Pediatric Critical Care Medicine

Panoramic view of OHSU's Marquam Hill campus.

The Pediatric Critical Care Medicine Fellowship is a three-year subspecialty training program designed to follow residency training in pediatrics or combined internal medicine-pediatrics. The fellowship program seeks to develop outstanding clinicians, educators, researchers and leaders in pediatric critical care medicine. With one fellow per training level, we are a small program with the ability to prioritize educational goals. Curricula will vary as they are tailored to individual fellow circumstances, career goals, American Board of Pediatrics approval, and other needs.

PICU Fellowship Aims

OHSU is where healing, teaching and discovery come together. As Oregon’s only academic health center and medical school, we provide comprehensive health care, educate the next generation of pediatric intensivists and explore new solutions to healthcare problems.

The Pediatric Critical Care Fellowship at Doernbecher Chidren’s Hospital trains academic physicians with an emphasis on provision of excellent patient care. We specifically focus on training compassionate and collegial physicians with strong communication skills and who work well in interdisciplinary teams. Given the multidisciplinary nature of critical care, strong teamwork is at the core of what we do and teach. 

We have a diverse  patient population providing breadth to the training of our fellows. In addition to our very experienced PICU faculty, we have an exceptional and comprehensive team of pediatric subspecialists to support the care of these patients and who are involved in the training of our fellows. Our graduating fellows excel in the management of critically ill children with multisystem disease.

With a PICU serving Oregon, southern Washington, eastern Idaho, and northern California, the fellows are exposed to a broad range of patients from rural and urban settings. They become adept in managing the complex transport of patients over long disances, using various modes of transport. Fellows will accompany our dedicated pediatric critical care transport PANDA Team on a select subset of transports longitudinally throughout training, with roles commensurate with their advancing skill levels. Another crucial aspect of care across long distances is the use of telemedicine. OHSU is home to one of the largest, most comprehensive telehealth networks in the world, and PICU fellows receive training in this important outreach modality.

Learn more about OHSU's Pediatric and Neonatal Critical Care Transport Team

Learn more about OHSU's Telemedicine Network

We strive to develop fellows who are aware of the physical, cognitive, psychological and social impact critical care admission has on patients and families in both the short and long term encompassed by the Post-Intensive Care Syndrome. Fellows participate in our critical care and neurotrauma recovery program through both inpatient consultation and outpatient follow-up. This is the only program of its kind on the West Coast. Fellows are educated in identification and management of Post Intensive Care Syndrome through a multidisciplinary team that includes faculty in Pediatric Critical Care, Neurology, and Neuropsychology. Fellows will experience first-hand the range of recovery seen in patients surviving critical illness and acquired brain injury. 

Learn more about the Pediatric Neurocritical Care Recovery Program

We believe that hard work today can result in a better tomorrow. To that end, fellows are trained in Quality Improvement (QI) science and methodology. Fellows participate in one or more team-based interdisciplinary projects aimed at improving patient care and safety, and over time develop skills to design, implement, and lead these projects independently. 

We do this in the setting of beautiful Portland, Oregon, in a small but comprehensive program where fellows get to interact closely with faculty and are treated as individuals and colleagues. We feel this provides an optimal learning environment.

Program leadership

Fellow Conferences

In addition to the conferences listed below, fellows also participate, under faculty mentorship, in delivering the core lecture series to residents rotating in the PICU and unit-based Mock Codes.

