The Pediatric Emergency Medicine Fellowship curriculum includes comprehensive training goals, objectives, evaluation and feedback mechanisms. Fellows can individualize training to meet their future goals while participating in quality-improvement initiatives, advocacy work, out-of-hospital training and ultrasound training.
Sample Rotation Schedules for Pediatrics-Trained Fellows
First-year pediatric emergency medicine (PEM) fellows who are pediatrics-trained complete five blocks of emergency medicine; one block each of research, anesthesia, trauma (adult), emergency department (adult) and PICU; two blocks of elective, three weeks of elective/one week vacation; and three additional weeks of vacation during emergency department blocks.
Second-year PEM fellows who are pediatrics-trained complete five blocks of emergency medicine; two blocks of research; one block each of emergency department (adult), child abuse/legal, toxicology, ultrasound, and an elective; three weeks of elective/one week vacation; and three additional weeks of vacation during emergency department blocks.
Third-year PEM fellows who are pediatrics-trained complete five blocks of emergency medicine; five blocks of research; one block elective; one block EMS; three weeks of elective/one week vacation; and three additional weeks of vacation during emergency department blocks.
Sample Rotation Schedules for Emergency Medicine-Trained Fellows
First-year PEM fellows who are emergency medicine-trained complete five blocks of emergency medicine; one block each of research, anesthesia, pediatric inpatient, pediatric outpatient, neonatal medicine, PICU and elective; three weeks of elective/one week vacation; and three additional weeks of vacation during emergency department blocks.
Second-year PEM fellows who are emergency medicine-trained complete seven blocks of emergency medicine; one block each of research and child abuse/ legal; three blocks of electives; three weeks of elective/one week vacation; and three additional weeks of vacation during emergency department blocks.
Year Three (optional)
PEM fellows who are emergency medicine-trained and choose to train for a third year complete six blocks of emergency medicine; four blocks of research; two blocks of electives; three weeks of elective/one week vacation; and three additional weeks of vacation during emergency department blocks.
Electives for PEM fellowship training include ophthalmology, OMFS, dermatology, radiology, cardiology, sports medicine / orthopedics, plastic surgery, EMS, ultrasound and toxicology as well as other options per fellow interests and needs—with program director approval.
During elective and research months, fellows do 4-6 shifts in the Emergency Department at Riley Hospital for Children, depending on rotation. During elective months, fellows have time for research. First-year fellows complete 14 shifts per month; those pursuing the two-year fellowship complete 16 shifts per month. Second-year fellows do 12 shifts per month; those pursuing the two-year fellowship complete 14 shifts per month. Third-year fellows complete 10 shifts per month.
Pediatric Emergency Medicine fellows complete clinical work at Riley Hospital for Children at IU Health in Indianapolis, which treats more than 1500 trauma patients each year and expects to see more than 50,000 patients in the emergency department this year. With a high patient acuity, this represents one of the largest admission rates of any pediatric ED in the United States. With one to two pediatric sedations per day in the Riley emergency department, PEM fellows are exposed to all major drugs used for pediatric sedations, including Ketamine, Propofol, Nitrous and a variety of intranasal medications. Adult trauma and general emergency medicine rotations take place at IU Health Methodist Hospital, the region’s largest Level 1 adult trauma center and busiest emergency department.
While IU School of Medicine pediatric emergency medicine faculty members serve as role models and mentors for PEM fellows throughout their clinical development, fellows have mentors who are members of the Department of Emergency Medicine and the Department of Pediatrics and have the opportunity for mentorship outside these departments.
Each week, Pediatric Emergency Medicine fellows are exposed to core PEM curriculum during four-hour division education, which is variable; topics may include current treatment of certain diseases, discussions of new pathways and hospital-specific topics. Subjects often involve outside speakers but may involve current division or departmental faculty. Quarterly multidisciplinary lectures and best practice sessions/consensus conferences are under development.
Fellows also participate interdisciplinary conferences, simulations, quarterly journal club, procedure sessions, EM and pediatrics Grand Rounds, research conferences and research project development as well as a weekly Board Review with faculty and fellows, starting in the first year. Board Review uses questions from the Wang et al Pediatric Emergency Medicine Question Review Book. Pediatric Emergency Medicine fellows are required to attend the Pediatric Fellows Workshop/ Conference, an event for all pediatric subspecialty fellows.
They are expected to attend EM and pediatrics Grand Rounds when topics are pediatrics-related and also attend appropriate EM weekly education topics. Fellows present Grand Rounds, EM education didactics on pediatric topics, didactics for pediatric noon conferences when appropriate, and assist with PEM simulations and workshops when appropriate.
Fellows attend the National PEM Fellow’s Conference, as well as other regional and national meetings to present their research.
Pediatric Emergency Ultrasound Training for PEM Fellows
Our division has an active Pediatric Emergency Ultrasound Fellowship, as well as faculty who are fellowship trained in ultrasound. Fellows begin scanning on day one of the fellowship. There are monthly quality reviews of ultrasounds as part of the didactic series, one-on-one scanning opportunities with trained faculty throughout the fellowship and a dedicated ultrasound month in the first year to learn from experts in both pediatric and general emergency ultrasound. At the end of training, fellows will have completed enough quality-reviewed scans that they will be able to be credentialed in ultrasound at any institution.
Participation in research is required by the American Board of Pediatrics as part of the training for pediatric fellows. Our fellows establish a scholarly oversight committee (SOC) within their first six months of training and develop a research focus. They complete a comprehensive literature review and their IRB proposal. All first-year fellows present at the National PEM Fellows Conference in late winter/early spring of the first year.
During the second year, fellows continue to develop their research project under the direction of their SOC, collect data and begin manuscript preparation. This is completed in the third year with the goal of submitting their research for publication prior to graduation from the program.
There are many opportunities to be involved in quality and improvement work, safety initiatives, informatics research, medical education research, and research in PEM-focused areas. These include ultrasound, disaster medicine, EMS/out-of-hospital medicine, toxicology, simulation and global health.