Pediatric Emergency Medicine

Pediatric Emergency Medicine

Pediatric Emergency Medicine

Program Goal

The PEM fellowship at Harbor-UCLA Medical Center is a two-year (EM-trained) or three-year (Pediatrics-trained) program designed to produce stellar clinicians able to care for acutely and critically ill children in the emergency setting, whether they are bound for a career in community practice or academics.

Program Highlights

Fellows get a well-rounded clinical experience in two PEDs that complement each other.

  • Harbor-UCLA Medical Center is an academic public hospital PED that sees around 25,000 pediatric patients annually. It is a Level I Trauma Center and a Pediatric Critical Medical Patient Receiving Center, and also serves the South Bay community providing “bread and butter” EM care.
  • Children’s Hospital of Orange County is an ED in a tertiary care private children’s hospital that sees nearly 100,000 pediatric patients annually. It is a Level II Trauma Center and provides general and subspecialty pediatric EM care to a large geographic area around Orange County.

Our program prides itself on providing fellows flexibility in curriculum and electives within the confines of ACGME-required rotations to accommodate individual learning needs. For example, a fellow:

  • Can be primarily EM or pediatrics residency-trained.
  • Wants to pursue a career in research, administration, or education.
  • Wants to explore other areas such as ultrasound, social EM, or EMS.

We also train combined PEM-US fellows.

Fellows gain graduated autonomy with rapid attainment of independence in seeing patients and supervising residents as well as in running the pediatric emergency department at Harbor-UCLA.

Numerous opportunities for education come in the form of protected conference time twice a month, POCUS training with ultrasound faculty, PALS, NRP, and ATLS, simulation center, cadaver labs, research methodology training, and mentorship.

Fellows have ample opportunity to gain procedure skills through procedure labs, a well-equipped and staffed simulation center, a pediatric anesthesia rotation, a rotation in a high-acuity PICU, training in a busy Level I Trauma Center, a fellowship housed within a Department of Emergency Medicine with a well-established EM residency program, and skills sessions as part of the core curriculum.

Fellows get the ability to develop skills in classroom and bedside teaching through supervision of residents, preparation and presentation of formal lectures to medical students and EM residents, and participation in presenting (with an emphasis on interactive lecture styles, e.g. games, questions, panels, etc.) as part of our fellowship core curriculum, which repeats every two years. Fellows receive mentorship from nationally recognized faculty speakers.

EM residency-trained fellows do two shifts per month in the adult ED to maintain their skills in treating adults and can moonlight in the adult ED as well.

Funds are available to support fellows presenting research at academic meetings.

Curriculum Overview

We have designed this curriculum based on whether a PEM fellow is primarily pediatrics or EM residency-trained. We have further customized it according to a fellow’s needs and goals established during individual meetings with the program director. You may find more information here.

EM Residency-Trained (Two-Year track)

Year 1

  • Harbor-UCLA PED and Research: Three to four months (10 PED shifts + two AED shifts)
  • CHOC PED: Two to three months (14 PED shifts)
  • CHOC PICU: One month (no ED shifts)
  • Pediatric Subspecialty Clinics & Child abuse: One month (one PED + one AED shift)
  • Clinics or Pediatric Dermatology: Two weeks (one PED + one AED shift)
  • Pediatric Cardiology: Two weeks (one PED + one AED shift)
  • Pediatric Anesthesia at CHOC: Two weeks (No ED shifts)
  • Research/Scholarly Activity: Two weeks (two PED + two AED shifts)
  • Elective: One month (none to four PED/AED shifts depending on elective)
  • Vacation: One month (generally taken in two two-week blocks)

Year 2

  • Harbor-UCLA PED and Research: Three to four months (10 PED shifts + two AED shifts)
  • CHOC PED: Two to three months (14 PED shifts)
  • CHOC NICU: Two weeks
  • CHOC PICU or CVICU: Two weeks
  • Admin/Research: One month (two PED + two AED shifts)
  • Research/Scholarly Activity: One month (two PED + two AED shifts)
  • Elective: Two months (none to four PED/AED shifts depending on elective)
  • Vacation: One month (generally taken in two two-week blocks)