Mondays

  • 12:00 - 1:30 p.m. PICU Fellows' Core Physiology Series (monthly)
  • 1:30 - 4:00 p.m. PICU Fellows’ Mega Mondays block didactic sessions (monthly)
  • 4:00 - 5:30 p.m. Combined PICU/Cardiothoracic Surgery M&M Conference (monthly)

Tuesdays

  • 12:00 p.m. Journal Club (3rd Tues); Research in Progress (4th Tues)
  • 1 p.m. Challenging Case Conversations (interdisciplinary, 1st Tues )
  • 2 p.m. Multidisciplinary Critical Care Lecture Series (campus-wide educational series directed by the Dept of Anesthesia, involving learners from multiple ICU fellowships as well as PICU, NICU; select sessions recommended for PICU fellows to attend)

Wednesdays

  • 11 a.m. PICU M&M (monthly) or Combined PICU/Pediatric Hematology-Oncology M&M Conference (quarterly)
  • 12:00 p.m. weekly PICU Case Conference

Thursdays

  • 8 a.m. Grand Rounds, Department of Pediatrics
  • 12:00 p.m. PICU Quality Improvement &Patient Safety Conference
  • 3:30 p.m. Fellow Didactics (lectures, simulation, core physiology and research skills series)

Fridays

  • 12:00 p.m. Pediatric Chair's Friday Forum (rotating series of Department-level presentations on Clinical Reasoning, Research in Progress, Evidence-based Medicine, Morbidity & Mortality, and Ethics)

Curriculum

Year one

  • 7 months combined pediatric intensive care/cardiac care unit (PICU)
  • 1 month Anesthesiology
  • 1 month Pediatric Cardiothoracic Surgery, Perfusion and Catheterization
  • 1 month Pediatric or Adult Cardiovascular Intensive Care (CICU)
  • 1 week CME
  • 7 weeks Research
  • 4 weeks Vacation

Year two

  • 4 months PICU
  • 6 months Research
  • 1 month Trauma ICU (TICU)
  • 2 weeks Point-of-Care Ultrasound
  • 2 weeks Procedural Sedation
  • 4 weeks Vacation

Year three

  • 4 months PICU
  • 7 months Research
  • 4 weeks Elective
  • 4 weeks Vacation

Dr. Erin Burns in the Doernbecher PICU.
About our PICU

The Doernbecher PICU is a 20-bed unit with an average daily census of 15 patients. We are an open, mixed unit with approximately 1400 admissions annually. Our diverse patient population includes pediatric medical, general surgical, cardiac medical &surgical, neurosurgical, renal transplant, and multi-system trauma patients. We care for approximately 13 ECMO cases per year, in addition to 15o intra-operative cardiopulmonary bypass procedures. 

Our catchment area includes Oregon, southern Washington, northern California, Idaho, and Montana. Doernbecher has an active &dedicated pediatric critical care transport team providing high-quality mobile ICU care to all of these regions, and allowing PICU fellows to become facile and comfortable with management of pediatric transports (approx. 1000 per year).

During a total of 15 four-week rotations in the PICU, fellows develop skills critical to management of the intensive care unit, including patient triage, leadership of a large team of medical trainees, cooperation with nursing leadership, and ongoing process improvement. Work hours during these clinical months consist of 3 weeks of day shifts, and 1 week of night shifts.

Faculty include 13 board-certified pediatric intensivists (who cover both the medical-surgical and cardiac ICU services) and a nurse practitioner, allowing adequate attending coverage to assure an excellent learning environment for the fellow. Attendings are in-house 24-7, including 2 attendings in-house during weekdays. There is also a complete spectrum of pediatric subspecialty consultants at Doernbecher, all of whom excel in their fields. With 1 fellow per year, there is always time for teaching.

Telemedicine

OHSU is home to one of the largest, most comprehensive telehealth networks in the world. PICU fellows receive training in this important outreach modality.

Learn more about OHSU's Telemedicine Network

Scholarship

Training our PICU fellows to become competent physician scientists is a priority of the fellowship program. Fellow scholars meet with the Program Director and Division Faculty to delineate research interests within the first several months of fellowship. Significant effort is dedicated to this process to maximize opportunity for a successful investigative career. This is followed by the choice of a research mentor(s) and project, with scholarly activities to commence within the first year of fellowship. 

A separate professional mentor is also selected by the fellow early in the First Year, to help guide the fellow more generally in the career and personal development. 

Additionally, the Pediatric Fellowship Committee, a larger governing body for all pediatric fellowship programs at Doernbecher, provides resources to fellows in project development and choosing a mentor.

