Pediatric Anesthesiology Fellowship
Jennifer Aunspaugh, M.D.
ACGME-accredited fellowship program (#0420421023) approved to train four fellows a year.
One year, beginning August 1st.
The Division of Pediatric Anesthesiology and Pain Medicine provided over 18,000 anesthetics in 2013. These occurred either in the operating rooms or in various sedation sites throughout the hospital. The Division currently has 35 anesthesiologists and a majority of anesthetics are provided by a faculty anesthesiologist with no resident or fellow in attendance; therefore there is no competition for interesting or difficult cases.
It is our intention that, at the completion of the fellowship, the fellow will
•be able to practice in a competent and independent manner in the management of simple and complex pediatric anesthesia cases, the management of common pediatric pain issues, and the provision of basic critical care support of the pediatric patient
•exemplify the characteristics of a professional in ethics, conduct, and communication
•serve as a knowledgeable consultant in pediatric anesthesiology
•continue to acquire and apply knowledge and skills to improve patient care
The fellowship is primarily a clinical training program with available research opportunities. The program is of 12 months duration, and subdivided into 13 four-week blocks to coincide with the rotation schedule for the UAMS anesthesiology residents in rotation. The clinical rotations include three blocks in the cardiovascular anesthesia service, a block each for rotations on the pain service and the critical care service (in the pediatric intensive care unit and/or the neonatal intensive care unit). The remainder of the year is spent in the general operating rooms and other anesthetizing locations at ACH. Three blocks of time are available for elective rotations, with approval from the fellowship director.
The program strictly adheres to all ACGME requirements for duty hours. Duty hours are tracked in the web-based New Innovations system and average approximately 50-60 hours a week over a 4-week cycle.
OVERSIGHT AND RESPONSIBILITY:
The fellow, while having completed full training in anesthesiology, remains in a training position while the ultimate oversight and responsibility (clinical and medicolegal) belongs to the attending anesthesiologist or staff physician of record. The fellow is closely supervised but provided increasing responsibility and independence as warranted over the course of the program. In addition, the fellow will often work in concert with other residents and fellows, and will have the responsibility of supervising junior residents at the direction of the attending anesthesiologist. Daily oversight is the responsibility of the attending physician involved in the fellow’s patient care. In addition, the fellow will select a physician advisor who will be responsible for assistance in guidance and mentoring, and will discuss quarterly evaluations with the fellow. The program director oversees the training program and the fellows, and is responsible to the chief of the division of pediatric anesthesiology and to the chairman of the department of anesthesiology. The fellow’s responsibility is to the patients and staff and to his/her education, as outlined in the code of conduct.
Purpose: To delineate the amount and type of call coverage provided by trainees in the pediatric anesthesiology fellowship program.
•To assist in the provision of anesthetic and pain management for patients at ACH
•To learn the perspective of patient management outside of regular working hours
•To participate in the management of uncommon or difficult cases pertinent to pediatric anesthesiology
We recognize that the fellow is in a transitional position between residency and faculty positions, and as such the fellowship should provide a different experience in terms of education and workload. The clinical cases necessary for training as a fellow should include the most unique and challenging patients and surgeries as well as the basics of pediatric anesthesia practice. There is also a need to provide service to the patients and surgeons at this institution, and the practical arrangement of call coverage is an educational goal of training as well. As such, there are expectations of the pediatric anesthesiology fellows during their training:
Main OR call: While assigned to the Main Operating Room rotation, each fellow will be expected to take a minimum of:
•One weekend of in-house call per month (one day call and one late call)
•Two weeks of fellow call (from home) per month for the following cases:
◾Congenital diaphragmatic hernia
◾Neonatal emergent laparotomy / laparoscopy, e.g., for NEC
◾Gastroschisis and omphaolcoele, primary closure
◾Anterior mediastinal mass
◾Major pediatric traumas
◾Other unusual cases at request of faculty member on call
CVOR call: while assigned to the cardiac rotation, the fellow is expected to cover cardiac call from home. Call coverage will abide by all ACGME standards, and provide for at least two weekends free of call (one night in seven).
ICU call: While assigned to the PICU, NICU, or CVICU, the fellow is not expected to cover nighttime call.
Pain call: While assigned to the pain service, the fellow is expected to cover two weeks of pain call from home. While it is infrequent that call will require a return to the hospital, call coverage is expected to abide by ACGME rules.
Fellows are given three weeks per year of vacation leave, one week of sick leave and one week of educational leave. Educational funds are $1,500.00 per year.
Pediatric Anesthesiology Fellowship Program
Stacey Boone, Education Coordinator
Arkansas Children’s Hospital
1 Children’s Way, Slot 203
Little Rock, AR 72202