UCSFCHO Pediatric Critical Care Fellowship Program

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UCSF/CHO Pediatric Critical CareFellowship
Program
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Overview

• Goals
• Training program
• Clinical
• Career development
• Mentoring
• Alumni
• Work environment
• Life in the Bay area

3
In a nutshell

• The UCSF/CHO Pediatric Critical Care Program is
  a
• Moderately sized
• Academically oriented fellowship
• Located in San Francisco and Oakland CA

4
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

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Overview of Training Program

• Fellow as Clinician
• Fellow as Investigator
• Fellow as Educator

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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

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Developing Fellows as Clinicians

• Nuts and bolts of year 1
• (13 4-week-rotations)
• Anesthesia (CHO) 1
• ICU Service 8
• Research 3
• Vacation 1

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Developing Fellows as Clinicians

• Nuts and bolts of year 2
• ICU Service 5
• Adult ICU 1
• Research 6
• Vacation 1

• Nuts and bolts of year 3
• ICU Service 2
• Elective 1
• Research 9
• Vacation 1

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Developing Fellows as Clinicians

• Formal clinical learning opportunities
• Fellows Conference
• Journal Club
• PICU CICU MM Conference
• Pre-Surgery Cardiac Cath Conference
• ECLS Conference
• Pediatric Grand Rounds
• Adult ICU Lecture Series
• Joint Pediatric, Adult, Neonatal ICU Lectures

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Developing Fellows as Clinicians

• Clinical Resources
• UCSF Childrens 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

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Developing Fellows as Clinicians

• Clinical Resources
• Childrens 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

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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

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Building Your Career

• Goal Train top notch clinicians for
  academically-focused careers
• What does it take to get a great academic job?
• Excellent clinician
• Tangible scholarly work Clinical,
  translational, or basic research Master Educator
• Board certification

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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

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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

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Developing Fellows as Investigators

• Research Resources
• UCSF gt1,200 active basic/translational science
  labs
• Cardiovascular Research Institute
• The Gladstone Institute
• Biomedical Sciences Training Program
• Program in Biological Sciences
• Childrens 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 Masters Degree Program

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Developing Fellows as Investigators

• Opportunities 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

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NIH T32 Research Training in Pediatric Critical
Care Medicine

• 4 year program which includes 2.5 years of
  protected research training
• Both laboratory and clinical-translational
  tracks
• Diverse mentored research opportunities

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NIH T32 Research Training The Perks

• Multiple layers of supervision and mentorship
• Integrated with UCSF Fellows College
• Educational stipend
• Flexible clinical commitment
• Funds for TICR and Masters in Clinical Research

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Developing Fellows as Educators

• Opportunities for teaching
• Resident Lectures
• Fellows Conference
• Division Meetings
• Chairmans Rounds
• Noon Conference
• Bench to Bedside
• Teachable moments with residents and medical
  students

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Developing Fellows as Educators

• Opportunities for the Master Educator career
  track
• Haile Debas Institute of Medical Education
• Development of exportable learning materials

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Mentoring Program

• Mentors dont just give advice they make things
  happen for your career
• -Art Weiss
• School of Medicine Programs
• Graduate Program Seminar Series
• Departmental Fellows College
• Divisional Mentoring Formal and informal
• Frequent feedback
• Division
• Scholarship Oversight Committee (SOC)

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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

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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)

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Environment

• The Hospital
• The People
• The Patients
• San Francisco

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Work Environment The Hospital

• UCSF Childrens 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

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Work Environment The Hospital

• Childrens Hospital Oakland
• Free-standing Childrens 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

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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

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Work Environment The People
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Strengths of clinical service

• Integration/collaboration of laboratory
  scientists and clinicians
• Great Housestaff
• Awesome Fellows
• Exceptional Ancillary Support

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Work Environment The Patients

• Families from many different cultures with
  diverse socioeconomic status
• Large referral base

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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 Unlimitedland, sea, sky
• Just a cool place to be!

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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 housingallowance
• Many on-line rental agencies
• Local landlords prefer residents
• and fellows

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Environment Life in the Bay Area
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Special Learning Opportunities

• NIH T32 - Research Training
• International Health
• Masters In Public Health - UC Berkeley
• Masters in Clinical Research (TICR)
• Sponsored International Conferences

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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!!!