Pediatric Emergency Fellowship Program - Rotations

Pediatric Emergency Department (PED)

In the first 2 years fellows are paired with an attending PEM physician and function with progressing independence. In year 3 fellows are able to act as attendings, working independently in a single coverage role. Our PED is run with single attending coverage at lower volume times of day and double coverage for high volume afternoon/evening hours. We have a variety of learners at all times, including pediatrics, EM and family medicine residents, as well as 3rd and 4th year medical students. The fellow's responsibilities include precepting residents and medical students, running surgical traumas and medical resuscitations, answering EMS medical control, as well as performing procedures and caring for patients.

Adult Emergency Department

Boston Medical Center has an exceptionally busy and high acuity adult emergency department with a strong emergency medicine residency. For 3 months of fellowship our fellows work as residents under the supervision of emergency medicine attendings. In year two fellows function as the “Resuscitation Resident” and in year three they act as the “Trauma Resident.” In the resuscitation resident role, the fellows act as code leader for all medical resuscitations and have first priority for all procedures in the department. This role serves as an excellent opportunity for fellows to practice their ACLS and code leadership skills as well as to obtain repetitions with procedures which are less common in pediatric emergencies such as chest tubes, central lines, and ultrasound guided IVs. In the third year the fellows return to the AED as the Trauma Resident where they lead all traumas. The trauma resident also receives priority for all intubations in the emergency department.

Ultrasound

Fellows complete a month rotation in point of care ultrasound in the first year and participate in a longitudinal ultrasound curriculum with dedicated PEM and EM ultrasound faculty throughout the remainder of fellowship. Our graduating fellows complete enough scans for independent credentialing. We have had multiple fellows continue on to US fellowships and PEM US leadership.

EMS Rotation

During the first year, each fellow spends time with Boston EMS gaining a hands-on understanding of the work of emergency medical services personnel. Fellows are assigned to an ambulance and ride with that ambulance to emergencies. Also included in this experience is a visit to the medical control center and meetings with the leadership of Boston EMS.

Toxicology

Fellows spend one month at the Regional Center for Poison Control and Prevention. They participate in toxicology rounds and provide telephone coverage for the poison control center.

Pediatric Intensive Care

Our fellows spend one month at Boston Children's Hospital (BCH) PICU. They act as PICU fellows in the Medical Surgical ICU. This challenging rotation provides excellent exposure to concepts in tertiary critical care.

Anesthesia/Airway Management

Fellows rotate in their first and third years with the BMC Anesthesia Department. This rotation is focused exclusively on developing airway management and intubation skills.

Electives

There are numerous electives available. They include: trauma, sports medicine, orthopedics, radiology, ENT, anesthesia, dermatology, international electives and others. We are happy to arrange almost any elective if it is pertinent to the fellow's education.

International Elective

Fellows have the opportunity to spend time throughout their fellowship working internationally in an underserved country as volunteer physicians. The program protects time for such work and covers travel expenses. Recent fellows have traveled to Lesotho, Colombia, Cambodia, and Haiti. This opportunity is available to fellows in their third year.