UCSF/CHO Pediatric Critical Care
Transcript of UCSF/CHO Pediatric Critical Care
UCSF/CHO Pediatric Critical CareFellowship Program
Overview
Goals
Training program• Clinical• Career development
Mentoring
Alumni
Work environment
Life in the Bay area
In a nutshell…
The UCSF/CHO Pediatric Critical Care Program is a:
• Moderately sized• Academically oriented fellowship• Located in San Francisco and Oakland CA
Goals/Philosophy
To train top notch competent, compassionate clinicians destined for success in academic environments
Trainees will be well prepared to engage in meaningful research in a variety of fields related to critical care medicine
To achieve this, we will provide:• A strong clinical training program• Exposure to basic, translational, and clinical research • Opportunities to develop superior teaching skills• Strong mentorship and career development
Overview of Training Program
Fellow as Clinician
Fellow as Investigator
Fellow as Educator
Fellowship Overview
1st Year
Master clinical critical care medicine
Identify a career focus
2nd and 3rd Years (and…)
Build a career focus
Solidify clinical skills
Developing Fellows as Clinicians
Nuts and bolts of year 1
(13: 4-week-rotations)
Anesthesia (CHO) 1
ICU Service 8
Research 3
Vacation 1
Developing Fellows as Clinicians
Nuts and bolts of year 2ICU Service 5
Adult ICU 1
Research 6
Vacation 1
Nuts and bolts of year 3ICU Service 2
Elective 1
Research 9
Vacation 1
Developing Fellows as Clinicians
Formal clinical learning opportunities• Fellow’s Conference• Journal Club• PICU & CICU M&M Conference• Pre-Surgery Cardiac Cath Conference• ECLS Conference• Pediatric Grand Rounds• Adult ICU Lecture Series• Joint Pediatric, Adult, & Neonatal ICU
Lectures
Developing Fellows as Clinicians
Clinical Resources• UCSF Children’s Hospital: 120 in-patient beds, 6,300
annual discharges, 50,000 clinic visits- PICU: 14 beds; CICU: 8 beds, 9 intermediate beds- ~1,200 annual ICU admissions, ~250 open cardiac cases- Transplant - bone marrow, kidney, liver, small bowel- Rapid deployment ECLS
Developing Fellows as Clinicians
Clinical Resources• Children’s Hospital Oakland: 170 in-patient beds, 9,200
annual discharges, 100,000 clinic visits, 26,000 annual ED visits
- PICU: 23 beds- 1,800 annual ICU admissions, ~150 open cardiac cases- Pediatric Trauma Center of Northern California
Developing Fellows as Clinicians: Night Call
• CHO:• every 4th night
• UCSF: • 2 week 12 hr PM shifts• 2 weekends off
per rotation
•Non-clinical months
are call free except:• 12 Saturdays (24 hr
shifts)
in 2nd and 3rd year
Building Your Career
Goal: Train top notch clinicians for academically-focused careersWhat does it take to get a great academic job?
• Excellent clinician• Tangible scholarly work: Clinical, translational, or basic
research; Master Educator• Board certification
Developing Fellows as Investigators
Goals • Help fellows develop academic focus and area of expertise• Prepare fellows to secure K08 or K23 funding• Enable graduates to launch successful academic careers as
independent investigators
Developing Fellows as Investigators
Options:• Basic/Bench Research• Translational Research• Clinical Research• Master Educator
Finding a lab/mentor• Not restricted to Division/Department• Investigators at Parnassus, Mission Bay,
CHORI, Berkeley, Lawrence Livermore, etc. are all potential choices
Developing Fellows as Investigators
Research Resources• UCSF: >1,200 active basic/translational
science labs- Cardiovascular Research Institute- The Gladstone Institute- Biomedical Sciences Training Program- Program in Biological Sciences
• Children’s Hospital Oakland Research Institute (CHORI)
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Developing Fellows as Investigators
Research Resources (Clinical Science)• Pediatric Clinical Research Center
• Department of Epidemiology and Biostatistics- Training in Clinical Research Program (TICR)
– The Master’s Degree Program
Developing Fellows as InvestigatorsOpportunities for all fellows
• Molecular Biology and Clinical Research Workshops (AACR/ASCO)
• Biomedical Sciences (BMS) Graduate Program- Basic science courses- Seminars
• CVRI Courses and seminars- Biostatistics- Science Writing- Art of Lecturing
• TICR (Training in Clinical Research - 6 weeks)• ATCR (Advanced Training in Clinical Research - 1 year)• Molecular Medicine Weekly Conference
NIH T32: Research Training in Pediatric Critical Care Medicine
Clinical-Translational Training
Laboratory Research Training
NeuroscienceProgram
CardiovascularProgram
PulmonaryProgram
• 4 year program which includes 2.5 years of protected research training• Both laboratory and clinical-translational tracks• Diverse mentored research opportunities
NIH T32: Research Training: “The Perks”
Advisory Committee
(Sterring Committe for the Department Program in Pediatric Science) (Drs. Hawgood, Irwin, + Wara)
