Pediatric Emergency Medicine Fellowship Curriculum | NYU Langone Health

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Pediatric Emergency Medicine Fellowship Pediatric Emergency Medicine Fellowship Curriculum

Pediatric Emergency Medicine Fellowship Curriculum

Throughout their three years of training, fellows in pediatric emergency medicine at NYU Langone rotate primarily through the pediatric emergency service at NYC Health + Hospitals/Bellevue and the pediatric emergency care center at KiDS Emergency Department, part of Hassenfeld Children’s Hospital at NYU Langone.

Fellowship Clinical Curriculum

Our fellowship is designed to provide graduated leadership as fellows gain clinical skills. Fellows work directly with an attending physician, with progressive opportunities for autonomy throughout training.

First Year: Emergency and Critical Care Skills

The focus of the first year is building essential emergency medicine and critical care skills. For the first few months, fellows in the pediatric emergency department see patients in a primary role, precepting directly to the attending, in order to master the clinical and logistical tasks of caring for acute patients in our systems.

Fellows begin to precept residents after they have mastered these skills and learn to balance seeing patients and precepting in response to volume and flow. First-year fellows focus on the airway during acute resuscitations and are expected to build their procedural skills. Fellows may see patients in the higher age range (NYU Langone’s pediatric emergency departments admit patients up to 20 years), which allows for exposure to a greater range of patient acuity, pathology, and procedures.

In addition to five months of dedicated time in the pediatric emergency service and pediatric emergency care, first-year fellows spend clinical time in trauma, pediatric intensive care, anesthesiology, adult emergency medicine, and toxicology.

Second Year: Teaching and Preceptorship

During the second year, fellows grow their precepting and bedside teaching skills and learn how to efficiently balance patient care and education. During clinical rotations, fellows also start to build autonomy and develop resuscitation team leadership skills.

Outside of the emergency department, clinical rotations include trauma (at the R Adams Cowley Shock Trauma Center at the University of Maryland Medical Center in Baltimore) and adult emergency medical services, with significant time for research and electives so fellows can round out their clinical skills and start building niches of expertise. Elective months are available in pediatric and surgical subspecialties including plastic and hand surgery, child protection, orthopedics, ultrasound, and others.

In conjunction with clinical teaching, second-year fellows are responsible for developing and coordinating conference and educational curricula under the leadership of the associate program director.

Third Year: Leadership and Administration

In the final year of fellowship, trainees focus their clinical skills on team leadership, flow management, and autonomy. They are afforded opportunities to run the pediatric emergency service autonomously and are encouraged to develop administrative skills with regards to patient referrals, nursing and staff communication, and disposition management.

Senior fellows complete their adult emergency medicine time and have significant elective and research time. In line with administrative skills, third-year fellows are responsible for overseeing fellow shift scheduling in conjunction with the associate program director.

Fellowship Didactic Curriculum

Fellowship clinical training is supported by a robust didactic curriculum that integrates various modes of learning such as flipped classroom, case-based, simulation-based, and hands-on. In addition to a weekly pediatric emergency medicine division conference, the Ronald O. Perelman Department of Emergency Medicine and Department of Pediatrics provide enriching conferences that fellows are encouraged to attend.

Pediatric Emergency Medicine Conference Schedule

Every Tuesday, fellows and academic faculty gather for our half-day division conference.

Time First Tuesday Second Tuesday Third Tuesday Fourth Tuesday
8:30AM–9:30AM Five-minute “coffee case” and pediatric emergency medicine fellow core content or biostatistics Five-minute “coffee case” and pediatric emergency medicine fellow core content: board review Five-minute “coffee case” and pediatric emergency medicine fellow core content or research design Five-minute “coffee case” and pediatric emergency medicine fellow core content
9:30AM–10:15AM Research review Case conference Fellow ultrasound didactics Case conference
10:15AM–11:15AM Journal Club Didactic x 2 (fellow or faculty) Didactic x 2 (fellow or faculty) and journal updates Joint conference case reviews
11:15AM–12:00PM Administrative meeting (faculty and fellows) Fellow simulation session Administrative meeting (faculty) Fellowship huddle (11:15AM–11:30AM)
12:00PM–1:00PM   Fellowship huddle Fellow and faculty simulation session or procedural skills In situ trauma simulation session

Pediatric Emergency Medicine Conference Sessions

The five-minute “coffee case” is a brief case presentation facilitated by the teaching fellows that features succinct teaching points to start the morning.

Pediatric emergency medicine fellow core content is an overarching three-year curriculum that provides case-based, interactive, and flipped-classroom teaching that targets core knowledge acquisition for fellows. Sessions are weekly for one year and monthly for two years. Once a month, core content is in the form of board review using the MedChallenger website.

