident having completed a minimum of two years but may have finished adult general surgery training in preparation for a possible pediatric surgery fellowship. It is also possible that such an individual will have already completed a general pediatric surgery residency, and now desires further specialty training in pediatric surgery.

    Goals and Objectives

    The goals of this new fellowship address three issues:

    1. The current duty-hour restrictions of the two pediatric surgery residents do not allow them to attend to all of the learning opportunities available now at Cincinnati Children’s and stay within the 80-hour work week restriction. As such, there is enough learning opportunity for an additional resident to participate in the care of patients in the NICU, PICU and CICU that are being considered for ECMO, on ECMO or completed an ECMO course. The fellow will also participate in clinic, operating room experiences and on-call responsibilities.
    2. We would hope to establish an Extracorporeal Membrane Oxygenation (ECMO) Fellowship Training Program in which individuals participate in the broad clinical and academic experience available while caring for the variety of patients who require extracorporeal support.
    3. This position would facilitate outstanding communication between the intensivists and the surgeons. This individual will be the point person for every patient on ECMO. This position could be filled by:  

    • A general surgery resident in the middle of a training program and looking to have a one or two years of exposure in caring for the most critically ill children and learning the comprehensive care of patients on ECMO
    • A general surgery-trained individual who comes for a one- or two-year ECMO experience and would serve as the ECMO fellow in preparation for a possible pediatric surgery fellowship
    • A fully trained pediatric surgeon who desires additional ECMO experience

    During the training period, the resident will have a choice in participating in basic scientific research within the Department of Pediatric Surgery or partake in the general pediatric surgery rotation with our current residents, sharing operative and on-call responsibilities and in the educational activities of our service. Further, this individual will participate in the nightly call schedule in order to provide more clinical exposure in general pediatric surgery and allow us to lessen the workload of our current resident staff, helping us to maintain compliance with the work-hour restrictions. The trainee’s primary responsibility, however, will be to ECMO, and he or she will be expected to participate in the initial evaluation of the patient, the cannulation process, daily rounds and management of the ECMO patient and all ECMO-related educational conferences. The resident will be expected to participate in mentored ECMO-related research.

    The goal of this position is to enable the trainee to gain expertise in the care for neonatal, pediatric, and cardiac critically ill patients that require the use of extracorporeal membrane oxygenation. This will enhance the opportunity for application for a more formal general pediatric surgery fellowship in the future, or if he or she has completed training in pediatric general surgery, will enhance expertise in ECMO in anticipation of a subspecialization in this area.

    Program Certifications

    None at this time.

    Resources

    Teaching Staff

    • Pediatric Surgery – Jason Frischer and Daniel von Allmen
      The training program director, Frischer, will coordinate all aspects of the fellowship training program for the ECMO fellow.

    Facilities

    All training is conducted at Cincinnati Children’s, a private medical center providing 523 registered beds. The hospital is one of the largest children’s care facilities in the United States in several categories: number of beds, number of emergency room visits and number of operative procedures.


  • Educational Program – Basic Curriculum

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    Clinical and research components

    During the training period, this individual will be expected to participate in the pediatric surgery educational programs, outpatient and inpatient care and routine and complex surgical procedures. The trainee will also be involved in clinical research projects. The trainee may also participate in shared general pediatric surgery clinical experiences with our current pediatric surgery trainees when deemed to be beneficial.

    Supervisory / patient care responsibility

    The ultimate responsibility for care of the patients is the attending surgeon. No patient is admitted to the hospital, undergoes a procedure or has a consultation without the attending surgeon being made fully aware and assuming all responsibility. The fellows interact with the attendings on a daily basis to go over the patient’s progress or to raise any concerns. The attending surgeon is routinely called directly by the fellow. The fellows round with the attendings on all patients. There is frequent communication both at the bedside and in the department regarding patient management decisions.

    Didactic components

    Daily

    • Bedside rounds

    Weekly

    • Pediatric Surgery Grand Rounds
    • Pediatric Surgery / Radiology Conference
    • Pediatric Surgery Morbidity and Mortality Conference

    Monthly

    • Trauma Case Review
    • Trauma Morbidity and Mortality Conference
    • Bowel Management Conference

    Evaluation

    Fellows are evaluated every three months by the program director, and a summary evaluation is conducted at the conclusion of the fellowship. In addition, the subspecialty residents are expected to provide formal evaluations of the individual faculty members, the program of learning and the program resources on an annual basis. This information is collated and presented to the faculty in an anonymous fashion.