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Critical Care Medicine - Fellowship


 

Children's Hospital Colorado in Aurora, Colorado is a 314-bed free-standing children's hospital affiliated with the University of Colorado School of Medicine (CU School of Medicine). The 32-bed Pediatric Intensiv​e Care Unit (PICU) at Children's Colorado admits approximately 1,600 patients per year from the Denver metro area and surrounding Rocky Mountain Region. In addition, there is a separate Cardiac Intensive Care Unit (CICU) providing care to cardiology and cardiac surgery patients (500 cardiac surgeries per year). Fellows rotate through both units.

The Section of Pediatric Critical Care Medicine and the Department of Pediatrics at Children's Colorado offer a fully accredited pediatric critical care fellowship for up to 9 trainees at a time (average 3 per year) designed for board-eligible pediatricians planning a career devoted to the care of the critically ill child.

The fellowship program offers broad-based training in both the practice of pediatric critical care medicine and the conduct of biomedical research related to pediatric critical care. Emphasis is placed on the stabilization and management of the critically ill child with acute single or multisystem organ failure due to cardiac, pulmonary, infectious, neurologic or traumatic illness. The PICU serves active programs in pediatric general surgery, trauma surgery, solid organ and bone marrow transplantation, cardiac surgery, ENT, and orthopedic surgery. Critical care fellows participate actively in the multidisciplinary teams responsible for the care of every patient in the PICU, including the medical PICU team and a dedicated cardiac ICU team.

Numerous funded academic and research opportunities are available to critical care fellows. This includes but is not limited to basic science and translational research in pulmonary vascular disease, developmental lung biology, oxygen radical-induced injury, biomechanical engineering, and neuro-trauma. Clinical research is supported through an active and growing critical care research program, and outcomes-based research and quality improvement projects are also available to interested fellows.

Critical Care Medicine consists of ten faculty, all board certified or board eligible in pediatric critical care medicine, with two dual-boarded in pediatric pulmonology as well as three full-time PhD investigators. In addition, several members of the Departments of Pediatric Pulmonology, Cardiology, and Anesthesiology provide key roles in the education and training of the fellows.
 

Printable PDF - Fellowship Program Description .pdf

Developmental Lung Biology Laboratory
Director: Kurt R. Stenmark, MD
The Developmental Lung Biology Laboratory is located in Research 2 on the new UCSOM Anschutz Medical Campus. There is approximately 7,000 sq. ft. of research space, including core cell culture and imaging labs. Presently, the group consists of three physicians and three full-time PhD researchers, as well as doctoral and postdoctoral research fellows, including pediatric critical care fellows. Current areas of investigation include both normal and pathologic mechanisms involved in lung cell growth and development, factors controlling vascular tone and structure in the pulmonary circulation, and responses of the vasculature to injury. A current emphasis is on the role of inflammation and progenitor cells in pulmonary vascular remodeling

Cardiovascular Pulmonary Laboratory (CVP)
Director: Kurt R. Stenmark, MD
Also located in Research 2 at the UCSOM Anschutz Medical Campus, the Cardiovascular Pulmonary Research (CVP) Laboratory comprises over 10,000 sq. ft. of laboratory space. It offers research opportunities in cardiovascular-pulmonary physiology and cell biology. Topics of research include the pulmonary circulation, acute lung injury, endothelial cell damage, as well as high altitude physiology. Drs. Dwight Klemm, Sonia Flores, Jack Dempsey, Dave Irwin, and Raphael Nemenoff offer an outstanding research experience for fellows in a collaborative relationship with the UCSOM Department of Medicine.

National Jewish Health (NJH)
On a separate campus near Children's Colorado and UCSOM, NJH has major investigative programs in basic immunology as well as physiological disturbances in pulmonary disease, with emphasis on airway smooth muscle function, exercise-induced bronchospasm, respiratory muscle strength and lung mechanics.

Department of Bioengineering – College of Engineering and Applied Sciences
Director: Robin Shandas, PhD
The Department of Bioengineering’s mission is to improve human health through the application of engineering principles, ideas, methods, and inventions in order to solve important clinical problems. Staffed with 8 core PhD’s, over 35 affiliated MD and PhD faculty, and more than two dozen graduate students, this department has active projects in cardiovascular biomechanics and hemodynamics, diabetes, imaging and biophotonics, neuroscience engineering, ophthalmology, orthopedic biomechanics, and surgery and urological sciences.

