Pediatrics

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Pediatric Cardiac Intensive Care Fellowship

The Division of Pediatric Critical Care at Indiana University School of Medicine offers a one year non-ACGME accredited Pediatric Cardiac Intensive Care Fellowship to physicians who have completed an accredited fellowship in pediatric critical care medicine and are interested in achieving expertise in the most advanced aspects of pediatric cardiac intensive care.

Based at Riley Hospital for Children at IU Health, fellows receive core training in pediatric critical care, including cardiac intensive care and anesthesia as well as invasive and noninvasive pediatric cardiology.

More than 400 patients annually undergo pediatric cardiac surgery at Riley Hospital, along with hundreds of other patients who undergo cardiac catheterization or require non-surgical medical care for critical cardiac disease. This large and diverse patient population offers fellows excellent opportunities for gaining the expertise necessary to care for complex patients and build effective collaborative treatment in partnership with the numerous providers who participate in the care of a patient with critical cardiac disease.

Pediatric Cardiac Intensive Care faculty consists of a pediatric cardiac intensivists, pediatric cardiologists, cardiac surgeons, neonatologists, PICU fellows, nurse practitioners, respiratory therapists, pharmacologists, nutritionists, and cardiac ICU nurses.

Training Facility

Fellows and faculty in the IU School of Medicine Division of Pediatric Critical Care see patients at Riley Hospital for Children at IU Health, one of the largest pediatric heart centers in the Midwest and the only comprehensive children’s hospital in Indiana providing pediatric specialty care for patients, medical education for clinicians, and state-of-the-art research advancements. Riley has more than 245,000 inpatient and outpatient pediatric visits annually. It is home to an internationally ranked ECMO program in the state’s most comprehensive neonatal units, one of the world’s largest pediatric sleep disorders center and one of the nation’s largest autism treatment centers. This hospital also has one of the nation’s largest pediatric residency programs.

Curriculum

During the first six months of the Pediatric Cardiac Critical Care fellowship, the fellow completes clinical rotations under the direct supervision of pediatric cardiac critical care medicine, pediatric cardiology, pediatric cardiothoracic surgery and pediatric anesthesia faculty. As they progress through the training experience, fellows assume graduated autonomy with increasing responsibility for patient care and pediatric cardiac intensive care team management. During clinical rotations within the cardiovascular intensive care unit (ICU), fellows have opportunities to direct morning rounds and patient hand-offs, supervise junior fellow trainees and advanced practice providers within the unit, and enhance their expertise in the performance of invasive procedures in critically-ill neonates, infants and children with cardiac disease. During the clinical months rotating through the CVICU, fellows are expected to be on call in-house approximately every fourth night, or three overnight calls per two-week block.

For rotations, outside of the cardiovascular ICU (e.g. cardiac catheterization suite, echocardiography suite, and cardiovascular surgery operating rooms), fellows directly take part in processes and procedures necessary for the patients receiving care in these areas under the supervision of the cardiology, cardiovascular surgery or cardiac anesthesiologist attending physician. These rotations provide exposure that typically does not occur in traditional pediatric critical care fellowships, and consequently, helps develop expertise that has become increasingly more necessary to excel in the evolving specialty of pediatric cardiac intensive care.

The following table summarizes the time commitment allotted for each rotation to meet the specific goals and objectives of the fellowship.

Rotation Time
CVICU 24 weeks
Cardiac catheterization / Electrophysiology 4 weeks
Echocardiography/Imaging 6 weeks
Cardiac anesthesia/CV OR 2 weeks
Research 12 weeks
Vacation 4 weeks
Total 52 weeks

Research

Fellows choose a clinical research project at the beginning of the fellowship year with the guidance of CVICU mentors and the PICU research team. Research that can logistically be completed during a one year fellowship with 12 weeks of dedicated research time include retrospective chart review, prospective observational study, hypothesis-driven quality improvement project, or database queries. This is a 12-week rotation divided into 2- to 4-week blocks throughout the course of the year; fellows are not responsible for in-house call in the CVICU during this rotation.

Fellows are also expected to attend local and regional education sessions to learn the fundamentals of statistical analysis and research design and to learn the fundamentals of hypothesis-driven research in a mentored setting including the development of proper experimental design and methodology, data collection and analysis.