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 opportunities for progressive autonomy throughout training. We offer two different tracks depending on the type of residency (Pediatrics or Emergency Medicine) completed.

Pediatric Residency Graduates

Graduates of Pediatric residency programs complete a 3-year fellowship with a focus on the care of acutely ill and injured pediatric patients. Fellows complete rotations in adult emergency medicine, trauma, toxicology, and critical care (including both pediatric and cardiac critical care). Fellows also have ample research time to dedicate to their scholarly project.

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. In both NYU Langone and Bellevue's pediatric emergency departments, fellows see patients up to 20 years of age), 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 department, 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 medicine, with significant time for scholarship 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 serve in a Teaching Fellow role and 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 department 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 serve are responsible for overseeing fellow shift scheduling in conjunction with the associate program director, in an Administrative Fellow role.

Emergency Medicine Residency Graduates

Graduates of Emergency Medicine residency programs complete a 2-year fellowship with a focus on pediatric skills. Fellows complete rotations in neonatal, pediatric, and cardiac critical care units; pediatric inpatient medicine; outpatient general pediatrics; and outpatient pediatric subspecialty clinics (including adolescent and gender-affirming clinics, child protection, dermatology, and gastroenterology and hepatology). While the ABP does not require a scholarly product of EM residency graduates, we do require that all fellows engage in scholarly work during training.

First Year: Pediatric Knowledge

The focus of the first year is developing general pediatric knowledge. Fellows see patients in a primary role in the pediatric emergency department for the first few months while they broaden their pediatric knowledge base. Once they begin precepting residents, fellows are expected to balance primary patient care and precepting in response to volume and flow. First-year fellows take the airway role during acute resuscitations. In addition to five months of dedicated time in the pediatric emergency department, first-year fellows spend clinical time rotating through pediatric anesthesia, inpatient medicine, outpatient general pediatrics, child protection clinic, and critical care (either neonatal or pediatric, depending on residency experience).

Second Year: Teaching, Leadership, and Administration

During the second and final year, fellows continue to hone their teaching and leadership skills, flow management, and autonomy. While on clinical rotations, fellows spend time in the pediatric and cardiac critical care units as well as outpatient pediatric subspecialty clinics Second-year fellows serve in a Teaching/Administrative Fellow role, contributing to the development and coordination of educational curricula, conferences, and shift scheduling.

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, fellows attend enriching conferences in both the Ronald O. Perelman Department of Emergency Medicine and the Department of Pediatrics.

Pediatric Emergency Medicine Conference Schedule

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

	8:30-9:30AM	9:30-10:30AM	10:30-11:30AM	11:30AM-12PM	12:00-1:00PM
First Tuesday	Coffee Case Fellow Core Content or Research Design/Biostatistics	Research Review	Talk Journal Update	Admin	Fellowship Huddle
Second Tuesday	Tisch Interdisciplinary In-Situ Simulation	Coffee Case Talk/Flex	Talk x2	Fellow Board Review	Fellow Wellness Lunch
Third Tuesday	Fellow Huddle Fellow Core Content	Ultrasound Didactic	Journal Club	Admin	Fellow/Faculty Simulation or Procedural Skills
Fourth Tuesday	Joint PEM/EM Conference Coffee Case	Morbidity, Mortality, and Improvements or Joint Subspecialty Conference	Case Conference	Talk/Flex	Bellevue Interprofessional In-Situ Trauma Simulation

Pediatric Emergency Medicine Conference Sessions

Educational sessions are structured around a two-year curriculum based on Rosh Review pediatric emergency medicine question bank to ensure that all key topics are covered.

The fifteen-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 provides case-based, interactive, and flipped-classroom teaching that targets core knowledge acquisition for fellows. Sessions range from weekly to monthly depending on other concurrent curricula such as research or biostatistics (see below). Fellows present board review questions on a monthly basis.

The research design and statistics course is a two-year formal curriculum that comprises didactics and practice sessions in biostatistics and research design.

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

Simulation-based health professions education is an integral part of our program’s educational experience; sessions consist of both complex interprofessional simulation cases and procedural workshops.

Fellow ultrasound didactics feature ultrasound lectures that supplement hands-on scanning shifts.

Case conference features a discussion of interesting and challenging cases.

Division didactics are 30-minute talks by faculty and fellows, with a focus on evidence-based medicine in a case-based format.

Journal Club is a formal monthly journal club, prepared by fellow-faculty dyad.

Joint conference serves as an opportunity for the PEM division to liaise and discuss cases and/or topics with other divisions such as pediatric hospitalist medicine, pediatric surgery, and pediatric critical care.

Morbidity, mortality, and improvements (MMI) consists of a detailed case review through a quality improvement/patient safety lens.

Administrative meetings provide the opportunity for the division to discuss updates and issues.

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

Fellows enjoy monthly lunches together to promote wellness and community.

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 consecutive didactic sessions integrating lectures, case conferences, MMI, journal club, 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.

Lewin Morning Report consists of a case presentation by a senior emergency medicine resident; three sessions per month are dedicated to pediatric cases and are mentored by a PEM fellow-faculty dyad.

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

The Fellow and Faculty Development Curriculum is a monthly curriculum for fellows and faculty in the Department of Emergency Medicine that focuses on various topics such as professional development and wellness.

Department of Pediatrics Didactics

Fellows in the Department of Pediatrics participate in a quarterly Fellow’s College Session, which consists of an afternoon session devoted to topics such as professional development.

The pediatric academic half-day sessions comprise weekly didactics for the pediatric residents; several sessions are led by a pediatric emergency medicine fellow-faculty dyad.

Weekly Pediatric Grand Rounds feature visiting or institutional faculty presenting critical topics in pediatric care.

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

The pediatric multidisciplinary morning report is a more informal case-based discussion.

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. We have robust interprofessional in-situ simulation curricula at both our NYU Langone and Bellevue sites, as well as dedicated fellow and faculty simulations and procedural skills sessions held at the New York Simulation Center for the Health Sciences (NYSIM). Our simulation curriculum offers fellows the opportunity to learn mentored core skills in case writing, multi-method 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 vice chair for education of the Department of Emergency Medicine; 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.