What We Teach:
The Pediatric Critical Care experience at Johns Hopkins Hospital provides for a broad multidisciplinary exposure to the many facets of pediatric critical care medicine. The PICU is a 40-bed unit: 1/2 admissions are medical patients and 1/2 admissions are surgical patients. The Johns Hopkins Children’s Medical and Surgical Center is the pediatric trauma and transplant center (heart, liver, kidney) in our region. We have the largest cardiac surgery ECMO program in the state of Maryland. We have an active critical care transport team that receives medical direction from the PICU. Fellows rotate in the pediatric ICU as the primary caretaker for patients in one of three capacities: As a daytime fellow, night fellow, or transport fellow. During transport shifts, the fellow provides medical direction and participates in ground and air transport of critically ill patients. There are no shifts worked for more than 14 hours.
Accredited by: Accreditation Council for Graduate Medical Education (3232321009)
Duration of Program: Thirty-six (36)months
Positions Available: 4
Application enrollment date(s) or deadline: We participate in the NRMP match. Applications are accepted through ERAS. Interviews are conducted between August and November.
Applicant Qualifications: All applicants must have completed a pediatric residency from an American Board of Pediatrics (ABP) approved training program or be ABP certified in pediatrics.
- We currently participate in the NRMP fellowship match, all applications are accepted through ERAS only with the following supporting documentation:
- CV with photo
- Medical School Transcripts
- Medical School Performance Evaluation (in English)
- USMLE (1 & 2) or COMLEX Scores
- In-Service Exam Scores (Peds Anesthesia Applicants Only)
- Minimum of 3 Letters of Recommendation (include one letter from current training program)
o Copy of Visa (if applicable)
- Copy of ECFMG Certificate (only applicants who attended medical school outside of the US)
- Upon application approval, an interview will be scheduled with the Program Director and Pediatric Critical Care Faculty.
- If position is offered and accepted, the prospective fellow will go through the Credentialing Process.
- If the prospective fellow successfully completes the credentialing process, he/she is then scheduled for an orientation.
Applications will be closely reviewed only after receipt of all required materials. The director of the fellowship initiates interview requests, and not all applicants are granted interviews. An on-site interview is required before consideration for acceptance. Intangibles such as evidence of scholarship, judgment, maturity, motivation, and interpersonal skills are all considered. Acceptance into a program is based on demonstrated academic qualification, interpersonal skills, and evidence of ability to function in a multidisciplinary setting.
By the completion of training, fellows will exhibit an enhanced degree of maturity in their patient management skills, increased awareness and effort as primary educators and the development of leadership skills such that they can manage the PCCM team of residents, fellows, faculty, nurses and respiratory therapists. They are expected to be technically excellent, competent to function as a pediatric intensivist and leaders among their peers. Their independent research careers will augment their intellectual thought processes and allow them to develop creative solutions to difficult problems.
By the end of the third year, the fellows are expected to have achieved competency in the following areas in accordance with ACGME criteria:
- Gather accurate and essential information about their patients.
- Communicate effectively and demonstrate caring respectful behavior when interacting with families and patients.
- Make informed decisions and diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence and clinical judgment.
- Develop and carry out patient management plans.
- Counsel and educate patients and their families.
- Perform competently all medical and invasive procedures considered essential for PCCM training.
- Provide health care services aimed at preventing further health problems.
- Know and apply basic and clinical sciences appropriately to PCCM.
- Demonstrate an investigatory and analytical thinking approach to clinical situations.
Interpersonal Skills and Communication
- Create and sustain a therapeutic and ethically sound relationship with patients.
- Use effective listening skills and elicit and provide information using effective nonverbal, explanatory questioning and writing skills.
- Work effectively with others as members or leader of the health care team.
- Properly utilize ancillary health care professionals, including those from other disciplines, to provide focused patient care.
- Demonstrate respect, compassion and integrity: a responsiveness to the needs of patients, their families, and society that supersedes self-interest; accountability to patients, families, society and the profession; and a commitment to excellence and on-going professional development.