PROGRAM DIRECTOR (Dr. Fineman)
ASSOCIATE DIRECTOR Laboratory Science Center
(Dr. Hawgood)
ASSOCIATE DIRECTOR Clinical-Translational Science Center
(Dr. Hulley)
CORE DIRECTOR Neuroscience (Dr. Ferriero)
CORE DIRECTOR Cardiovascular (Dr. Bernstein)
CORE DIRECTOR Pulmonary
(Dr. Matthay)
• Multiple layers of supervision and mentorship• Integrated with UCSF Fellow’s College• Educational stipend• Flexible clinical commitment• Funds for TICR and Masters in Clinical Research
Developing Fellows as Educators
Opportunities for teaching• Resident Lectures• Fellow’s Conference• Division Meetings• Chairman’s Rounds• Noon Conference• Bench to Bedside• Teachable moments with residents and
medical students
Developing Fellows as Educators
Opportunities for the Master Educator career track• Haile Debas Institute of Medical Education• Development of exportable learning
materials
Mentoring Program
“Mentors don’t just give advice; they make things happen for your career”-Art Weiss
School of Medicine ProgramsGraduate Program Seminar SeriesDepartmental Fellows’ CollegeDivisional Mentoring: Formal and informalFrequent feedback
• Division• Scholarship Oversight Committee (SOC)
Fellows’ College
Half-day workshop for all fellows, 3x per year• Prepare fellows for successful academic careers• Develop camaraderie
Topics:• Fellow as Clinician: How to do a consult; How to be an
effective supervisor; Transition from 3rd year to Fellow• Fellow as Investigator: Choosing a mentor/how to be a
mentee; How to choose a lab; How to write a grant; How to give a research talk
• Fellow as educator: How to give a talk; Teachable moments• Life after fellowship: Inside the NIH; Developing a CV;
Managing Life; Job searches; Negotiating
UCSF/CHO Pediatric Fellowship Alumni-Track Record
• In past 10 years, 60% Academic University Appointments (18/30)
• 7 Directors of Critical Care Medicine; 2 Vice-Chairs Pediatrics; Director of PALISI
• 13 current NIH-funded graduates (2 of 5 PCCM K12 awards)
Environment
The Hospital
The People
The Patients
San Francisco
Work Environment: The Hospital
UCSF Children’s Hospital• Hospital within a hospital• Tertiary to quaternary care facility in a University setting• Educational focus • Full ancillary pediatric trained support staff
Intensive care• PICU (31 beds)• ICN (55 beds)
Pediatric Clinical Research Center (PCRC)• NIH-sponsored research center for diverse clinical trials• Dedicated nurses, biostatistician, core laboratory
Ambulatory Care Center• Includes all specialty clinics
Work Environment: The Hospital
Children’s Hospital Oakland• Free-standing Children’s Hospital• Pediatric trauma center of Northern California• Very busy emergency department
Intensive care• PICU (23 beds)• ICN (55 beds)
CHORI• NIH-sponsored research center for diverse clinical trials• Dedicated nurses, biostatistician, core laboratory
Ambulatory Care Center• Includes all specialty clinics
Work Environment: The People
Team-oriented approach to care
• Diverse ICU faculty doctors• 9-11 fellows• Nurse practitioners• Clinical nurse specialists• Palliative care coordinator• Discharge planners• Social workers• Dedicated pharmacist• Dedicated nutritionist• Pediatric PT/OT/speech
therapists• Child-life specialists• Spiritual care specialists• Educational liaison
Work Environment: The People
Strengths of clinical service
•Integration/collaboration of laboratory scientists and clinicians•Great Housestaff•Awesome Fellows•Exceptional Ancillary Support
Work Environment: The Patients
Families from many different cultures with diverse socioeconomic status
Large referral base
Environment: Life in the Bay Area
Benefits: MANY! Culturally, extremely diverse
Geographically small (a “walk-around” city)
Unique weather (subtropical, never snows or
freezes) (But driving distance to snow!)
Food and fun capital of the U.S.
“Outdoors Unlimited”—land, sea, sky
Just a cool place to be!
Environment: Life in the Bay Area
Challenges: Cost of housing--$$ Unique weather--cool, fog Earthquakes (only occasionally!)
Solutions: Modest housing in a good neigh- borhood Public transportation savings NEW!!--$500/month housing
allowance Many on-line rental agencies Local landlords prefer residents and fellows
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Environment: Life in the Bay Area
Special Learning Opportunities
• NIH T32 - Research Training
• International Health
• Masters In Public Health - UC Berkeley
• Masters in Clinical Research (TICR)
• Sponsored International Conferences
UCSF/CHO Pediatric Fellowship Training Program
Fellows who thrive (not just survive) in our program:• Embrace diversity• Desire an environment small enough for personalized attention but
big enough to achieve the critical mass necessary for an excellent education
• Like to work hard and play hard and HAVE FUN!!!