Changeover from the call team happens at 7am daily. Our changeover includes the ICU fellow and/or attending who were on call the previous night, along with two daytime fellows and two daytime attendings. Evening changeover is at 5pm, again with all fellows and attendings signing out patients together in order to facilitate additional learning and consistent communication.
How are fellow calls structured?
We utilize a tiered call schedule with fellows taking fewer calls each successive year of training. This allows our first-year fellows to take advantage of typically steep learning curves while giving senior fellows additional time to dedicate to their academic work. All call is in the PICU except when fellows are on CVICU service and there is no difference in call number between service and research months.
1st year fellows – 6 calls per month
2nd year fellows – 5 calls per month
3rd year fellows – 4 calls per month
Our approach to graduated autonomy:
During the first-year fellows are always partnered with a faculty member during calls. Starting in the spring of the first-year fellows are given graduated autonomy wherein on call faculty members typically leave the hospital at midnight. Starting in the second year the fellows take PICU call without a faculty member in house.
During CVICU months the fellows take 5 calls per month, regardless of year of training. A CVICU attending is always in house with the fellows during these calls.
How is holiday/vacation time structured?
Fellows receive four weeks of paid vacation per year. Fellows work one major holiday per year (Christmas, New Year’s and Thanksgiving) and one minor holiday per year (Labor Day, July 4th and Memorial Day).
What attractions does Indianapolis offer?
Indianapolis has a fantastic cost of living and is home to a wide range of attractions:
Museums, including the award-winning Children’s Museum of Indianapolis, the largest children’s museum in the world
Parks, golf courses, and playgrounds
Trails wind through the city including the Cultural Trail, Monon Trail and Central Canal Towpath
The world-famous Indianapolis Motor Speedway, home of the Indianapolis 500
The Indianapolis Colts, the Indy Fuel, the Pacers, and the Indy Eleven as well as the Indianapolis Indians
Peaceful state parks are located both within Indianapolis and just outside the city limits. Be sure to check out Eagle Creek Reservoir and The Indiana Dunes National Lakeshore (the newest national park)
Great dining and local craft breweries are conveniently located in downtown Indianapolis, on Mass Avenue, in Fountain Square and in the Broad Ripple neighborhood – all within minutes of the hospital.
Local theater productions as well as touring Broadway shows at the Murat provide great entertainment
Beef & Boards, an award-winning dinner theater, as well as various concert venues in and near Indianapolis provide great weekend entertainment
For movie buffs, Indianapolis has several theaters, including drive in theaters, and hosts the Heartland Independent Film Festival
Chicago, Louisville, Cincinnati, and St. Louis are accessible with a short drive while more distant destinations are easy to reach from the Indianapolis International Airport
What are the research interests of your fellows? What types of research opportunities are possible?
Our fellows have completed research in such areas as quality improvement, clinical and translational research, and educational scholarly work. Our fellows are encouraged to design a project that both advances their career plans and focuses on an area of personal interest. With strong mentorship both inside and outside of our department, our graduating fellows have all successfully completed their research, gained important academic skills, and have begun to develop an area of academic expertise during their fellowship. The average fellow presents at national meetings, completes 1-3 publications, and often applies for a grant during fellowship.
Are the ICUs at Riley "open" or "closed"?
Both the CVICU and PICU at Riley are closed. All patients in these ICUs are managed by pediatric intensivists along with subspecialists in a variety of medical and surgical specialties. Our patients benefit from a strong collaborative approach to care with frequent co-management of trauma, neurosurgical and stem cell transplant patients. Our fellows are integral in this model, frequently communicating with fellows and attendings from a wide range of specialties.
How does the CVICU faculty interact with the PICU fellows?
All CVICU attendings are trained in pediatric critical care medicine with some dually boarded in pediatric cardiology. The team also includes cardiologists, cardiovascular surgeons, neonatologists and genetics. This multidisciplinary approach is crucial in providing excellent care to our patients and provides the fellows with teaching and training across specialties. The CVICU is housed within the division of critical care.
Who is in the daytime PICU rounding team?
The PICU at Riley has two separate teams each day. Each time includes an attending, PICU fellow, 4-5 residents, pharmacist and nutritionist. We utilize patient-centered rounds that include the nursing staff and respiratory therapists along with the families and patients. There is a separate rounding team for the CVICU.
What is an average patient volume in the PICU and CVICU?
Our 44 bed PICU cares for a wide range of surgical and medical patients with an average of 2500 admissions a year. Our 18 bed CVICU averages 500-600 admissions per year with 300 pump cases. We additionally care for critically ill children in a 10 bed burn unit, the only pediatric burn unit in the state. Riley is an ELSO Platinum Center of Excellence, averaging between 40-45 ECMO runs a year.
What are the procedural opportunities for fellows?
Fellow procedural opportunities are excellent in our high-volume, high-acuity ICU with fellows reaching competency and quantitative goals early in their first year. Our fellows are trained in endotracheal intubations, central venous and arterial line placement, PICC placement, chest tube placement and abdominal paracentesis as well as point-of-care ultrasound.
You're in the middle of Indiana. How diverse is the Riley PICU working environment?
Pediatric critical care fellows at Riley benefit from exposure to a wide range of learning opportunities. As the only dedicated children’s hospital in the state of Indiana offering the full complement of pediatric specialties, we care for hundreds of patients with common medical problems each year as well as a wide range of uncommon illnesses. Riley is ranked in all ten U.S. News & World Report pediatric specialties and as such serves as a state and regional referral center. Our hospital is the only level 1 trauma center in the state and we have strong stem cell and solid organ transplant programs, providing heart, lung, kidney and multivisceral transplants.
In addition to the clinical diversity, our pediatric critical care department includes 25 intensivists from a variety of residency and fellowship programs. This diversity of training provides the fellows with exposure to a range of practice styles and skillsets. Our faculty and fellows are additionally culturally diverse, originally coming from four different countries and ten states.
What didactic opportunities are provided?
The pediatric critical care division has three weekly didactic times that are protected for fellows. Board review and CVICU lectures alternate Mondays. Case discussions and special topic lectures are held each Wednesday at noon. A core PICU curriculum lecture series takes place for one hour each Thursday morning. Additionally, there is an ECMO lecture series that occurs in collaboration with neonatology and pediatric general surgery. Finally, the department of pediatrics hosts monthly workshops that cover a variety of topics relevant to all academic pediatric subspecialists. All of these educational opportunities are prioritized and protected for the fellows.
Pediatric Intensivist, Lutheran Hospital - Fort Wayne, IN