Pediatric Emergency Medicine Fellowship

Our program offers a unique opportunity for PEM subspecialty residents to train in a variety of pediatric emergency settings. The majority of our clinical training takes place at the Komansky Children's Hospital, located on the Upper East Side of Manhattan. This urban, tertiary, level-one trauma center and regional burn center provides care for diverse general and subspecialty patients, many with highly complex medical and surgical issues. We accept referrals from private physician offices and neighboring schools, as well as transfers from many hospitals throughout the greater New York metropolitan area.

PEM subspecialty residents also perform clinical rotations in the pediatric emergency service at NewYork-Presbyterian Morgan Stanley Children's Hospital (Columbia Campus), located in Washington Heights, New York, serving a high-volume, inner-city community. This tertiary, level-one pediatric trauma center serves a diverse clinical patient population and offers education from a nationally acclaimed pediatric emergency medicine faculty.

PEM residents are afforded the opportunity to develop medical investigation, rapid assessment and triage, evidence-based analysis, simulation-based education and technical procedure skills. Subspecialty residents learn to prioritize care and manage patient flow, and, with an advancing independent role during the training program, acquire the skills essential to supervise and oversee all aspects of a busy, urban emergency department. Pain management, child health advocacy and patient satisfaction are greatly emphasized.

A robust emergency simulation educational program incorporates simulation-based scenarios for infrequently seen medical entities, resuscitation procedures, communication, team training and leadership into the clinical curriculum.

WCM places a strong emphasis on the development of clinical educators. PEM subspecialty residents are provided formal training and close mentorship to develop teaching skills in a variety of modalities. Opportunities to teach, both domestic and abroad, include one-on-one bedside sessions with medical students and pediatric residents, as well as delivery of presentations to pediatric and emergency medicine residents and faculty in a range of academic venues, including grand rounds. Lecture development, public speaking skills and incorporation of an interactive teaching style are emphasized.

Emergency simulation is also incorporated throughout the curriculum. A focused emergency simulation rotation affords fellows the foundation and tools to develop simulation scenarios with high-fidelity mannequins, independently run scenarios, and skillfully debrief student participants. First-year PEM fellows attend our annual Base Camp, a high-intensity, fully immersive weekend of pediatric emergency simulations where fellows and nurses work together in multidisciplinary teams to manage critically ill and injured simulated patients. During the second and third year of training, fellows participate in Base Camp as a junior faculty mentor and/or instructor.

Our program emphasizes the importance of academic investigation and scientific advancement in the field of pediatric emergency medicine. In collaboration with the Weill Cornell Department of Emergency Medicine, we offer all essential resources our trainees require to attain expertise in the design, methodology, statistical analysis and composition of original clinical research and/or scholarly activities.

Formal coursework in research design and biostatistics provides an introductory foundation in the first months of training. PEM faculty mentors meet with fellows for monthly research review, and PEM subspecialty residents present ongoing research progress to the Scholarship Oversight Committee (SOC) biannually.

PEM subspecialty residents have the opportunity to attend the National Pediatric Emergency Medicine Fellowship Conference twice during the training program to present individual research projects to and receive feedback from peers and nationally acclaimed scholars in the field of pediatric emergency medicine. PEM subspecialty residents are expected to present research at a national meeting, as well as prepare a completed manuscript or work product at the completion of the training program. PEM curriculum includes 12 months of dedicated research time, distributed throughout the three years of training, to support the development and successful completion of meaningful clinical research.

PEM subspecialty residents are exposed to a variety of administrative roles and leadership opportunities, which may vary based on the experience and unique interests of an individual resident. PEM residents may develop pediatric emergency service programmatic and operational enhancements, serve on a departmental or institutional committee, participate in safety and quality improvement, develop programs for pediatric advocacy and/or join in community outreach activities. Formal education is offered in the areas of physician wellness, ethics, healthcare economics, safety and quality improvement.

The Division of Pediatric Emergency Medicine in the Department of Pediatrics at the NewYork-Presbyterian Phyllis and David Komansky Children's Hospital is part of the NewYork-Presbyterian Hospital/Weill Cornell Medical Center, a world-renowned university hospital affiliated with Weill Cornell Medicine, The Hospital for Special Surgery and Memorial Sloan Kettering Cancer Center. The hospital is a tertiary care medical center and is designated by the New York City Regional Trauma Advisory Committee and the New York State Department of Health as a level-one trauma center for children and adults.

The WCM Departments of Pediatrics and Emergency Medicine have distinguished and nationally recognized faculty in all applicable subspecialties, offering the highest caliber of teaching and clinical consultation. Areas of expertise include toxicology, emergency ultrasound, simulation, patient safety and pediatric critical care. Our pediatric general and critical care units collaborate with the Emergency Medicine Department to care for children with highly complex medical and surgical entities. In addition, the WCM Pediatric Emergency Service serves as a robust educational venue for residents in both the Pediatrics and Emergency Medicine Departments, as well as WCM medical students.

