Clinical Components
During the 1st year, the fellow is expected to acquire working knowledge the basic physiology of the common ICU pathology and become proficient in mechanical ventilation and in the following procedures:
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Airway management (bag-mask ventilation, endotracheal intubation and extubation)
Central line placement (femoral, subclavian, and jugular)
Arterial line placement
Chest tube placement
Thoracenthesis and paracenthesis
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During the 2nd year, the fellow is expected to develop expert-level understanding of the common ICU pathology and skills to analyze the less-commonly seen conditions in terms of basic pathophysiological mechanisms. In addition to the previously-mastered procedures, the fellow is expected to acquire skills in the following:
- Placement and use of the pulmonary artery (Swan-Ganz) catheter
- Pericardiocenthesis and placement of the pericardial drain
- Management of the difficult airway, including fiberoptic techniques, jet insufflation, and cricothyroidotomy.
- High-Frequency Oscillatory Ventilation
- Extracorporeal membrane oxygenation
- Inhaled gasses, including HeliOx and Nitric Oxide
During the 3rd year the fellow is expected to increase their knowledge of recent advances in critical care at a physiologic and basic science level, and have a strong data base of the fundamentals of critical care medicine. In addition, they should have attending-level competency in all the mentioned procedures. Opportunities exist for fellows to function as attending pediatric cardiac intensivist supervised by one of the faculty.
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Research Goals
First year:
- Select research project, review and summarize pertinent literature
- Select project committee and prepare the research proposal
- Submit the proposal to IRB or animal-care committee for approval and funding
- Successfully complete the research seminar offered by the Director of the Advocate Center for Pediatric Research
Second year:
- Begin research project (recruitment and/or basic science laboratory experiments, data collection and data entry)
- Start the research manuscript
Third year:
- Complete the manuscript
- Submit the manuscript to peer-reviewed journals
- Revise the manuscript in accordance to the reviewers' comments and resubmit for publication
The research progress of the fellows is monitored and reviewed by a Research Oversight Committee per ACGME requirements.
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Educational Components of Fellowship
Didactic components of the program include:
- Pediatric Critical Care Medicine Journal club
- Pediatric Intensive Care Unit Morbidity and Mortality conferences
- Research conferences
- Basic-science lectures
- Visiting-professor lecture series in Pediatric Critical Care Medicine
- Dedicated Pediatric Cardiac Critical Care Medicine lecture series
- One weeklong SCCM-run pediatric critical care board review every other year
Various additional research and educational opportunities are provided by Advocate Lutheran General Hospital and other Advocate Healthcare sites. The fellows are given one week/year of approved CME time and are expected to attend one mechanical ventilation conference, one Society of Critical Care Medicine conference, one Society for Pediatric Research Conference, and one Chest conference.
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Evaluation
The fellows are evaluated by the attending/supervising physician at the end of each rotation. These evaluations are reviewed with the individual fellows. Critical care nursing, ancillary professionals, and parents also participate in fellows evaluations. The program director meets twice a year with all trainees to discuss their academic and clinical progress. In addition, the fellows' research progress is reviewed twice a year by the Research Oversight Committee.
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