- Demonstrate a commitment to ethical principles pertaining to provision or withholding of clinical care; confidentiality of patient information, informed consent and business practices.
- Demonstrate sensitivity and responsiveness to patients’ culture, age, gender and disabilities.
Practice-Based Learning and Improvement
- Analyze practice experience and perform practice-based improvement activities using a systematic methodology.
- Locate, appraise and assimilate evidence from scientific studies related to their patients’ health problems.
- Obtain and use information about PCCM patients and the larger population from which their patients are drawn.
- Apply knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness.
- Use information technology to manage information and access on-line medical information.
- Facilitate the learning of residents, students and other health care professionals.
- Understand how patient care and other professional practices affect other health care professionals, the health care organization and the larger society and how these elements of the system impact their own practices.
- Know how types of medical practices and delivery systems differ from one another.
- Practice cost-effective health care and resource allocation that does not compromise quality of care.
- Advocate for quality patient care and assist patients in dealing with system complexities.
- Use information technology to support patient care decisions and patient education.
A 36-month pediatric critical care fellowship training program include:
- 1 month anesthesia training in the pediatric operating room paired with a pediatric anesthesiologist and critical care facult
- 14-15 months of clinical pediatric critical care
- 18 months research experienc
- 3 months vacation
The PICU fellowship includes clinical training in the diagnosis and treatment of respiratory, neurologic and cardiac failure as well as critical care transport. Areas of focus include implementation and use of ECMO (extracorporeal membrane oxygenation), helicopter and ambulance pediatric transport, principles of ventilator management and renal replacement therapy.
Pediatric Critical Care Lectures Series consists of:
- PICU Journal Club and Evidence Based Medicine Lecture series- bimonthly
- PICU Case Review and Goals of Care Conference – occurring every Tuesday
- PICU Case of the Week Conference- occurring every Thursday
- PICU/ Pediatric Surgery joint Conference – occurring six times per year
- PICU Board Review – occurring quarterly
- PICU Morbidity and Mortality conference – occurring bimonthly
- PICU Fellow simulation learning series – five sessions per year
- Molecular Medicine in Critical Care conference series- occurring monthly
A two year fellowship in Pediatric Critical Care Medicine is available from an American Board of Pediatrics approved residency for individuals who are also board certified in Anesthesiology. The Sequential Anesthesiology Residency and Pediatric Critical Care Medicine Fellowship at Johns Hopkins currently is as follows:
Year 1: Anesthesiology residency year 1
Year 2: Anesthesiology residency year 2
Year 3: Anesthesiology residency – 5 months anesthesia training, doing pediatric cases exclusively; 7 months elective: 4 months research, 3 months Pediatric Intensive Care Unit (PICU)
Year 4: PICU fellowship: 20 weeks PICU, remainder research
Year 5: PICU fellowship: 20 weeks PICU, remainder research
During the 4th and 5th year, fellows doing this sequential training in pediatrics, anesthesia, and then pediatric critical care, may elect to participate in the pre, intra, and post-operative management of children requiring surgery. If specialty training is desired in Pediatric Anesthesiology, a sixth year may be added to the sequence as year 4, either after the Anesthesia Residency or as year 6.
All applicants must have completed a pediatric residency from an American Board of Pediatrics (ABP) approved training program or be ABP certified in pediatrics.
The following are minimum requirements for consideration for the fellowship interview:
- Transcript of medical school record, certified by the medical school
- Medical School Dean’s letter of recommendation
- Three letters of recommendation
- Completed application (either electronic or regular mail)
- Visa status information if pertinent. All J and H visa holders must complete a Hopkins post doctoral affairs reciprocity review.
- ECFMG certification if pertinent.
Applications will be reviewed only after receipt of all required materials. The Director of the Fellowship initiates interview requests, and not all applicants are granted interviews. An on-site interview is required before consideration for acceptance.
Pediatric Critical Care Fellowship Program
Department of Anesthesiology and Critical Care Medicine
Bloomberg Children’s Center
The Johns Hopkins Medical Institutions
1800 Orleans Street, Room 6349 D1
Baltimore, MD 21287