For the fellow research review sessions, fellows prepare and present their research progress to scholarly oversight committee members, peers, and faculty in order to receive feedback. Faculty are also invited to share their research.

Fellow ultrasound didactics feature ultrasound lectures that supplement scanning shifts.

The research design and statistics course is a bimonthly formal curriculum spanning two years, comprising didactics and practice sessions in biostatistics and research design.

The division case conference features informal presentations and discussion of interesting and challenging cases.

Division didactics are 30- to 60-minute talks by faculty and fellows, with a focus on 1 to 3 evidence-based clinical questions.

Journal Club is a monthly formal journal club, prepared by fellow and faculty combination.

Simulation sessions integrate complex simulation-based cases, procedural workshops, and targeted fellow-only simulations.

The administrative meeting provides updates and discussion with division and site directors.

Fellowship huddles offer a chance for fellows, our program director, and our associate program director to touch base. Each quarter, this huddle is expanded into an hour-long meeting for the program evaluation committee.

Department of Emergency Medicine Didactics

The didactic curriculum in emergency medicine immerses learners in day-to-day case management and helps them build professional skills.

The emergency medicine academic half day comprises four consecutive didactic sessions integrating lectures, case conferences, morbidity and mortality rounds, journal review, ethics, procedure skills, invited lectures, and simulation. Fellows are required to attend a minimum of six half-days during the academic year, and encouraged to attend more. Fellows are also encouraged to join the department’s Scholarly Academies to benefit from didactics, networking, and mentorship.

The emergency medicine resident morning case conference is an informal case presentation by a senior emergency medicine resident, with a pediatric focus once per week co-facilitated by pediatric emergency medicine fellows and faculty. A Social Justice Report, featuring instructive cases with regards to structural racism, inequity, and social determinants of health, is also part of this curriculum.

The NYC Poison Control Center toxicology consultant rounds are monthly two-hour discussions of cases presenting to the center.

The emergency medicine fellows’ series is a required monthly curriculum for all fellows in the Department that focuses on career development skills.

Department of Pediatrics Didactics

The didactic curriculum in pediatrics enables fellows to develop expertise that combines emergency medicine and pediatrics. The monthly pediatric fellow series, which focuses on career development, is required for fellows, while the remainder of departmental didactics is encouraged.

The pediatric academic half day comprises monthly didactics that are largely case-based to generate discussion and in-depth review. In the Pediatric Grand Rounds weekly conference, often led by a visiting professor, learners engage in critical topics in pediatric care.

The pediatric morbidity and mortality conference features a patient case presentation and brief discussion surrounding pertinent diagnostic and management guidelines.

The pediatric multidisciplinary morning report is a case-based discussion of pediatric patients admitted to the Pediatric Intensive Care Unit, Neonatal Intensive Care Unit, and general pediatrics ward with the department chair, vice chair, and residency director.

Regional Educational Conferences for Fellows

In addition to institutional didactics, fellows benefit from rich educational collaborations with regional pediatric emergency medicine fellowships and divisions. We encourage fellows to attend the following local and regional educational conferences:

  • New York City Pediatric Emergency Medicine Fellows Evidence-Based Medicine Course: a two-day intensive review of the basic principles of evidence-based medicine with an emphasis on developing teaching skills
  • New York City Pediatric Emergency Medicine Fellows Teaching Conference: a one-day intensive review of instructional methodologies for second-year fellows
  • Pediatric Emergency Medicine Fellow Base Camp: a high-intensity, immersive base camp of simulated pediatric emergencies, where fellows work with interdisciplinary teams to manage crisis conditions and emergency resuscitations
  • Ultrasound Intensive Course: many local institutions (Mt. Sinai, St. Luke’s, Maimonides, and NewYork-Presbyterian) offer one- or two-day intensive ultrasound courses for pediatric emergency medicine faculty and fellows
  • Medical Toxicology Course: a three-day course that integrates lectures, simulations, and small-group formats for an intensive toxicology review
  • Long Island Jewish/Cohen Children’s Medical Center Annual Pediatric Emergency Medicine Symposium: a symposium highlighting cutting-edge developments in pediatric emergency medicine

Fellowship Teaching Responsibilities

We place great importance on building fellows’ teaching skills, training future educators, and promoting educational scholarship. In addition to bedside teaching and contributions to the division conference, fellows facilitate a range of sessions for learners under the mentorship of faculty members. These include the pediatric intern procedure workshop, the pediatric resident case conference, pediatric resident simulation cases, the emergency medicine morning conference, and emergency medicine resident lectures.

