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The average daily Pediatric Surgical Service inpatient census is approximately 40 patients with a range of 15-70 plus. Of the 17 main campus operating rooms, a minimum of 2 per day, and regularly 3 or 4, are committed to the General and Thoracic Pediatric Surgical Service. This is in addition to a six O.R. ambulatory Surgicenter that is part of the Children’s Health System and located about 10 minutes south of the main campus. This latter facility serves as a site of pediatric surgery ambulatory training when fellows desire to attend, but often the surgical offerings at the main campus facility more than adequately meet the needs for suitable training opportunities. Ambulatory (1/2 day) weekly clinic experience is a mandatory part of the trainee experience as well.

The training program has been designed to maximize exposure to a high volume of diverse surgical problems in infants and children, representing all the essential areas in contemporary pediatric surgery. The trainee will be exposed to congenital, neoplastic, infectious and other acquired conditions of the GI system and other abdominal organs; of the blood and vascular system; of the integument; of the diaphragm and thorax (exclusive of heart); of the endocrine glands; of the gonads and reproductive organs; and of the head and neck. 鈥疭imilar experience is afforded in traumatic conditions of the abdomen, chest, head, neck and extremities in patients up to the age of 18 years. 鈥疶his includes both nonsurgical and operative management of multi-organ system injury and burns. This also includes experience with and the development of competence in the complete care of the critically ill infant or child, including ECMO, management of ventilators, basic and advanced monitoring techniques, nutritional assessment and management and competence in recognition and management of clotting and coagulation disorders.

Advanced laparoscopic pediatric surgery is a programmatic strength and this experience is integrated into the training program. The surgical faculty includes thirteen pediatric surgeons from diverse training backgrounds at a variety of career stages working collectively with three pediatric cardiovascular surgeons, two dedicated plastic surgeons, five pediatric urologists, four neurosurgeons, six pediatric orthopedic surgeons, and eleven pediatric otolaryngologists within a single practice unit.

The training program curriculum includes exposure to, and progressive responsibility for, a large volume of routine, as well as complex patients with pediatric surgical problems. Graded responsibility is given to the fellow for evaluation, perioperative management, and operative care of these patients. The curriculum includes a structured series of didactic sessions that address pathophysiology, relevant basic science and clinical principles based on the SCORE curriculum. There is clinical correlation of complex congenital and acquired problems of the gastrointestinal tract, cardiorespiratory system and urologic tract as well as responsibility for surgical oncology, critical care, trauma and burns. Both the junior and senior trainees have generally attended one annual pediatric minimally invasive training course put on by the Association of Pediatric Surgery Training Program Directors, and the senior fellow attends a similar pediatric oncology program at St. Jude’s Children’s Hospital.鈥� The program is committed to supporting trainees to attend these national endeavors. Fellows are supported for one professional meeting annually, usually the APSA or AAP meeting, as well as other meetings for professional presentations as approved by the program director.

The two-year fellowship is designed to advance the skills of the trainee in a graded fashion. 鈥疍uring year one, the trainee has the opportunity to spend one month each on neonatology, the pediatric intensive care service or the urology service if desired, and these rotations are highly encouraged. 鈥疘n addition, elective time is available in other specialties that may suit the trainees needs. 鈥疶he trainee maintains night call responsibilities on the pediatric surgical service during off-service rotations. ACGME hour restrictions and rules are followed explicitly. 鈥疨articipation with the cardiac surgery service is on an individual case basis for PDA ligations, vascular rings, coarctations, or the other occasional but relevant procedures as they arise. 鈥疉irway and esophageal foreign bodies are assigned on an alternating weekly basis to the otolaryngology and pediatric surgical services. The first year includes a minimum of 6 months on the pediatric surgical service to familiarize the trainee with general pediatric surgery, although most fellows spend at least 10 months of dedicated time on the pediatric surgical service. The entire second year is spent on the pediatric surgical service. The senior fellow takes on oversight responsibilities for the entire clinical service and will serve as the administrative leader of the house staff. At present, the junior pediatric surgery fellow, a pediatric surgical critical care fellow, a general surgery PGY4, and two senior general surgery research residents alternate senior in-house call. In house call is necessary because the Children’s Hospital is a designated American College of Surgeons Level I Pediatric Trauma Center. Additionally, the generally high volume of the inpatient service, EDTC and inpatient consultations, and critical care management predict active involvement both day and night by the senior residents and fellows. 鈥疓eneral surgery PGY1 and PGY2 residents are also part of the call team with an established night float system; therefore, there is always a senior surgical trainee and a junior surgical resident in house.

Mandatory Conferences

Pediatric Surgery Fellow Conference | Every Monday, 6:30-7:30 a.m.
Oral boards format that follows the SCORE curriculum and is led by rotating faculty

Pediatric Surgery M&M Conference | Every Thursday, 7-7:45 a.m.
Led by the first-year fellow including identifying and presenting cases as well as assigning quality and safety designations within the division’s surgical database

Pediatric Surgery Grand Rounds | Every Thursday, 7:45-8:30 a.m.
Presenters and topics are identified on a bi-annual basis and include on-service residents and fellows, institutional faculty (both from the pediatric surgery group and other departments), and visiting faculty

Trauma Conference | 1st Tuesday Monthly, 6:30-7:30 a.m.

Optional Conferences

• Colorectal Conference | Every Monday, 7-8 a.m.
• Research Conference | Every Tuesday, 4-5 p.m.
• Fetal Anomalies Conference | Every Wednesday, 7:30-8:30 a.m.
• 麻豆学生精品版Department of Surgery Grand Rounds | Every Wednesday, 7:30-8:30 a.m.
• Solid Tumor Conference | Every Friday, 12-1 p.m.

The basic and clinical science research programs in the Division of Pediatric Surgery are quite active and several faculty have ongoing clinical research. Each trainee is encouraged to develop an abstract or manuscript for national publication annually although this is not mandatory. Appropriate research personnel are available to provide assistance, as trainee time for IRB submission and research endeavors is limited. The first-year fellow is responsible for the weekly morbidity and mortality conference and its attendant quality and safety designations within the divisions’ surgical database. This role typically extends into the development of, or work on, a quality improvement initiative during the two-year fellowship program.