Pediatric emergency medicine requires the family-centered, diagnostic expertise of the skilled pediatrician and the efficient and decisive resuscitative abilities of the emergency physician. Pediatric emergency physicians expertly manage the emergent aspects of disease across all medical and surgical subspecialties with a kind, reassuring presence in a busy environment. Residency training in either pediatrics or emergency medicine provides the fundamental ground work for this transition to pediatric emergency practice. At Carolinas Medical Center, in Charlotte, NC, our fellowship builds on the unique baseline skill set of physicians from either background to refine their clinical expertise, teaching ability, research acumen, and administrative proficiency. It is our mission to create leaders that will continue to advance pediatric emergency care in both academic and community practice settings.
Fellows practice in a busy 40,000 patient visit per year urban emergency department dedicated to the care of children 0-17 years. During clinical shifts in the Children's emergency department (ED), fellows also participate in the resuscitation of 1,000 pediatric trauma activations per year at our Level I Trauma Center. Carolinas Medical Center, an urban 874 bed tertiary care center, is the flagship hospital of the Carolinas HealthCare System. Carolinas HealthCare System is the third largest non-profit public system in the nation with 33 affiliate referring hospitals. Our medical center provides graduate medical education for more than 250 physicians in 18 specialties.
Core subspecialty rotations occur at the attached Levine Children's Hospital, a 234 bed state-of-the-art facility, recognized as one of "America's Best Hospitals" by U.S. News & World Report. Ancillary support services maximize the fellows' time with patients and their family. These providers include emergency department, child life specialists, bedside interpreters, a fast-track appointment scheduler, 24-hour social work services and dedicated sexual assault nurses for forensic evidence collection. Fellows maintain the highest standard of care while advancing their leadership role across the clinical training experience in a busy, but efficient tertiary care training environment.
Fellows complete independent, prospective clinical or bench research projects during fellowship. CMC offers competitive research awards of up to $25,000 per year to qualified proposals from fellow, house staff, or junior faculty. Our department also offers the John Marx Scholarship award of up to $5000 for a qualified project. Our fellows are encouraged to apply.
Research didactics include statistics, epidemiology, technical writing and research design. Fellows present their research to faculty and receive feedback on content, delivery, and the use of computer presentation software. Fellows are expected to complete a project of publishable quality, and present their research at a national scientific meeting. The emergency medicine faculty includes NIH-funded researchers who are available to provide mentorship to fellows interested in a career as a clinician-researcher.
Fellows' research efforts are integrated with their month-to-month clinical experience and there is also a dedicated research month each year in September. During this research month, fellows also have a task-based curriculum that is geared to help them prepare for the knowledge-base requirements in scholarship, and teaching for the pediatric emergency medicine board examination. Fellows can earn additional protected research time as they progress through their research timeline.
Fellows with a submitted IRB proposal who are in the data collection phase of their studies receive a two-shift per month reduction.
Fellows actively teach medical students, emergency medicine residents, pediatric residents, nurses, and the faculty during their fellowship. They develop proficiency in various teaching formats including lectures, small group exercises, low and high fidelity simulation, education boards, and bedside teaching. Through these myriad experiences, our fellows compile a substantial teaching portfolio over the course of their training. At Carolinas Medical Center, dedicated staff can mentor fellows in the development of curricula, learning assessment tools, portfolio design, and educational research projects. Other supplementary activities are also available for fellows interested in a career as a clinician-educator.
Fellows have the option to do an elective in administration during their fellowship. Fellows also receive didactic education in documentation, risk management, billing/coding, in clinical policy implementation. Fellows actively participate in the quality assurance program that is part of the Division of Pediatric Emergency Medicine here at Carolinas Medical Center.
Fellows interested in a career in administration or medical direction may participate in additional skill building opportunities including Lean process improvement projects, quality improvement initiatives, service excellence training, and information technology systems management. The Levine Children's Hospital Center for Advancing Pediatric Excellence provides grants, mentorship and administrative support for quality improvement projects in pediatric care. Fellows are encouraged to apply.
In a multi-institutional collaboration, our faculty has developed the first emergency medicine residency in East Africa at Muhimbili National Hospital in Dar es Salaam, Tanzania. Fellows may choose to participate in this project by assisting in on-site clinical care, teaching, and research or may contribute to the project remotely from Charlotte by assisting with curriculum development and revision. In collaboration with the Carolinas Heart Institute and the World Affairs Council of Charlotte, fellows may pursue international experiences in other locations.
Carolinas Medical Center has a nationally and internationally respected program in emergency medical services (EMS) and disaster medicine. At the forefront is Carolinas MED-1, a mobile hospital designed, equipped, and staffed to manage minor to severe emergency medical conditions, including operative trauma surgery and intensive medical care.
Our medical transport service, MedCenter Air, provides comprehensive pediatric critical care transport services with ground teams as well as fixed wing and helicopter transport of patients from medical facilities or injury scenes from 11 neighboring counties. Our department also works closely with the National Disaster Medical System. Fellows with a primary residency in pediatrics complete a two week EMS rotation. Fellows interested in a career in Pediatric EMS and Disaster Preparedness will have numerous opportunities to develop this career interest.
The injury prevention division provides information and resources, promotes injury prevention research, and provides community and faculty education programs in injury prevention. Fellows may elect to engage in injury prevention research or write educational materials for this division to develop expertise in this area.
Fellows complete a one month rotation in toxicology working with the toxicologists on ED and inpatient consultations and participating in daily teaching rounds with emergency medicine residents, toxicology fellows, and pharmacy doctoral students. In addition to toxicology consults at CMC and LCH, fellows receive exposure to the diverse cases reported to the Carolinas Poison Center, part of the Division of Toxicology.
Carolinas Medical Center Emergency Medicine has a Level I accredited simulation center. Monthly simulation exercises promote the practice of high stakes, low frequency and high frequency, low stakes diagnostic and procedural skills. Fellows participate in these exercises, low fidelity mock codes in the department, and hands-on skill building in the annual Wound Care Management Course and Difficult Airway Management Course.
All fellows will learn ultrasound guided line placement, master the pediatric FAST exam, and utilize ultrasound to assist in the decision to terminate pediatric resuscitation efforts. Fellows will also learn to complete evaluations for ectopic pregnancy for patients with complications during the first trimester of pregnancy. Fellows may participate in an elective ultrasound course with the faculty from our nationally recognized ultrasound fellowship program. Interested fellows may use this elective experience to build additional skills in first trimester pregnancy management, peripheral IV access, and other ultrasound guided procedures, including pediatric lumbar puncture and nerve blocks. There is a dedicated ultrasound machine used during all clinical shifts in the children's Emergency Department. All fellows participate or teach in a mandatory two day introduction to ultrasound workshop at the start of their training. This begins in the second year of training.
For more information contact:
Asuncion Erikson, Program Coordinator
Carolinas Medical Center
1100 Blythe Blvd.
MEB, Suite 304
Charlotte, NC 28203