Overview
The fourth-year clinical fellow in the pediatric cardiac intensive care unit is expected to assess and stabilize preoperative cardiac patients, seeking guidance from the attending physician as necessary.
The fellow will develop a thorough understanding of common operative interventions in the cardiac ICU, with a focus on pathophysiology and detailed anatomy. Additionally, the fellow will gain foundational knowledge of less common anatomical conditions.
Throughout the year, the fellow will progressively take on more independent responsibility in managing patients with congenital and acquired heart disease, ensuring readiness for independent practice by the end of the year.
The curriculum offers a comprehensive foundation essential for a successful career in pediatric cardiac critical care medicine by including specialized rotations across cardiac ICU, pediatric ICU, neonatal ICU, cardiovascular anesthesia, cardiac surgery, perfusion and point-of-care ultrasound as well as procedural skill development.
Curriculum Information by Year
Clinical “on-service” rotations will span 10 months, including five months in the cardiac ICU (with two months of every fourth night in-house call, and two months of junior attending call), and five months in elective rotations (with one to two months every fourth night in-house call), tailored to the fellow’s training background.
The program includes two months dedicated to research. Four weeks of vacation may be taken during the time that is allotted for research. Academic projects will be conducted in collaboration with an assigned faculty mentor.
The research experience will focus on developing the fellow’s skills in experimental design and data analysis, providing a solid foundation for future academic contributions and success in the field.
Sample Schedule by Rotation
- Pediatric Cardiology: 5 months
- Pediatric Critical Care: 5 months
- Neonatology: 4 months
- Pediatric Cardiology: 1 month
- Pediatric Critical Care: NA
- Neonatology: 2 months
- Pediatric Cardiology: 2 weeks
- Pediatric Critical Care: NA
- Neonatology: NA
- Pediatric Cardiology: 1 month
- Pediatric Critical Care: NA
- Neonatology: NA
- Pediatric Cardiology: 2 weeks
- Pediatric Critical Care: 2 weeks
- Neonatology: 2 weeks
- Pediatric Cardiology: 2 weeks
- Pediatric Critical Care: 2 weeks
- Neonatology: 2 weeks
- Pediatric Cardiology: 2 weeks
- Pediatric Critical Care: 2 weeks
- Neonatology: NA
- Pediatric Cardiology: NA
- Pediatric Critical Care: 1 month
- Neonatology: 1.5 months
- Pediatric Cardiology: NA
- Pediatric Critical Care: 2 weeks
- Neonatology: 2 weeks
- Pediatric Cardiology: NA
- Pediatric Critical Care: 1 month
- Neonatology: 1 month
- Pediatric Cardiology: 2 months
- Pediatric Critical Care: 2 months
- Neonatology: 2 months
- Pediatric Cardiology: 1 month
- Pediatric Critical Care: 1 month
- Neonatology: NA
Limitation of trainee work hours will comply with current Accreditation Council for Graduate Medical Education recommendations.
Trainees will be formally evaluated at the end of each monthly rotation. They will also be given the opportunity to evaluate faculty and the rotation itself.
Research
Research will be conducted on a clinical topic in cardiac critical care during the two months allocated for research within the fellowship year. The fellow should define the project within the first one to two months of the academic year, in collaboration with an assigned faculty mentor.
A project proposal must then be developed and a grant application submitted for either internal or external funding. Alternatively, fellows may continue projects initiated in previous fellowship years. It is expected that the research will lead to the publication of a manuscript in a peer-reviewed journal.
Additionally, the mentored research experience will enhance the fellow’s skills in experimental design and data analysis, laying the foundation for future academic contributions to the field.
Additional Details
A curriculum will be provided at the beginning of the academic year that will include seminal papers covering key topics in pediatric cardiac critical care.
Procedural skills will also be honed depending on the needs of the individual in the following areas:
- CPR and cardioversion
- Temporary pacing
- Central and arterial line placement
- Endotracheal intubation and ventilator management
- Thoracentesis and chest tube placement
- Pericardiocentesis
- ICU echocardiography
Conferences
Trainees will be required to attend all Texas Center for Pediatric and Congenital Heart Disease conferences when not in conflict with on-service requirements. Fellows may be asked to present patient information during these meetings or conduct brief literature reviews on specified topics.
- TCPCHD Case Conference
- Heart Center Fetal Cardiac Conference
- Heart Center Quality Assurance Conference
- TCPCHD Research Meeting
- Multidisciplinary Perioperative Review
- TCPCHD Multidisciplinary Review