OHSU/Doernbecher has a plethora of talented faculty in many areas applicable to pediatric critical care who enjoy mentoring fellows in professional development &scholarly endeavors. 

Human Investigations Program (HIP)

All pediatric fellows receive funding to participate in the Human Investigations Program (HIP), a unique and highly-valuable resource for fellowship trainees at OHSU, which is supported by an NIH K30 grant. The HIP is a formal, expertly-taught graduate program housed under the Oregon Clinical and Translational Research Institute (OCTRI) and fulfilling all American Board of Pediatrics (ABP) criteria for education in epidemiology, biostatisitics, research design, proposal development &manuscript preparation/review. Fellows also learn to integrate principles of molecular and cell biology, new pharmacology techniques, genomics and medical informatics into modern clinical, translational, and basic science research. The primary objective of HIP is to increase the competency of physician-scholars in the investigative process, and the coursework is directed toward young investigators and fellows as well as junior faculty. The curricula may result in a Certificate in Human Investigations (1-year), or Master of Clinical Research (2-years), depending on the career goals of each individual fellow. 

As part of their career development, fellows may choose to pursue an advanced degree, including a Masters of Public Health and Clinical Research.

Oregon Clinical and Translational Research Institute (OCTRI)

Beyond HIP, OCTRI has a wide array of resources to help investigators and research staff plan and implement successful research studies. OCTRI provides funding and support for novel translational research projects and educational opportunities for faculty, fellows, students, and study coordinators. With major funding from the National Institutes of Health through the Clinical and Translational Science Awards (CTSA), and significant institutional commitment from OHSU and Kaiser Permanente, OCTRI's mission is to improve human health by enhancing clinical and translational research. OCTRI provides a coordinated infrastructure of core research tools. The OCTRI research infrastructure supports investigators with expertise, equipment, facilities, and tools in bioinformatics, biostatistics, community-engaged research, compliance and regulatory support, inpatient and outpatient clinical research, and laboratory analysis. There are many other research centers supporting trainees in research, finding funding, and writing grants.

Salary and benefits

Education and training

Because we believe that effective faculty development must begin during training, we offer our PICU fellows the opportunity to enroll in the Education Scholars Program at OHSU, a highly-regarded longitudinal seminar for motivated and promising clinical teachers.

Learn more about OHSU's Education Scholars Program

Simulation

In addition to participation in unit-based mock scenarios and teaching within the Pediatric Resident Mock Code curriculum, PICU fellows have regular access to OHSU's state-of-the-art Simulation Center on the South Waterfront, which houses the PALS/ATLS program in addition to Central Line WetLabs and Ventilator Simulations.

Global Health

The Department of Pediatrics works closely with several hospitals in SE Asia through relationships buil by the OHSU Global Health Center.

Learn more about Doernbecher Children's Hospital's Global Health Program

Pediatric Palliative Care

As intensivists, we work closely with members of Doernbecher's dedicated Pediatric Palliative Care Medicine service to provide compassionate goal-directed care of the whole child and family. 

Learn more about Doernbecher Children's Hospital's Bridges Program

Wellness

How to apply

For questions regarding the fellowship, please contact . Applications are through Electronic Residency Application Service (ERAS) and the National Resident Matching Program (NRMP)

OHSU Terms & Conditions of Employment

Please do not send us application materials directly unless requested.

Upon receipt of an application, our review committee will take several weeks to review and notify each applicant by email of the interview decision and possible interview dates. Unfortunately, due to the volume of applications and small size of our program, we are unable to interview all qualified applicants. Applicants are invited for an interview based on the strength of their application.

International Graduates

For graduates of a foreign medical school, residency must have been completed in the US in order to apply. Applicants must be legally able to work in the US, or eligible to obtain work. Applicants must also provide a copy of a valid certificate from the Educational Commission for Foreign Medical Graduates, participate in the National Residency Match Program and apply through ERAS.