Main Operating Room (six months) - The fellow is 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 most challenging cases on the schedule each day.
Mentoring: 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 and others. During this same month (on different days), the fellows are given the opportunity to run the OR schedule with faculty back-up as a way of exposing them to the interpersonal and systems issues related to "making the schedule work."
Out-of-Operating-Room Experiences. The fellow also has the opportunity to spend a week in out-of-OR locations, including MRI/CT diagnostic imaging interventional radiology, GI procedures and neuroradiology. This opportunity allows the fellow to understand the special techniques needed and the pitfalls involved in working in an off-site location.
Airway Rotation: One month is designated as an airway rotation, during which time the fellow is assigned to the best airway cases on a daily basis. Specifically, the fellow does cleft lip/palates and dental cases as well as many fiberoptic intubations and infant direct laryngoscopies and bronchoscopies as possible.
Cardiac Anesthesiology (two months) - The fellow works in the Cardiac ORs and the cardiac catheterization lab, generally divided 2/3 to 1/3. Most fellows do approximately 10 cardiopulmonary cases per month.
Pain Service (two months, separated) - This rotation has three priorities, in this order:
- Management of acute perioperative pain
- Performance of ultrasound-guided peripheral nerve blocks
- Exposure to chronic pain patients
The fellow has the responsibility for managing patient-controlled analgesia and epidural catheters, as well as for evaluating consults requested by medical services. The fellow sees chronic patients in the clinic with the attending physician.
Pediatric Intensive Care Unit (one month) - The fellow is a member of one of the PICU teams, has direct patient care responsibility, and writes notes/makes management decisions on the patients. In addition, the PICU faculty expects anesthesia-related didactic/bedside teaching of the team by the anesthesiology fellow and assistance with airway issues as well as line placement (central and arterial) on PICU patients.
Elective (one month) - The fellow may choose to do an extra month of cardiovascular or pain, a month in the CVICU, or a special elective, which must be approved the program director.