Pediatric Heart Lung Center
Director: Steve Abman, MD

Research in the Pediatric Heart Lung Center includes both clinical and laboratory based studies that employ diverse approaches to heart and lung problems. General topics include studies on acute lung injury, neonatal pulmonary hypertension, respiratory distress syndrome in premature newborns, chronic lung disease after premature birth (bronchopulmonary dysplasia; BPD); postoperative cardiac care, long-term management of pulmonary hypertension, and others. Current studies include: basic science laboratory investigations, single-center physiologic and outcome studies, and multicenter randomized clinical trials.

Pediatric Critical Care Clinical Research Program
Director: Peter Mourani, MD

The Pediatric Critical Care Clinical Research Program supports clinical and translational research projects within the Children’s Hospital Colorado Pediatric Intensive Care Unit. With the contribution of many of the Critical Care faculty as well as investigators from outside the Section, the program provides the infrastructure to execute investigator initiated and multi-center studies, including feasibility analysis, research management, and mentorship and research training. The program participates in the Virtual PICU System (VPS), a clinical database dedicated to standardized data sharing and benchmarking among pediatric ICUs. Present studies local include: the role of the airway microbiome in ventilator-associated pneumonia, the impact of Vitamin D in respiratory disease among preterm infants, hyponatremia in critical illness, and acute lung injury. The program also participates in several multicenter studies including the Genetic Epidemiology of Influenza in Children, Heart and Lung Injury – Pediatric Insulin Titration Trial, and Pharmacokinetics of Understudied Drugs Administered to Children per Standard of Care.

The First Year
The first year is designed to provide the fellow trainee with the necessary experience to become an excellent clinician and teacher in the field of critical care medicine. The year is fully structured and almost entirely clinical. Responsibilities include:

  • Eight months of clinical service in the PICU, on both the medical ICU (6 months) and cardiac ICU (2 months) services. Fellows are primarily responsible for all medical patients in the PICU, and they comanage all surgical patients.
  • Two months of pediatric anesthesiology in the first half of the year; this is designed to teach airway management, intubation, vascular access, and sedation skills.
  • One month on the pediatric pulmonary medicine service at Children's Colorado. Fellows gain bronchoscopy experience during this month, as well as a broader view of pediatric pulmonary disease.
  • One month of research time, to be used to an academic project for the remainder of the fellowship program, as well as participation in University of Colorado mini-courses including clinical trial design, COMIRB, budget management, recruitment, and clinical trial conduct and practicum.
  • Night call is taken in-house, and averages every 4th night when on-service and every 7th night when off-service.

Fellows participate in Children's Hospital Emergency Transport Service and manage, with supervision from the ICU attending, transports and admissions to the PICU.

Fellows participate in the weekly Critical Care educational conferences and journal clubs. All other pediatric, anesthesia, pulmonary, and other specialty conferences are open to fellows.

The fellows participate in a Departmental Fellows Core Curriculum and an annual First-Year Fellows Retreat designed by the Pediatric Committee for Fellowship Education for all first-year fellows. These forums cover topics relevant to fellows in all subspecialties, including Evidence-Based Medicine, Quality Improvement and Safety, Ethics, Communication, Teaching, and Mentoring.

In addition, the fellows review assigned charts for complications and/or deaths, present the cases for an ICU Morbidity and Mortality Review Team, and participate in the monthly M&M Conference.

The Second and Third Years
The second and third years of the training program are primarily devoted to a research experience with the assistance of a specific mentor. Research work can be performed at Children's Colorado, the Pediatric Critical Care/ Developmental Lung Biology Laboratory at UCSOM, the Cardiovascular Pulmonary Research Laboratory at UCSOM, or at National Jewish Health (NJH). Research mentors are experienced principal investigators with ongoing studies in either clinical or basic science research. Academic experiences are also available in physiology, cell and molecular biology, biochemistry, immunology, pharmacology, neuro-trauma, biomechanical engineering, outcomes research, and quality improvement.

Second- and third-year fellows also participate in the Departmental Core Curriculum statistics course and the annual Departmental Fellows Retreat, which is geared to address issues facing senior fellows including grant opportunities, job negotiations, and life-work balance.

