Intensive Care Unit: The PICU is divided into two teams. Each team includes an attending intensivist, a fellow, two pediatric intern, one pediatric resident and a third-year anesthesia resident or second-year emergency medical residents. Working closely with the attending, the fellow will be responsible for the delivery of care to patients in the intensive care unit. Fellows work with the attending and, as skills and confidence are attained, gradually assume a more active role in helping, supervising and teaching house officers in the unit. During the time that they are in the unit, fellows will have no other clinical responsibilities and will be expected to be available to the unit at all times during the days and during their night calls. Night calls will be every fourth night (shared with the other fellow in the PICU, the fellow in the PTICU and the fellow on day Transport). The PICU fellow may be asked to consult on emergency room and floor patients who may require PICU admission. An ICU attending will serve as back-up for situations where more help is needed.

Pediatric Trauma Intensive Care Unit: This is a fellow-directed unit without pediatric residents. This allows for significant one-on-one teaching and interaction between the fellow and the PTICU attending. There are also 2-3 critical care pediatric nurse practitioners in lieu of residents. The PTICU fellow may be asked to consult on emergency center and floor patients at Children's.

Cardiac Intensive Care Unit: The fellow will be under the direction of Cardiac Intensivists and will participate in all aspects of cardiothoracic surgical care, including cardiac case conferences and cardiac catheterization conferences. In addition to the care of post-operative patients, the fellow is expected to "scrub-in" on selected major cardiac repairs so as to improve the fellow's understanding of surgical anatomy as well as cardiopulmonary bypass. Call is one in three during these months.

Operating Room Anesthesia: During the months the trainee is in the operating room, he/she will be under the direct supervision of an attending anesthesiologist. He/she will learn the principles and practice of pediatric anesthesia and the practical aspects of airway management and total support of the patient's vital functions. Fellows take every fourth night ICU call during their anesthesia month.

Research: A core program of research methods in clinical trials, animal experimentation, cell biology and molecular biology will be provided for all fellows. Fellows are expected to develop and pursue research questions of interest. A tailored research program will be devised for each fellow; research may be conducted in the critical care medicine laboratories or in the laboratories of an independent investigator at the university whose interests more closely match those of the fellow. Clinical research is conducted at the PICU, CICU and PTICU and is facilitated by three full-time clinical research coordinators. Participation in research is required. During the first year, fellows will have access to a number of established researchers within our campus with whom they can develop the necessary knowledge and skills to complete a project. Ideally, as fellows progress through the three years, they will develop skills that will eventually allow them to become independent basic science or clinical investigators. You may want to inform us of your research interest ahead of time so we can arrange an interview with a mentor in that field at UTSWMC. Each trainee is required to spend at least 12/36 months in research, to complete, present, and publish a first-author project. Most fellows spend 18/36 months in research, and some spend 24/36 months in research. All fellows admitted to the NIH training grant will have 24/36 months of protected research time.

Electives

Depending on the individual trainee's goals, elective rotations may be taken during the three-year program. These include:

Pediatric Cardiac Catheterization Laboratory: Time in the pediatric cardiac catheterization laboratory will be arranged with Dr. David Fixler, chief, pediatric cardiology. The trainee will learn the principles and manual skills involved in the diagnosis of congenital heart disease, including an introduction to cardiac catheterization. He/she will be expected to learn the calculations of oxygen consumption, cardiac output and shunts, which are performed daily in the catheterization laboratory. Call schedule requirements (if any) will be arranged with Dr. Fixler.

Pediatric Pulmonary Disease and the Pulmonary Function Laboratory: During the time of this service, the trainee will be under the direct supervision of Dr. Peter Luckett, Director CMCD Pulmonary Services. Trainee will see patients with Dr. Luckett and spend time in the pediatric pulmonary physiology laboratory in order to attain familiarity with equipment, calculations of test results and interpretation of these results. Call schedule requirements (if any) will be arranged with Dr. Luckett.

The Burn Unit - Parkland Memorial Hospital: During this period of time, the trainee will be under the direct supervision of Dr. John Hunt, director of the Parkland burn unit. The trainee will be part of the burn unit service and will be integrated into the service with the surgery and internal medicine residents caring for the patients in the burn unit. Although it cannot, of course, be arranged, there are usually pediatric patients in the burn unit who will be assigned to the pediatric ICU trainee. Specific call responsibilities will be arranged with Dr. Hunt. Fellows, when assigned to the PTICU, are responsible for consultations from the burn unit.

Other electives: Specific arrangements by permission of program director. In addition, time may be available for rotation on other services such as pediatric surgery and trauma, pediatric cardiovascular surgery, nutrition/metabolic service, radiology, hematology, nephrology, neurology, infectious disease, liver transplantation, gastroenterology, etc.