SPA Newsletter

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Fellows Corner

What should a pediatric fellowship include, a fellow's perspective

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(Let fellowships be for the fellows)

As a fellow in pediatric anesthesia I have watched the recent past as large centers obtained accreditation from the ACGME. If the momentum of these efforts continues along what seems their natural path, then in the not too distant future a new boarded specialty in anesthesia will emerge. Much discussion has begun to take place centering on what is, or should be taught to fellows in pediatric anesthesiology. As the field begins to define itself, programs seem eager to develop a more formal curriculum, perhaps even to standardize a national curriculum. Everyone seems to have his or her own two cents about what should be included, so here's mine.

The fellowship process should of course have some formalized goals, delineating the types of experience and knowledge that will be gained by the participant, a curriculum of important topics in pediatric anesthesia, opportunities to gain experience, confidence and improve manual skills. All these things clearly belong in a fellowship, but there should also be time allotted to adjust the experience to meet future career goals. Much is not taught to residents for the sake of keeping the scope circumscribed and manageable. Fellows ought to be taught additional topics: operating room design, scheduling and business management would prove useful for those who think they may like to become administrators. Presentation development, and lecture techniques would be invaluable to those who would be educators. Experimental design, statistical analysis, and writing grant proposals are important abilities for those who plan a future in research. Job searching skills such as contract negotiations and practice evaluation ought to be divulged during fellowship.

These are just some examples of the information and knowledge which could be passed on. My list is by no means complete. There should be enough flexibility in the planning of the fellowships, so that each individual can get exposed not just to pediatric anesthesia, but the various ways of practicing as well. Enough time should remain, so fellows may endeavor to begin practicing while they still have a bevy of mentors available to them. This is what will prepare tomorrow's fellows to enter the world fully prepared for whatever career path they choose.

Lucas V. Terranova, MD

Fellow in Pediatric Anesthesia

Children's Hospital of Philadelphia

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