Clinical Training

The Pediatric Emergency Department (PED) at Hasbro Children’s Hospital is the only emergency department in the region that focuses on the emergent and urgent care of children and adolescents. Hasbro Children’s Hospital is a tertiary care referral center with Level 1 pediatric trauma designation with over 54,000 pediatric visits annually.

Fellows experience graduated goals and objectives as clinical milestones are reached. New fellows begin with a foundation of skills including airway management, wound repair, procedural sedation, and pediatric trauma. Junior fellows progress to precepting residents and overseeing trainees while learning administrative duties of the emergency physician.  Senior fellows integrate these skills while running the emergency department as the senior physician on overnight shifts. 

Beyond the PED, fellows rotate at Rhode Island Hospital and Miriam Hospital Emergency Departments, which have a combined annual volume of 150,000 visits. Fellows enjoy clinical rotations and electives that supplement their emergency medicine education, including anesthesiology, trauma, child protection, emergency medical services, obstetrics and gynecology, orthopedics, pediatric critical care, plastic surgery, dentistry, ophthalmology, simulation and ultrasound.

The child life and nursing team presented the physicians with artwork by their patients turned into tiles for an installation in the ED.The child life and nursing team presented the physicians with artwork by their patients turned into tiles for an installation in the ED.

Clinical Goals and Objectives

Year 1: (July – November) the PEM fellow sees patients primarily with a focus on learning local protocols and resources.  The fellow develops a solid foundation of skills in: airway management (BVM ventilation, tracheal intubation), wound management (suturing), orthopedic (fracture recognition and stabilization), performance of procedural sedation and analgesia, and pediatric trauma. 

Year 1 (December – July): the fellow begins to precept residents in emergency medicine and pediatrics. The focus is on moving from managing single patients to overseeing the management of several patients by trainees while obtaining an adequate independent assessment and in order to detect occult or subtle presentations of serious illness or injury. 

Year 2: The fellow is expected to supervise the care of multiple patients in one-half of a busy pediatric ED and to demonstrate and teach an evidence-based approach to patient care effectively. The fellow responds to the trauma room and is expected to direct the evaluation and resuscitation of critically ill and injured patients. Beginning 2nd year the fellow will work 1-2 overnights/month during primary dept months with a “shadow” attending in house for backup.

Year 3: The fellow should demonstrate clinical skills and efficiency on par with junior PEM faculty.  Fellows and encouraged to develop their own style and to reduce their reliance on laboratory testing as their clinical expertise develops.  They are expected to resolve conflicts with staff, patients, families and consultants in a professional manner with only occasional intervention by faculty.  The fellow should demonstrate an awareness of overall ED flow and functioning and collaborate effectively with the charge nurse and attending and all available providers. Fellows will work solo 1-2 overnights/month during primary dept months.

SCHEDULE

YEAR ONE

Pediatric Emergency Medicine

5 months

Anesthesiology

2 weeks

Trauma

1 month

Adult Emergency Medicine

1 month

Orthopedics/Sports Medicine

1 month

Radiology

2 weeks

Toxicology

1 month

Child Protection

1 month

Ultrasound

1 month

YEAR TWO

Pediatric Emergency Medicine

5 months

Ultrasound

1 month

Obstetrics/Gynecology

1 month

Pediatric Critical Care

1 month

Research (call free)

2 months

Adult Emergency Medicine

1 month

Plastic Surgery

1 month

 YEAR THREE

Pediatric Emergency Medicine

4 months

Adult Emergency Medicine (Critical Care)

1 month

Anesthesia

2 weeks

EMS

2 weeks

Ultrasound

1 month

Research (1 month call free)

5 months

DURING CALL FREE MONTHS FELLOWS HAVE THE OPPORTUNITIES TO DO AWAY ELECTIVES INCLUDING GLOBAL HEALTH ROTATIONS.

FOR EMERGENCY MEDICINE TRAINED FELLOWS

Adult EM, Trauma, Tox will be substituted for rotations in NICU/Newborn Nursery, Primary Pediatrics, Pediatric Cardiology, and other elective time to be discussed with Program Director.