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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 SOM). 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 13 faculty, all board certified or board eligible in pediatric critical care medicine, with two dual-boarded in pediatric pulmonology, three full-time PhD investigators and 12 midlevel (PA/NP) practitioners. In addition, several members of the Departments of Pediatric Pulmonology, Cardiology, and Anesthesiology provide key roles in the education and training of the fellows.

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 co-manage all surgical patients.
  • One month 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 develop an academic project for the remainder of the fellowship program, as well as to participate 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 and averages every 5-6 nights.

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.


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 CU SOM, the Cardiovascular Pulmonary Research Laboratory at CU SOM, 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.

Developmental Lung Biology Laboratory

Director: Kurt R. Stenmark, MD

The Developmental Lung Biology Laboratory is located in Research 2 on the new CU SOM 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.


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 local studies 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, acute lung injury, immune tolerance in sepsis, and Provider - Family Communication During Family Meetings . The program also participates in several multicenter studies including the Genetic Epidemiology of Influenza in Children, Heart and Lung Injury – Pediatric Insulin Titration Trial, Coagulation and Fibrinolysis in Pediatric Insulin Titration Trial (CAF-PINT), Pharmacokinetics of Understudied Drugs Administered to Children per Standard of Care, and Age of Blood in Children in Pediatric Intensive Care Units.


Children’s Clinical Research Organization:

Director: Lalit Bajaj, MD; Associate Directors: Peter Mourani, MD and Tim Bernard, MD

The Children’s Clinical Research Organization (CCRO) at the Children's Hospital Colorado (CHCO) provides comprehensive research services, facilities and personnel to support the facilitation and conduct of research, including research start-up, execution and close-out.  The CCRO sits within the CHCO Research Institute and is the primary centralized implementation and coordination organization for execution of clinical research at CHCO.

https://research.childrenscolorado.org/content/childrens-clinical-research-organization-ccro-overview


Cardiovascular Pulmonary Laboratory (CVP)

Director: Kurt R. Stenmark, MD

Also located in Research 2 at the CU SOM 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.


Department of Bioengineering

Director: Robin Shandas, PhD

College of Engineering and Applied Sciences

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.


National Jewish Health (NJH)

On a separate campus near Children's Colorado and CU SOM, 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.

The Application Process

Nationally, Pediatric Critical Care Fellowship programs use the ERAS application system.  For our program the application period will begin July 15, 2014.  Completed ERAS applications are screened and selected applicants are invited to travel to Denver to meet with faculty, fellows and tour our facilities.  Our interview season begins in August and ends in November of 2014.

Fellow selection is accomplished by participation in the National Residency Matching Program Match service, which occurs in the fall each year. Applicants must be eligible for a Colorado medical license. International medical graduates must have a valid ECFMG (see below).

Review Period and Match Date


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
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
Email: Eva.Grayck@ucdenver.edu

Critical Care Fellows (025) Cropped 2014.jpg.png

Pediatric Critical Care Medicine Fellows

Back row, left to right: Jon Haywood, Malcolm Anderson, Brian Jackson, Tim Stidham
Front Row, left to right: Rita Alvarez, Aline Bernard, Leslie Ridall, Anne-Laure Martin
Not Pictured: Chris Osborne


First Year Fellows

Ryan Good, MD
Residency: University of Vermont Pediatric Residency Program
Medical School: University of Michigan Medical School
Research Interests: TBD
Ryan.Good

Christopher Ruzas, MD
Residency: University of Colorado Pediatric Residency Program
Medical School: University of Colorado School of Medicine
Research Interests: TBD
Christopher.Ruzas

Allison Santana, MD
Residency: University of Colorado Pediatric Residency Program
Medical School: University of Southern California Keck School of Medicine


Second Year Fellows

Rita Alvarez, MD
Residency: SUNY Downstate Medical Center, Brooklyn NY
Medical School: Drexel University College of Medicine, Philadelphia PA
Research Interests: TBD
Rita.Alvarez@childrenscolorado.org

Malcolm Anderson, DO
Residency: Phoenix Children's Hospital
Medical School: University of North Texas Health Science Center, Texas College of Osteopathic Medicine
Research Interests: TBD.
Malcolm.Anderson@childrenscolorado.org

Jon Haywood, MD
Residency: Emory University, Atlanta GA
Medical School: University of North Carolina at Chapel Hill School of Medicine, Chapel Hill NC
Research Interests: TBD.
Jon.Haywood@childrenscolorado.org


Third Year Fellows

Aline Bernard, MD
Residency: University of Colorado Pediatric Residency Program
Medical School: Vanderbilt University School of Medicne
Research Interests: In collaboration with the adult critical care department, Aline conducts a research project evaluating immune suppression in severe sepsis, its association with organ dysfunction, and potential epigenetic markers.
ALine.Bernard@childrenscolorado.org

Brian Jackson, MD
Residency: University of Colorado Pediatric Residency Program
Medical School: George Washington University School of Medicine
Research Interests: Brian is studying how well families and physicians understand each other during care conferences when discussing prognostic information, and what support structures help families better understand information presented during care conferences.
Brian.Jackson@childrenscolorado.org

Christopher Osborne, MD
Residency: Children’s Hospital of Philadelphia
Medical School: West Virginia School of Medicine
Research Interests: Chris conducts bench research into acute airway injury after exposure to mustard gas, chlorine gas, and adenovirus with Dr Livia Veress and Dr Carl White in the Heart/Lung Institute of the University of Colorado.
Christopher.Osborne@childrenscolorado.org

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