Critical Care

Online Application

Fellowship Overview

The Pediatric Critical Care Fellowship Program at the Columbia University, College of Physicians and Surgeons/Morgan Stanley Children's Hospital offers trainees a diverse education in clinical, administrative, and research-based Pediatric Critical Care Medicine at a state-of-the-art facility. The Program is fully accredited by the Accreditation Council for Graduate Medical Education and participates in the National Residency Matching Program for Pediatric Critical Care Medicine. The Program has a track record of training Fellows in specialized programs such as the Physician Scientist Development Program, Masters of Public Health programs, and combined training in two pediatric subspecialties, as well as training Fellows in general and cardiac Pediatric Critical Care.

Clinical experience is provided at the Morgan Stanley Children's Hospital of New York-Presbyterian, one of the largest pediatric facilities in the country. The Morgan Stanley Children's Hospital includes a newly constructed pediatrics tower, which opened in the fall of 2003. This facility includes gradual expansion of the current 33-bed unit to a total of 41 Pediatric Intensive Care beds.

The PICU serves the critical care needs of the immediate community, as well as provides tertiary/quaternary care for metropolitan New York, and for many patients from across the United States and abroad. Fellows coordinate care for patients from all medical and surgical pediatric subspecialties. In particular, the Fellows actively participate in the care of patients in specialized clinical programs such as:

• Cardiothoracic Surgery
• Solid Organ Transplantation
• Bone Marrow Transplantation
• Neurosurgery
• Plastic and Reconstructive Surgery
• Orthopedic Surgery
• Pediatric Trauma
• Subspecialty Cardiology such as Pulmonary Hypertension, Electrophysiology, Interventional Catheterization, and Heart Failure services

In addition to training in general critical care procedures and principles, Fellows receive training in advanced ICU techniques including:

• ECMO
• High Frequency Ventilation
• Inhaled Nitric Oxide Administration
• Surfactant Administration
• Continuous Renal Replacement Therapy
• Hepatic Replacement Therapy
• Pediatric Transport
• Neurological Monitoring
• Ventricular Assist Devices

The rich research environment of the Columbia University College of Physicians and Surgeons is available for mentored laboratory or clinical research experience. All Fellows have an individually tailored Scholarship Oversight Committee convened to follow and advise them throughout their training in research or scholarly activities. For Fellows interested in pursuing laboratory-based research, the divisional basic science research program is directed by a renowned, full-time, senior research faculty member, Dr. Susan Vannucci. Active areas of basic science investigation include:

• Nutrient transport and energetics in response to hypoxic-ischemic injury in the developing brain
• Interactions between hypoxia-ischemia and diabetes in brain injury
• Cerebral and cardiopulmonary resuscitation
• Neuroprotectant strategies after cardiac arrest and CPR
• The roles of scaffold proteins in apoptosis

In addition, the division has an active clinical research program with on-going investigations in the following areas:

• Clinical uses of nitric oxide
• Pharmacologic studies
• Inflammatory states in critical illness
• Evaluation of clinical outcomes using "database mining"
• Cerebral cooling in CPR
• Ethical issues of interactions between families and medical systems
• Informed consent for emergency procedures

Recent and current research efforts performed by Fellows include:

• Basic Science Studies
  • Role of actin in oxygen radical mediated endothelial lung injury
  • Neuroprotective role of a scaffold protein homologue
  • Developmental changes in myocardial nutrient transporters
  • Ketone body utilization in global brain ischemia
  • Neurodevelopmental impact of repeated episodes of hypoglycemia
• Bench-to-Bedside Studies
  • Neuroprotective role of Omega-3 fatty acid supplementation in focal brain ischemia
  • Use of MR scanning and spectroscopy to evaluate the hyperglycemic brain
  • Biventricular pacing in pediatric cardiac failure
• Clinical Studies
  • Use of renal replacement therapies in management of fluid balance and inflammatory states
  • Neurologic monitoring in post-operative cavo-pulmonary connections
  • Use of amiodorone in resuscitation
  • Treatment of vasodilatory shock after cardiopulmonary bypass

In addition to the above, multiple established laboratories and clinical research collaborations exist in the Department of Pediatrics, throughout the College of Physicians and Surgeons, and the General Clinical Research Center to provide additional facilities for Fellow's research efforts.

Educational goals are met through an established curriculum. Focused clinical curriculum is centered on weekly Fellows Conference meetings at which advanced principles of physiology and patient management are discussed, monthly Pediatric Cardiac Critical Care Conferences, and weekly Division Chief Rounds.

Additional learning opportunities include didactic sessions, directed readings, mortality and morbidity conferences, quality improvement meetings, laboratory meetings, research conferences, and journal clubs. Fellows receive formal education in biostatistics and study design, ethical and legal aspects of critical illness, PICU administration, and scientific writing.

Applications

Application to the Fellowship is highly competitive. Persons who wish to apply should be board eligible/board certified in Pediatrics. Applications from women and minorities are encouraged. Completed applications must be received by September 1 of the year preceding the start of Fellowship. Please note that the completed application includes:

• Completed application form
• Three letters of recommendation, including a letter from the applicant's Chairman or Residency Program Director
• Curriculum vitae
• Additional information, such as personal statements and manuscript reprints, is welcomed.

Applicants may wish to consider addition al clinical and research training experiences that are available for selected Fellows. These experiences include:

• Combined training in two pediatric subspecialties, particularly training in Pediatric Cardiology and Pediatric Critical Care Medicine
• Concentrated research training through the Physician Scientist Development Program
• Concentrated clinical research training through Public Health School Scholarships

Applicants wishing to pursue any of these opportunities must identify themselves to the Program Director early in the application process.

Applications may be obtained and submitted online using the link at the top of the page. A hardcopy of the application may be obtained by calling the Division administrator at 212-305-9717. Please send hardcopy applications, letters of recommendation, and other supporting documents to the address below.

Katherine V. Biagas, M.D., FCCM, FAAP
Director, Pediatric Critical Care Medicine Program
Columbia University
BHN 10-28
630 W 168th Street,
New York, NY 10032-3784