| Emergency
Medicine
Division of Pediatric Emergency Medicine Robert Gochman
FACULTY: Joy Nagelberg, MD, Chief, Assistant Professor of Pediatrics Robert Gochman, MD, Fellowship Director, Assistant Professor of Pediatrics Susan Lee Chan, MD, Assistant Professor of Pediatrics Diana Crevi, MD, Assistant Professor of Pediatrics William Krief, MD, Assistant Professor of Pediatrics Philomena Thomas, MD, Assistant Professor of Pediatrics Pediatric Emergency Medicine Fellows: 5 The Division of Pediatric Emergency Medicine tallies approximately 25,000 patient visits per year and is staffed by pediatric attendings, fellows, residents, and nurses uniquely dedicated to the facility on a 24 hour per day basis. The pediatric emergency department is specially designed to cater to the needs of infants through adolescents and is equipped to handle a full spectrum of illness from simple injury to cardio-pulmonary arrest. The Pediatric Emergency Department has been designated a Level 1 Pediatric Trauma Center. The Division is a valuable resource to both referring physicians as well as those patients that are self-referred. The patient mix is one of high acuity and results in an admission rate of over 20% with one of eight admissions sent to the Pediatric Intensive Care Unit. FELLOWSHIP PROGRAM: Our fully accredited, three-year fellowship training program has been designed to take advantage of the vast resources of SCH/LIJMC emphasizing clinical medicine, teaching, research, and administration. In addition to an intense learning experience preparing the fellows to supervise the ED facility, the fellowship consists of a variety of rotations including orthopedics, ENT, gynecology, ophthalmology, toxicology, anesthesia, critical care, trauma, and adult emergency medicine, as well as an ongoing course in research design. The overall goal of the program in pediatric
emergency medicine at Schneider Children's Hospital is to provide progressive
clinical, teaching, research and administrative experiences that will enable
our residents to acquire the expertise necessary to become an academic
pediatric emergency medicine physician. It is expected that during the
three-year program the subspecialty resident will (a) become clinically
proficient in the practice of Pediatric Emergency Medicine with emphasis
on the acutely ill and injured child, (b) become competent in teaching
other professionals, health care providers and families about appropriate
topics in their field of expertise, (c) demonstrate competence in research
and (d) become familiar with the administrative issues relevant to an emergency
department.
The fellowship curriculum is as follows. Year 1 is designed to introduce the resident to the core elements of their fellowship. Emphasis is placed on attaining the knowledge and skills necessary to function as an effective care provider, supervisor, teacher/consultant, and researcher. This is accomplished from the beginning by direct observation of ED attendings who demonstrate techniques that assure smooth, safe "flow" in the ED while maintaining an academic environment that allows for teaching and consultation. Within the first six months of training the residents rotate through anesthesia, critical care and trauma. Over the remainder of the year other core rotations such as ophthalmology, ENT, orthopedics, and adult emergency medicine are completed. Once sufficient knowledge base, skills and confidence are attained (based on the results of monthly evaluations) the first year residents begin to supervise the ED on a limited basis with attending back-up. This typically begins after 6-8 months of training. Teaching is expected to consist of informal lectures which are critiqued by the Faculty as well as senior residents. Introduction to research starts in September when the residents begin a six month course that meets weekly in biostatistics, epidemiology, and study design. This course prepares them for launching their own first research project and enhances their ability to critically review medical literature. Year 2 is designed to enhance the knowledge and skills attained in the first year while expanding the residents experience in supervision, teaching, administration and research. In addition to second rotations in critical care and adult emergency medicine, the resident completes rotations in pre-hospital transport, adolescent gynecology, and toxicology. Over the second year the residents experience more supervisory time as they "double-cover" shifts with the Faculty who serve as supervisory mentors and thereby enhance clinical and teaching skills. Additional responsibility is placed on the residents to present more elaborate lectures to a variety of audiences thus enabling them to strengthen their teaching skills. In the second year it is expected that the residents become familiar with administrative issues related to the ED and are required to participate in Performance Improvement projects as well as become a member of an ED committee such as Policy and Procedure or Disaster Planning. During the second year subspecialty residents are given protected time as needed in order to allow for completion of the data collection for their first research project. Year 3 is designed to allow the resident to fine tune their clinical and administrative experience as well as complete their research projects. One-on-one teaching, academic lectures and case presentation skills are emphasized as well. A third month is spent in the adult emergency department. Protected time is provided as needed to allow the residents to complete their research projects. The balance of time is available for electives as well as supervisory time in the ED. With a successful ten-year history, the fellowship in Pediatric Emergency Medicine at SCH has become highly competitive. Applicants are encouraged to arrange electives in the pediatric emergency department prior to the application deadline of October 1. For more information or to request and application contact the Program Director, Dr. Robert Gochman via email at Gochman@lij.edu. |
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