Our program offers a single PEM resident position over a three-year training period. Subspecialty residents work closely with PEM faculty, ensuring maximal exposure to all possible clinical experiences in the Pediatric Emergency Department. Given our limited size, we are able to tailor curriculum to the unique interests and individual learning objectives of each subspecialty resident.

In July 2017, the PEM Fellowship Program introduced a Global Health Medicine Track – the first of its kind in the New York Metropolitan area - to promote pediatric emergency medicine and acute care programs for children internationally, through leadership, teaching, advocacy, research and clinical skills. This new track enables PEM fellows to meet all required ACGME standards, while at the same time receiving intensive, focused education and experience in the field of international health for children. This curriculum addresses the unique needs of children in resource-limited communities, both in the U.S. and abroad.

The PEM Global Health track offers a clinical rotation at Weill Bugando in Mwanza, Tanzania. Trainees may choose to travel to another community with which they may already have an established relationship, if deemed appropriate by program faculty.

PEM Global Health fellows also have the opportunity to complete a scholarly project with the goal of enhancing international child health. Scholarly projects may be conducted in resource-limited communities, under the auspices of the appropriate institutional review board, with mentorship both at home and abroad.

Our program has been developed to meet the individualized interests and needs of each PEM resident while adhering to ACGME program guidelines. The three-year program is structured to foster academic and personal growth, with increased independence and responsibility afforded to the resident each training year.

Clinical rotations at NewYork-Presbyterian/Weill Cornell Medicine include:

• pediatric critical care
• adult emergency medicine
• emergency simulation
• emergency ultrasound
• Emergency Medical Services (EMS)
• Anesthesia
• telemedicine
• toxicology - performed at the New York City Poison Control Center, an internationally recognized regional poison center receiving more than 90,000 consultations each year
• trauma - performed at the R Adams Cowley Shock Trauma Center at the University of Maryland Medical Center in Baltimore - consisting of an intense month of training, during which highly skilled trauma surgeons supervise the PEM subspecialty resident's acute assessment and management of severely injured adults and adolescents
• electives - including burn surgery, orthopedics, sports medicine, otolaryngology, ophthalmology, oral surgery, plastic surgery, emergency radiology, obstetrics, child protection, wilderness medicine, adolescent medicine and gynecology.

Competency-based goals and objectives are outlined for each rotation and reviewed with subspecialty residents before and after the completion of each rotation. Rotation evaluations from residents provide critical feedback and serve as a basis for programmatic modifications, enabling continuous and ongoing curriculum improvement.

PALS, BLS, ACLS and ATLS certifications are required throughout the training period.

Global Health (GH)

Didactic Curriculum

The PEM-GH training program partners with WCM Global Health to foster an academic environment that includes:

• humanitarian crises and disaster response
• program and emergency systems development
• global and public health and prevention
• cultural disparities in international healthcare

WCM Conferences

• monthly global health grand rounds
• global health career seminars
• global health emergency courses

Regional and/or International Conferences

• International Committee of the Red Cross Health Emergencies in Large Populations (H.E.L.P.)
• Missioncraft: Leadership in Effective Disaster Relief
• Harvard Humanitarian Initiative

Experiential Curriculum

PEM-GH fellows have a variety of opportunities to perform clinical fieldwork over their three-year curriculum, uniquely developed based on individual interest and prior experience, and coordinated and supervised by the PEM-GH Track Director and PEM Fellowship Program Director. Fieldwork may be conducted at NYP-WCMC affiliated sites, in partnership with other universities or organizations, or at a site with which the fellow has had prior affiliation. Field experiences are designed to increase the fellow’s knowledge base and opportunity to practice acquired skills. Fellows are expected to take an active leadership role during field experiences.

Established international experience locations include Bugando Medical Centre (Mwanza, Tanzania).

Research/Scholarly Curriculum 

PEM-GH fellows are provided with foundations for research design and project development, as well as guidance regarding unique facets of research within an international construct and community. Fellows are strongly encouraged and supported to complete at least one grant proposal during their fellowship, with the opportunity to join an ongoing faculty project or develop and implement their own individualized study with close mentorship and support. Twelve months of non-contiguous research time is allotted to complete each global health scholarly project.

Potential international research areas include:

• early recognition and management of acute illness and injury in children
• pediatric skills for critical and emergency care
• Pre-hospital and emergency health systems for children
• epidemiology and/or public health for children
• humanitarian assistance and/or disaster response for children
• educational initiatives for pediatricians and/or emergency physicians