All fellows become proficient in advanced cardiac life support and advanced trauma life support, and they become instructors in pediatric advanced life support. Additionally, fellows contribute to Pediatric Emergency Medicine Guides and Pediatric Emergency Medicine Critical Article Reviews, ebooks developed by Michael A. Mojica, MD, and the Division of Pediatric Emergency Medicine as point-of-care resources for clinicians.

Fellowship Ultrasound Curriculum

Through a robust ultrasound curriculum, our fellows meet American College of Emergency Physicians competency requirements for point-of-care ultrasound in all core pediatric emergency medicine applications. Our ultrasound curriculum comprises monthly didactics in a recurring year-long curriculum.

Additionally, the fellowship ultrasound director conducts weekly to semiweekly asynchronous image reviews and two, four-hour supervised scanning shifts per month with fellows.

During the second year, there is a required 2-week ultrasound rotation during which fellows complete a minimum of 10 supervised scanning shifts and attend departmental ultrasound conferences. All fellow ultrasounds are reviewed for quality assurance and feedback by ultrasound faculty.

As part of visual diagnosis teaching, and due to interest and expertise in pediatric cardiac emergencies, the ultrasound director also integrates “EKG of the Week” into ultrasound image review sessions.

Fellowship Simulation Curriculum

Our fellowship boasts an ever-growing and innovative simulation curriculum comprising regular joint faculty and fellow simulations, fellow-only simulations, procedural sessions, in situ simulations, and teaching simulations.

We have the great benefit of multiple dedicated simulation faculty within the Department of Emergency Medicine at NYU Langone and the New York Simulation Center for the Health Sciences at Bellevue, one of the nation’s largest and most sophisticated urban health science simulation teaching facilities.

In the last year, our simulation directors have launched monthly interdisciplinary in situ trauma simulations at Bellevue that serve educational, quality improvement, and team communication purposes. In the upcoming year, we plan to pilot a comparable interdisciplinary program at NYU Langone’s Tisch Hospital. Our simulation curriculum offers fellows the opportunity to learn mentored core skills in case writing, multimethod debriefing, basic technical operations, and curricular design and evaluation.

Research Opportunities for Fellows

Our division is productive in educational, ultrasound, and simulation-based scholarship, and continues to grow its clinical research capacity. We participate in multicenter research through the Pediatric Emergency Medicine Clinical Research Committee, and our faculty are involved in research in pediatric prehospital care, injury prevention, toxicology, sedation, medical education, ultrasonography, and a variety of other topics.

Research experience and education occurs throughout the three years of training. The research curriculum consists of two major components. First, our fellowship offers a comprehensive two-year, longitudinal Research Design and Biostatics course delivered by the division director of medical education and the research director. This course covers concrete skills including biostatistics, critical appraisal of medical literature, study design, and microcomputer applications (such as IBM® SPSS® Statistics skills) in clinical research.

The second component is development and completion of an individual scholarly project, under the supervision of a faculty mentor and oversight by the fellowship director, research director, and scholarly oversight committee. Approximately 11 months of research time over the course of 3 years is allocated to scholarly activity.

Our fellows frequently present and publish the results of their research at national scientific conferences and in peer-reviewed journals.

Fellowship Wellness Initiatives

Promoting a healthy work–life balance for a successful and happy career is a cornerstone of our program’s philosophy. Our fellows make their own shift schedules, and we pay careful attention, respect, and equity to holidays, vacation requests, and circadian rhythms. Our program has a long history of respecting and promoting adult learning and autonomy, and we protect dedicated educational and research time throughout training.

As a small program and division, we benefit from a real “family feel.” Fellows, faculty, and program leadership enjoy open communication. We host numerous social events throughout the year, including a summer welcome barbecue hosted by the program director; division and departmental holiday parties; an intimate fellowship graduation dinner (in addition to larger departmental graduation celebrations); an annual retreat; and multiple smaller get-togethers driven by fellows’ input. Social events are adapted to virtual formats as needed.

The Department of Emergency Medicine also hosts various wellness events including comedy club performances, exercise classes, and group ski trips. Additionally, NYU Langone’s Graduate Medical Education program offers significant wellness and mental health benefits such as free, confidential therapy sessions; a 24-hour mental health hotline; and generous health insurance benefits. There are also comprehensive programs for work–life assistance (including backup emergency childcare) and discounts including gym memberships, restaurants, and retail stores. From a social perspective, we benefit from the rich and vibrant offerings of New York City, with world-class restaurants, theater, parks, and entertainment at our fingertips.