Although most applicants complete their fellowship training in three years, an optional fourth year of training is available to those interested in seriously pursuing a career as a physician-scientist or those who desire greater experience or possible dual-boarding in pulmonary or cardiac medicine.

Pediatric critical care fellowship programs use the ERAS system.  The completed ERAS applications are screened and selected applicants are invited to travel to Denver to meet with faculty and fellows and tour the facilities. Final fellow selection is accomplished by participation in the National Residency Matching Program Match for critical care fellows, which occurs in the fall each year. Applicants must be eligible for a Colorado medical license. International medical graduates must have a valid ECFMG.

International Medical Graduates

In order for International Medical Graduates to be eligible to enter our program, you must meet the following criteria:

  • Have a valid ECFMG Certificate
  • Be able to legally work in the United States:
    Residents in our program must be a U.S. citizen, lawful permanent resident, refugee, asylee, or possess the appropriate documentation to allow Resident to legally train at the University of Colorado School of Medicine.
  • Minimum selection criteria of the University of Colorado School of Medicine. Visit the Graduate Medical Education website to view the criteria.
  • Any other criteria as determined by the program.

Thanks again for your interest in our program and best wishes in your future endeavors.

Contact:
Eva Nozik Grayck, MD
Associate Professor of Pediatrics
Director, Pediatric Critical Care Fellowship
Critical Care Medicine
13121 East 17th Avenue
P.O. Box 6508
Aurora, Colorado 80045
Tel:  (303) 724-2393
Eva.Grayck@ucdenver.edu

Critical Care Cropped.jpg

 
Pediatric Critical Care Medicine Fellows
Left to Right: Aline Bernard, MD (PGY5 - 1st yr) Brian Jackson, MD (PGY4 - 1st yr), Timothy Stidham, MD   (PGY6 - 2nd yr), Leslie Ridall, DO (PGY5 - 2nd yr), Carol Okada, MD (PGY6- 3rd yr)
Not pictured: Jesse Davidson, MD (PGY8 - 2nd yr), Ricky Luu, MD (PGY6 - 3rd yr), Christopher Osborne, MD (PGY4 - 1st yr)

 

First Year Fellows:

Aline Bernard, MD
Residency: University of Colorado Pediatric Residency Program
Medical School: Vanderbilt University School of Medicne
Research Interests: TBD
Aline.Bernard

Brian Jackson, MD
Residency: University of Colorado Pediatric Residency Program
Medical School: George Washington University School of Medicine
Research Interests: TBD
Brian.Jackson

Christopher Osborne, MD
Residency: Children’s Hospital of Philadelphia
Medical School: West Virginia School of Medicine
Research Interests: TBD
Christopher.Osborne

Second Year Fellows:

Leslie Ridall, DO
Residency: St. Christopher’s Hospital for Children Philadelphia
Medical School: Philadelphia College of Osteopathic Medicine
Research Interests: The effect of chronic noninvasive ventilation on the progression of Cardiomyopathy in Duchenne's Muscular dystrophy.
Leslie.Ridall

Timothy Stidham, MD
Residency: University of Colorado Pediatric Residency Program
Medical School: University of Tennessee Health Science Center College of Medicine
Research Interests: The importance of genetic polymorphisms in critical illness, and is currently investigating the role of polymorphisms of the antioxidant enzyme EC-SOD on pediatric pulmonary arterial hypertension.
Timothy.Stidham

Third Year Fellows:

Ricky Luu, MD
Residency: Loma Linda University Pediatric Program
Medical School: University of California at Irvine School of Medicine
Research Interests: The importance of serum sodium derangements on PICU morbidity and mortality.
Ricky.Luu

Carol Okada, MD
Residency: University of Colorado Pediatric Residency
Medical School: Washington University School of Medicine
Research Interests: The impact of childhood obesity on medication dosing in the critically ill population.
Carol.Okada

Combined Cardiology/Critical Care Fellow:

Jesse Davidson, MD
Residency: University of Colorado Pediatric Residency
Medical School: Duke University School of Medicine
Research Interests: Biomarkers of adequate myocardial function in the setting of cardiopulmonary bypass.
Jesse.Davidson

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