Pediatric Anesthesiology Fellowship

The Texas Children's Hospital Pediatric Anesthesiology Fellowship is a one-year program approved by the Accreditation Council for Graduate Medical Education (ACGME). It has the distinguished honor of being re-accredited by ACGME for the next five years (the maximum allowed).

The anesthesiology department performs more than 32,000 anesthetics a year. They include nearly 1,000 cardiac surgery procedures, approximately 20 liver transplants, and the full range of neonatal and pediatric surgical procedures on healthy children as well as those with complex medical conditions. We are also actively involved in the delivery of anesthesia to gravid patients who present for fetal interventions.

Our practice is unique in that we work with both academic and community surgeons, which prepares our fellows for both private practice and academic careers. All faculty members are certified by the American Board of Anesthesiology and are fellowship-trained.

Apply

To apply for a fellowship position, submit the following by e-mail to dlsmith@bcm.edu or by US mail:

Texas Children’s Hospital Attn: Dr. Easley 6621 Fannin, Suite A3300 Houston, Texas 77030

A completed applicant file requires:

  • Completed application
  • CV
  • Personal statement
  • 3 letters of recommendation
  • Medical school transcript
  • Dean's letter
  • All ABA in-training exam scores
  • Photo (headshot)

Upon review of the application, competitive candidates will be invited to Houston for a one-day interview. We will cover one night of the hotel expense.

Qualifications and prerequisites

  • Successful completion of training in anesthesiology at an accredited program 
  • Board eligible or certified in anesthesiology 
  • Certified in Pediatric Advanced Life Support

Clinical rotations

  • Main operating room (6 months) - The fellow is exposed to a variety of cases from healthy children undergoing routine procedures to the most challenging cases. Every attempt is made to give the fellows "first dibs" at the most challenging cases on the schedule each day.
  • One month toward the end of the year is devoted to the fellow's development as a clinical educator, with mentored teaching of medical students, pediatric residents, and others. During this same month (on different days), the fellows are given the opportunity to run the OR schedule with faculty back-up as a way of exposing them to the interpersonal and systems issues related to "making the schedule work."
  • The fellow also has the opportunity to spend a week in out-of-OR locations including MRI/CT diagnostic imaging interventional radiology, GI procedures and neuroradiology. This opportunity allows the fellow to understand the special techniques needed and the pitfalls involved in working in an off-site location.
  • One month is designated as an Airway Rotation, during which time the fellow is assigned to the best airway cases on a daily basis. Specifically, the fellow does cleft lip/palates and dental cases as well as many fiberoptic intubations and infant direct laryngoscopies and bronchoscopies as possible.
  • Cardiac Anesthesiology (2 months) - The fellow works in the Cardiac ORs and the cardiac catheterization lab, generally divided 2/3 to 1/3. Most fellows do approximately 10 cardiopulmonary cases per month.
  • Pain Service (2 months, separated) - This rotation has three priorities, in this order:
    • Management of acute perioperative pain
    • Performance of ultrasound-guided peripheral nerve blocks
    • Exposure to chronic pain patients

The fellow has the responsibility for managing patient controlled analgesia and epidural catheters, as well as for evaluating consults requested by medical services. The fellow sees chronic patients in the clinic with the attending physician.

  • Pediatric Intensive Care Unit (1 month) - The fellow is a member of one of the PICU teams, has direct patient care responsibility, and writes notes/makes management decisions on the patients. In addition, the PICU faculty expects anesthesia-related didactic/bedside teaching of the team by the anesthesiology fellow and assistance with airway issues as well as line placement (central and arterial) on PICU patients.
  • Elective (1 month) - the fellow may choose to do an extra month of cardiovascular or pain, a month in the CVICU, or a special elective - which must be approved the the program director.

Didactic curriculum

  • Fellows' conference - Tuesdays, 0615-0700. Series of lectures and presentations by fellows and faculty, guest lectures, problem-based learning discussions, and journal club and "Case of the Day" discussions. Faculty and residents are encouraged to come, but the conferences are geared to fellows education.
  • Introduction to clinical research - month of July, 1700 -1930. Required graduate level course
  • Introduction to neonatology - month of July, 1200-1300, with several hands-on labs
  • Cardiac anesthesiology conference - Thursdays, 0615-0700. Covers a broad range of topics with leadership of the discussions by faculty and fellows.
  • QA conference - monthly, Friday 0615-0700. Fellows, residents, and faculty may present at this conference. Preparation for ABA Oral Exams, two Fridays per month, October through March with Dr. Glass, who is an ABA examiner.
  • Preparation for ABA written exams, as needed, with Dr. David Young
  • Professionalism, communications, career development Seminar - one Monday evening a month 1800-2000. Small group discussion with fellows, selected faculty leaders, guests on topics that are harder to discuss within the confines of the Tuesday conference, with an emphasis on issues of professional development and communication skills. Didactic readings, discussions, videotaping and role-playing are components of this new seminar.
  • Systems-based project - Fellows are required to select from a list of potential projects or suggest a project of their choice, designed to give the individual exposure to how new practices, products, policies are implemented within a large institution or practice. At the end of the year, the fellows will present their project at the fellows' conference with an emphasis on the learning experiences gleaned from the process of implementation.

All fellows are members of the Fellowship Selection Committee and the Departmental QA Committee. Fellows are active participants in the interviewing and touring of candidates for the fellowship, and are encouraged to provide input on candidates.

Call assignments

All call assignments meet compliance with the ACGME's 80-hour duty limits, requirement for the rest periods between shifts, and opportunity for days off during the month.

  • In the MOR, fellows take less call than anesthesiology residents, but there is no guaranteed number of calls because the number of residents varies month to month. First call, which is in-house call, begins at 1200 and ends at 0700 the following morning; the fellow has no clinical duties post-call. The second call trainee begins the shift with a "regular" OR day and stays into the evening until the OR comes down to one location. The fellow is usually relieved by 2300 and allowed to go home -and has the next day off. It is unusual for that person to be called back to the hospital once relieved, but he/she must be prepared to do so.
  • On the Pain Service, there is no call at night or on weekends, as the service is covered during those times by the attending on service.
  • In the PICU, the anesthesiology fellows do not take in-house night call, but are required to work during the day on two Saturdays to assist with coverage for pediatric residents and fellows.
  • On the cardiac anesthesiology rotation, hours can vary considerably depending on the caseload and the number of trainees rotating on the service, but fellows are given the day off after late call.

Benefits

Benefits, including salary and vacation time, are determined by the BCMGME Office.

  • Salary CA-4 level (PGY-5) $51,507
  • Vacation 15 working days
  • Health and dental benefits as per GME Office for all trainees
  • Personal/sick time five working days (the ABA does not allow trainees to be away more than 20 days per year without making up that time)
  • Books Provided: Bissonnette and Dalens, Pediatric Anesthesia
  • Book/Meeting Allowance $1,500
  • Parking is assigned by the GME Office (attempts are made to put fellows close to their service) and $72.50 will be deducted from the monthly paycheck.
  • Educational (meeting) time five days
  • Non-clinical time determined by service