Critical Care

Fellowship

Electronic Residency Application System (ERAS)

Fellowship Overview
The Pediatric Critical Care Fellowship Program at the Columbia University, College of Physicians and Surgeons and the Morgan Stanley Children’s Hospital of New York Presbyterian 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
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 pediatrics tower, which opened in the fall of 2003. This facility includes gradual expansion of the current 34-bed unit to a total of 41 Pediatric Intensive Care beds and includes a 14-bed Pediatric Cardiovascular ICU.

Research Experience
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, multiple relationships exist with top laboratories at Columbia offering a rich experience in active areas of basic science investigation, including:

• Stem cells in brain injury and mechanisms of brain injury
• Cerebral and cardiopulmonary resuscitation
• Neuroprotectant strategies after cardiac arrest and CPR
• The role of matrix metalloproteinases in lung and cardiac injury
• The roles of aldose reductase receptors in sepsis and inflammatory responses
• Modified channel expression in cardiac myocytes

• Clinical ethics
• Pharmacologic studies
• Bioinformatics
• Inflammatory states in critical illness
• Investigations of critical illness associated hyperglycemia
• Evaluation of clinical outcomes using "database mining"
• Cerebral cooling in CPR
• Interactions between families and medical systems
• Informed consent processes
• International health

Basic Science Studies

• Ventricular responses to nutritional deprivation
• Multi-site ventricular pacing in post-operative heart failure and heart transplantation
• Host-organism interactions in MRSA infection
• Role of bronchial epithelium in reactivity
• 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
• The role of matrix metalloproteinases in lung injury
• 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
• Role of aldose reductase receptors in clinical sepsis
• Understanding platelet storage injury
• Development of a biological pacemaker

Clinical Studies

• Incidence of hyperglycmemia associated with critical illness
• 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
• The incidence and impact of hypo-and hyperglycemia with pediatric critical illness
• Study of family-medical team interactions
• Investigations of organ procurement practices with donation after pediatric cardiac death

Educational Opportunities
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 Bedside 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 must be board eligible/board certified in Pediatrics. Applications from women and minorities are encouraged. It is preferred that applications be submitted through the Electronic Residency Application System (ERAS). Please note that the current 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 additional 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 or Pediatric Neurology and Pediatric Critical Care Medicine
• Concentrated research training through the Physician Scientist Development Program
• Concentrated clinical research training through Public Health School Scholarships

Inquires regarding the fellowship should be addressed to:

Katherine V. Biagas, M.D., FCCM, FAAP
Pediatric Critical Care Medicine Fellowship Program
Columbia University College of Physicians and Surgeons
630 W 168th Street, CHN 10-24
New York, NY 10032-3784