The overall objective of the training program is to provide the trainees with excellent clinical training, resources to pursue independent research, and unique opportunities for educational pursuits. Our philosophy is that by providing a strong foundation during the early parts of the fellowship and a stimulating environment, the trainee will acquire the skills necessary for independence in clinical decision making, research design, and educational and administrative endeavors.

Patient Characteristics
The Yale-New Haven Children's Hospital Pediatric Emergency Department is unique in that it serves a diverse population of patients. The ED enjoys a strong working relationship with the approximately 200 affiliated pediatricians who utilize the services of the Children's Hospital for emergency and inpatient care. The current annual census is 28,000 and growing.

Facilities
The pediatric emergency department is open 24 hours per day, seven days per week. It is a full service facility with eleven full-purpose rooms, one urgent care room, and a two-bay resuscitation suite. Yale-New Haven Children's Hospital is an ACS-certified Level I Trauma Center. The attendings and fellows provide pediatric trauma care in close cooperation with our colleagues from pediatric surgery.

Fellows in PEM also rotate through Hartford Hospital in Hartford, Connecticut, the site of the Connecticut Poison Center. For general emergency medicine, the fellows have opportunities to rotate through either Yale-New Haven Hospital or Bridgeport Hospital, a high-acuity, inner-city hospital located in Bridgeport, Connecticut.

Curriculum

Electives
Being closely affiliated with Yale University School of Medicine, the fellowship offers many options for elective time. The fellows have taken advantage of the elective months to pursue a variety of different interests. In the past these have included: pediatric radiology, pediatric critical care, wilderness advanced life support, pediatric cardiology, and emergency ultrasound. Research months may be used to complete an area of concentration such as toxicology, international medicine, etc. with approval of the fellowship director.

Process of Evaluation
The fellows are evaluated by the attending and nursing staff on a semi-annual basis.

Administrative Duties
The fellows participate in the weekly business meetings of the Section of Pediatric Emergency Medicine.

Clinical Duties
During the first six months of the fellowship the majority of the clinical duties will be in the pediatric emergency department. The shifts are between 8 and 10 hours. After the first six months the fellows will have overnight duties. During the PEM months the fellows will be assigned to between 11 to 13 shifts. The number of shifts is reduced during elective, administrative, and research months. There are no assigned shifts in the PED for months on trauma, adult EM, and pediatric critical care. Special arrangement can be made for "away" electives including international opportunities.

Educational Pursuits
The fellows actively organize and participate in weekly educational sessions. The formats of the meetings have included didactic teaching, hands-on workshops, interactive discussion of interesting cases, and morbidity and mortality conferences. Bi-weekly radiology round is conducted with dedicated pediatric radiologists.

The Section participates in daily morning resident teaching conferences, weekly mock resuscitations, monthly journal club, and monthly general emergency medicine didactic sessions. Section members also perform community outreach by providing education to parent groups, pre-hospital care providers, guardian ad litem, and day care and school staff.

Research Interests
The attendings and fellows actively pursue a wide range of research projects. Some of these include:

• Serious bacterial infections in febrile infants
• Faculty and staff effectiveness evaluations
• Forensic medicine
• Reduction of unnecessary outpatient antibiotic use
• Use of point-of-care testing
• Abusive versus accidental head trauma
• Inflammatory markers in appendicitis
• Pre-hospital care of asthma patients
• International health care

Application Process
Residents completing their training in either pediatrics or emergency medicine are encouraged to apply. The fellowship is highly competitive, with over 80 applications received each year for the one available spot. Completed applications must be received by September 1st. Interviews are conducted during September, October, and November. The pediatric emergency medicine program at Yale-New Haven Hospital participates in the national residency match through the Electronic Residency Application Service (ERAS).

Complete information, including faculty information, can be obtained by visiting the Department of Pediatrics, Section of Emergency Medicine Fellowship Training Program Website.

Additional information may also be obtained by emailing the fellowship director, Dr. Karen Santucci.

Contact Information
Karen Santucci, M.D., Fellowship Director