Curriculum
The PICU fellow works closely with the attending physician, and is given graduated autonomy in his/her management of the service. The philosophy of the PICU faculty is that autonomy should increase commensurate with the increase in knowledge and skills that are gained over the three year fellowship.
Year 1
The block rotations in the first year of the PICU fellowship training are focused on the development of clinical skills in the ICU, advanced airway management, and an introduction to the principles of research design and performance. Clinical rotations typically include two months in the PICU, one month in the Pediatric Burn ICU at Shriner’s Burn Hospital next door to MGH, one month in the Cardiac Intensive Care Unit at Boston Children’s Hospital, and one month in Anesthesia. A clinical elective in the NICU is also offered. In addition, a rotation through the PICU’s Conscious Sedation Program introduces the fellow to the administration of procedural sedation to infants and children undergoing painful procedures or studies requiring no movement.
The first year fellow is expected to participate in regularly scheduled teaching conferences, morbidity and mortality conference, journal club, mock codes and fellow-run didactic teaching for pediatric residents and medical students on basic pediatric critical care topics.
With respect to scholarly activity, the first year fellow is scheduled for approximately four months of dedicated research time during which he/she explores various research opportunities and begins laying the foundation for a scholarly project under the guidance of a research mentor.
Year 2
The second year curriculum continues to provide clinical experience, including 2 months in the PICU, one month in the burn ICU, and one month in the CICU. Elective time may also be spent in the Adult Surgical ICU at MGH or the Adult Neurology ICU at MGH. The second year fellow is expected to display progressively independent thought and management skills during these service months. The remainder of the year is dedicated to research, with continued participation in weekly teaching conferences and continued contributions to the teaching of pediatric residents and medical students in pediatric critical care medicine.
Year 3
The third year curriculum continues to focus more on research and teaching, though it also provides clinical experience, including 1-2 months in the PICU, one month in the burn ICU, and one month in the CICU. In addition to the electives already mentioned, third year fellows with a particular interest in cardiac intensive care may choose to rotate through the CICU at Children’s Hospital of Pittsburgh. An elective as a “pre-attending” in the PICU at University of Massachusetts is also offered. The third year fellow is expected to take responsibility for leading work rounds and team meetings and to take on a greater proportion of formal teaching in rounds and lectures. The remaining seven to eight months is dedicated to research, during which time the fellow is expected to complete his/her research project and often present their findings at a national conference.
