Pediatric Anesthesiology Fellowship

Program Director

Nancy L. Glass, MD, MBA
Professor of Anesthesiology and Pediatrics
Baylor College of Medicine
832-824-5800
nglass@bcm.tmc.edu

Administrative Contact
Angel Johnson
832-824-5809
angelj@bcm.tmc.edu

Application Process

Please call or email Angel Johnson for a copy of our electronic application. We require a completed application with personal statement, 3 letters of reference, a medical school transcript and Dean's letter, as well as copies of your ABA ITE scores. Upon review of the application, competitive candidates will be invited to Houston for a one-day interview; we will cover expenses up to $1000 for travel.

General

The TCH Pediatric Anesthesia Fellowship is a one-year ACGME-approved fellowship program. The Anesthesiology group at TCH performs more than 20,000 anesthetics per year, including nearly 1,000 cardiac procedures, about 20 liver transplants, and the full range of neonatal and pediatric surgical procedures on healthy children as well as those with complex medical conditions. Our practice is unique in that we work with both academic and community surgeons, which prepares our Fellows for both private practice as well as academic careers. All faculty members are fellowship-trained, and many are also Board-certified pediatricians.

Clinical Rotations

• Main OR (6 months) - the Fellow will be exposed to a variety of cases, from healthy children undergoing routine procedures, to the most challenging cases. Every attempt is made to give the Fellows "first dibs" at the good cases on the schedule each day.
  
  One month toward the end of the year is devoted to the Fellow's development as a clinical educator, with mentored teaching of medical students, pediatric residents, etc. During this same month, (on different days), the Fellow is given the opportunity to run the OR schedule, with faculty back-up, as a way of exposing him/her to the interpersonal and systems issues related to "making the schedule work."
  
  One month will be designated as an Airway Rotation, during which time the Fellow will be assigned to the best airway cases on a daily basis. Specifically, the Fellow will do cleft lip/palates and dental cases, as well as as many fiberoptic intubations and infant DLB's as possible.
• Cardiac Anesthesia (2 months) - the Fellow will work in the cardiac O.R.s as well as in the cardiac catheterization lab, generally divided 2/3 to 1/3. Most fellows do approximately 10 pump cases per month.
• Pain Service (2 months, separated) - This rotation has three priorities, in this order: 1) Management of acute perioperative pain, 2) Performance of ultrasound-guided peripheral nerve blocks, and 3) Exposure to chronic pain patients. The Fellow has the responsibility for managing PCAs and epidural catheters, as well as for evaluating consults requested by medical services. The Fellow sees chronic patients in the clinic with the Attending.
• Pediatric Intensive Care Unit (1 month) - The Fellow is a member of one of the PICU Teams, has direct patient care responsibility, and writes notes/makes management decisions on his/her patients. In addition, the PICU Faculty expect Anesthesia-related didactic/bedside teaching of the team by the Anesthesia Fellow, and assistance with airway issues on PICU patients.
• Elective (1 month) - The Fellow may choose to do an extra month of CV or Pain, a month in the CV ICU, or may propose a special elective - which must be approved by the Program Director.

Didactic Curriculum

• Fellows' Conference - Tuesdays, 0615-0700. Series of lectures and presentations by fellows, faculty, guest lecturers, PBLDs, journal club, and "Case of the Day" discussions. Faculty and residents are encouraged to come, but the conference is geared to Fellow education.
• Introduction to Clinical Research - month of July, 5:30-7:30 PM. Graduate level course offered at BCM, which we require you to take for credit
• Introduction to Neonatology - month of July, 12-1 PM, with several hands-on labs
• Cardiac Anesthesia Conference - Thursdays, 0615-0700. Covers a broad range of topics, with leadership of the discussions by Faculty and Fellows.
• QA Conference - monthly, Friday AM, 0615-0700. Fellows, residents, and Faculty may present at this conference.
• Preparation for ABA Oral Exams, Fridays, ~ 2X per month, October through March, with Dr. Glass, who is an ABA Examiner.
• Preparation for ABA Written Exams, as needed, with Dr. David Young
• Professionalism, Communications, Career Development Seminar-Monday evening, once a month, 6-8 PM. Small group discussion with fellows, selected Faculty leaders, guests, on topics that are harder to discuss within the confines of the Tuesday conference, with an emphasis on issues of professional development and communication skills. Didactic readings, discussions, videotaping and role-playing are components of this new seminar.
• Systems-Based Project - Fellows are required to select from a list of potential projects, or suggest a project of his/her choice, designed to give the individual exposure to how new practices, products, policies are implemented within a large institution or practice. At the end of the year, the Fellow will present his/her project at the Fellows' conference, with an emphasis on the learnings from the process of implementation.

Departmental Committee Membership/Participation

All fellows are members of the Fellowship Selection Committee and the Departmental QA Committee. Fellows are active participants in the interviewing and touring of candidates for the fellowship, and are encouraged to provide input on candidates.

Call

All call assignments meet compliance with the ACGME's 80 hour duty limits, requirement for rest periods between shifts, and opportunity for days off during the month.

In the MOR, fellows take less call than Anesthesia Residents, but there is no guaranteed number of calls since the number of residents varies month to month. First call, which is in-house call, begins at 12 noon and ends at 7 AM the following morning; the fellow has no clinical duties post-call. The second call trainee begins the shift with a "regular" OR day, and stays into the evening until the OR comes down to one location. He/she is usually relieved by 11 PM and allowed to go home - and has the next day off. It is unusual for that person to be called back to the hospital once relieved, but he/she must be prepared to do so.

On the Pain Service, there is no call at night or on weekends, as the service is covered during those times by the Attending on service.

In the PICU, the Anesthesia Fellows do not take in-house night call, but are required to work two Saturdays during the day to assist with coverage for Pediatric residents and fellows.

On the Cardiac Anesthesia Rotation, hours can vary considerably depending on the caseload and the number of trainees rotating on the service, but again - Fellows are given the day off after late call.

Benefits

Benefits, including salary and vacation time, are determined by the Baylor GME Office.

Salary CA-4 level (PGY-5)		$49,024 (2008-2009)
Vacation		15 working days
Health and Dental Benefits		As per GME Office office for all trainees
Personal/Sick Time (The ABA does not allow trainees to be away more than 20 days per year without making up that time.)		5 working days
Books Provided		Bissonnette and Dalens Pediatric Anesthesia
Book/Meeting Allowance		$1,500
Parking		Parking is assigned by the GME Office (attempts are made to put fellows close to their service) and $72.50 will be taken out of paycheck monthly.
Educational (meeting) time		5 days
Non-clinical time		Determined by service