Pediatric Critical Care Medicine Fellowship

The PICU is a state-of-the-art facility featuring private rooms for all patients, isolation rooms, and ample family support areas. It functions as a closed unit and uses nearly all forms of advanced life support technologies. The patients are separated into two-physician teams: PICU and PCICU (Pediatric Cardiac ICU). Our fellows rotate and lead both teams throughout their clinical training. The PCICU team is composed of PCICU faculty, PICU fellows, Cardiologists, Cardiothoracic Surgeons, Advanced Practice Providers.

The PICU has an active extracorporeal membrane oxygenation (ECMO) program with new state-of-the-art equipment that provides support for a wide variety of critical conditions in neonates and pediatric patients. Designed to be multi-disciplinary, the team in the PICU also includes dedicated pediatric respiratory therapists, pediatric pharmacists, pediatric dietitians, child recreation therapy, physical therapy, occupational therapy, and social work. The close-knit relationship between the pediatric nursing and physician staff is consistently rated as excellent.

Fellows are directly involved in all aspects of clinical management and decision-making for PICU and PCICU patients. They also provide direct supervision and education to fourth year medical students and residents from pediatrics, anesthesiology, emergency medicine, as well as other departments.

The UNC Pediatric Critical Care Medicine Fellowship is designed to provide the best possible research opportunities for fellows. Recognizing the individual nature of each fellow, we have tailored several programs to achieve the goals defined by the individual fellow.

Critical care fellows are given extensive research opportunities in both clinical research and basic science research, as well as quality improvement and medical education with strongly protected research time.

In the first year, fellows are encouraged to participate in a clinical research project and are introduced to the diverse research opportunities within and outside of the Division of Pediatric Critical Care Medicine. In the second and third years, extensive protected time is provided so that each fellow can complete their research requirements. Education and review sessions occur at least monthly and provide the fellows with a significant amount of opportunity for review.

The major focus of the research experience is to learn how to design a hypothesis-driven research project, acquire the necessary technical skills to test the hypothesis, analyze the data and present the work.

Each fellow’s research is developed and monitored by a Scholarly Oversight Committee comprised of at least three faculty with at least one PCCM faculty and other members with content specific expertise. All fellows’ research is expected to result in a first author peer reviewed manuscript in a high-quality medical journal.

At UNC, the PCCM Fellowship’s broad clinical training is heavily supplemented with an academic education curriculum that includes a mix of didactic and simulation-based learning. The didactic program includes multidisciplinary conferences with our neurosurgery, burn surgery, cardiothoracic surgery, cardiology, pulmonary, nephrology, neurology, and pediatric general surgery colleagues. In addition, the core PCCM curriculum involves a recurring lecture series designed to cover core PCCM topics over a 12-month period including lessons on pathophysiology, evidence-based medicine, and new and upcoming therapies. The simulation training involves high-fidelity simulators to cover a range of topics from skills training to crisis management to difficult conversations at the bedside.

The PCCM Fellows at UNC also participate in a biannual ECMO/VAD course, an annual Ultrasound course, as well as a regional boot camp at the start of fellowship followed by a regional boot camp for senior fellows.

In addition to the conferences listed below, fellows are also mentored by PCCM faculty in delivering the core lecture series to residents rotating in the PICU and in facilitating simulation training. These experiences combine to provide a solid foundation to an academic career.

MONDAY
12:00pm PCCM Fellow Core Curriculum

1. 1^st Journal Club (alternates in 3s- sentinel article review, round table discussion of recent publications, EBM)
2. 2^nd White Board Sessions
3. 3^rd Ethics
4. 4^th Multicenter PICU education collaborative – a joint educational series between 5 PCCM fellowships on the east coast

2:30pm PCICU M&M (once a month)
3:30pm Cardiac Cath Conference

TUESDAY
12:00pm PCCM Fellow Core Curriculum

1. 1^st Cardiac Lectures
2. 3^rd Simulation
3. Remaining Tuesdays Core Lectures

3:00pm PICU M&M (once a month)

WEDNESDAY
12:00pm PCCM Fellow Core Curriculum

1. 1^st Fellow Meeting with Program Director and Associate Program Director
2. 2^nd Case Conference
3. 3^rd Pediatric Schwartz Rounds
4. 4^th Board Review
5. Quarterly Pro-Con Debates

12:00pm Pediatric Schwartz Rounds (once a month)

THURSDAY
8:00am Pediatrics Grand Rounds
2:30pm PCCM Patient Safety and Quality Improvement Conference (once a month)

4:00pm ECMO Quality Review (once a month)

The Pediatric Critical Care Medicine Faculty is actively involved in medical education across the hospital. The faculty and fellows support the Pediatric Critical Care Medicine Interest Group for Residents (PIG) with regularly scheduled events to discuss career choices, journal clubs and other information relevant to the field of critical care medicine.

One of the many uniquely valuable – and popular – educational options for fellows is the opportunity to join and participate as an educational leader in the “UNC Academy of Educators.”
This robust, formal education training curriculum is designed to emphasize teaching excellence in faculty and fellows, while promoting curricular innovation. Participants enjoy many types of opportunities for peer-to-peer leadership and teaching, and additional networking opportunities.

There are currently over 380 Faculty, Fellow and Resident members participating in the UNC Academy of Educators program.

The Academy offers numerous academic program components as well as four core committees:

• Scholarship
• Programming
• Awards
• Membership

UNC has pioneered a 360 degree evaluation methodology. Using this approach, the fellow is evaluated by attending physicians, nurses and themselves twice a year. These evaluations incorporate all aspects of the fellows training including: Clinical, Research, Education, Interpersonal and Administrative functions focusing on the core competencies. The Fellowship Director discusses the evaluation with each fellow, providing them with formal feedback.

In addition, the fellows evaluate the faculty and the program biannually to allow for continued advancement and improvement in the PCCM Fellowship.