The Division of Pediatric Critical Care of the University of Maryland Medical System includes a 10 bed multi-disciplinary Pediatric Intensive Care Unit (PICU) and a fourteen bed intermediate care unit (IMCU). Over 1000 patients with various medical and surgical diagnoses (e.g., congenital heart defects, respiratory failure, neurological disorders, trauma, etc.) are admitted each year. At any one time, a critical care attending physician, fellow, and four pediatric residents in their second or third year of training are on service. All medical patients are admitted to the critical care service and the surgical patients are managed in consultation with their respective primary surgical service. The PICU/IMCU team also includes the critical care nurses, respiratory therapist, social workers, pharmacist, nutritionist, and others. All medical and surgical sub-specialty consultants are available when needed.
The fellowship training program provides a balance between the practical experience and theoretical knowledge necessary to achieve clinical excellence in treating critically ill children and the research training necessary to pursue a career in academic clinical PICU training. The total duration of the fellowship is three years. One year of basic or clinical research experience is also provided over this time. The final year can be oriented more toward either clinical training or research pursuits depending upon the career goals of the fellow. In exceptional circumstances, the program can be "customized" to meet specific needs of applicants. For example, applicants who desire to complement their pediatric or adult sub-specialty training with critical care experience or foreign medical graduates with limited training time available and specific requirements related to the positions available in their home countries may wish to undertake a shorter fellowship. However, while we seek to accommodate the needs of our fellows, a desire to pursue a career in academic critical care is a prerequisite in all cases.
Under the direction of the attending physicians, fellows learn to care for critically ill children in the PICU through a combination of hands-on experience and supervision of residents. As members of the transport team, the fellows also learn to stabilize critical ill children and act as consultants to physicians in community hospitals. Fellows rotate with pediatric anesthesiology and the Shock Trauma Institute. Responsibility for formulating care plans and managing the PICU is assigned to fellows in a graduated fashion commensurate with experience and ability. Administrative skills are taught through a seminar series and by assigning specific duties to the fellow as their career progresses. A weekly series of Divisional Conferences (Quality Assurance, Journal Club, Physiology Review, etc.) provide didactic session for the fellows and attending physicians.
Fellows are encouraged to pursue research training in one of the main areas of basic research activity in the Division--pulmonary circulation and cerebral anoxia. All fellows are also involved in clinical research projects in the PICU/IMCU. Since most fellows have had little previous research experience, the initial goals of the research training are to expose fellows to the mechanics of research (e.g.., developing a hypothesis, designing a study, carrying out the study, analyzing data, writing and presenting an abstract, paper writing, etc.). This introduction to research allows the fellow to decide whether a research career is something he or she wishes to pursue or whether other areas of academic excellence are more desirable to them. Those who do seek a research career will be assisted in preparing grant applications and learning the skills of grantsmanship. If an academically oriented critical care fellowship program appeals to you, please submit your curriculum vitae and a letter outlining your career goals. The University of Maryland is an equal opportunity/affirmative action employer.