Pediatrics Residency-Trained (Three-Year track)

Year 1

  • EM Orientation: Two weeks at the beginning of July (includes procedure labs and introduction to ultrasound, four PED shifts)
  • Pediatric Anesthesia at CHOC: Two weeks (no PED shifts)
  • Harbor-UCLA PED and Research: Three to four months (10 PED shifts, 50:50 clinical & research)
  • CHOC PED: Two to three months (14 PED shifts)
  • CHOC PICU: One month (no PED shifts)
  • Adult ED/Ultrasound: One month (12 Adult ED shifts)
  • Trauma/Ultrasound: One month (12 ED Trauma shifts)
  • Admin/Research: One month (four PED shifts + Admin meetings)
  • Vacation: One month (generally taken in two two-week blocks)

Year 2

  • Harbor-UCLA PED and Research: Three to four months (10 PED shifts, 50:50 clinical & research)
  • CHOC PED: Two to three months (14 PED shifts)
  • Research: Two months (four PED shifts)
  • Adult ED/Ultrasound: One month (12 adult ED shifts)
  • Toxicology/EMS: One month (includes four PED shifts)
  • Elective: One month (none to four PED shifts depending on elective)
  • Vacation: One month (generally taken in two two-week blocks)

Year 3

  • Harbor-UCLA PED and Research: Four to five months (10 PED shifts, 50:50 clinical & research)
  • CHOC PED: Two to three months (14 PED shifts)
  • Research: Three months (four PED shifts)
  • Elective: One month (none to four PED shifts depending on elective)
  • Vacation: One month (generally taken in two two-week blocks)

Electives

Elective opportunities include CVICU at CHOC, outpatient cardiology at UCLA, toxicology at UCLA, pediatric dermatology at CHLA, burn center at LAC/USC, orthopedics, radiology, additional ultrasound, advanced EMS and disaster, child and adolescent psychiatry, public health, medical Spanish, FOAM, as well as individually arranged electives.

Eligibility and Selection

Eligibility

We will consider your application if you:

  • Have graduated from a U.S or Canadian medical school accredited by the LCME, or
  • Are an International Medical Graduate with a current, valid ECFMG certificate, and
  • Have completed a residency in pediatrics or emergency medicine.

We are unable to sponsor J-1, H-1B, or F-1 visas.

Selection

Our program greatly benefits from having pediatrics and EM residency-trained faculty and fellows. Criteria for an applicant’s selection as a fellow include:

  • Review of ERAS application.
  • Interview with the program director and other department faculty.
  • Letters of recommendation (we require at least three).
  • Through the PEM fellow match, if the program participates in a given year.

On rare occasions and under special circumstances, we may select applicants outside of the match.

Selection depends on the dossier of an applicant; clinical, leadership, teaching, and supervisory skills; ability, aptitude, and academic credentials; and our program’s fit with the applicant’s needs and desires for training. We also consider professionalism and communication skills.

Our Faculty and Alumni’s FOAM Presence

PEMplaybook.org: Tim Horeczko, Program Director
PEMsource.org: Kelly Young, Program Director Emeritus
EIIC toolkits: Mohsen Saidinejad, DEM Faculty
ACEP Simbox: Ilene Claudius, DEM Faculty
EM ReSCu Peds: Patricia Padlipsky, DEM Faculty
PEMgems.com: Joe Ravera, PEM Fellow Alumnus
EMdocs.net: Manny Singh, DEM Faculty
Wikem.org: Ross Donaldson, DEM Faculty
IDHEAL Social EM Modules: Multiple DEM Faculty and Former Residents

Contact Information

Timothy Horeczko, MD, MSCR, FACEP, FAAP
Director, Pediatric Emergency Medicine Fellowship
Professor of Clinical Emergency Medicine
[email protected]

The Harbor-UCLA Family

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