A National Assessment of Pediatric Surgical Critical Care Fellowship Structure: Defining the Training Experience.

Abstract

Background: Pediatric Surgical Critical Care (PSCC) is a unique specialty incorporating fundamental principles of surgical, neonatal, and pediatric critical care. This study aims to characterize the current landscape of PSCC training to identify opportunities for educational standardization and improvement.

Methods: An anonymous electronic survey-based assessment was distributed to the program directors (PDs) of all current ACGME-accredited PSCC fellowships (n = 14). The survey investigated two main program domains: administrative (program size, accreditation, recruitment strategies) and educational (curricula components, learning resources, rotation schedule). Graduate outcomes (estimated board passage rates) were also assessed. Descriptive statistics were performed.

Results: The survey response rate was 100 %. The majority of primary administrative ACGME accreditation responsibilities are managed either by the pediatric surgery section/department (79 %) or the adult surgery department (21 %). Only 29 % of PDs use a pediatric specific structured curriculum that details specific benchmarks for medical and procedural knowledge. Formalized reading lists and standardized resources are utilized by 64 %. All programs offer recurrent educational lectures to fellows by a variety of faculty. There is marked heterogeneity related to time spent in various core and elective rotations. Average duration spent on a PSCC service was 5.1 months (0-10months). However, only 14 % of programs reported these months to consist of primary patient management responsibilities.

Conclusion: This evaluation of PSCC fellowships demonstrated variability in curriculum, content, and resources. These results support future multidisciplinary efforts to more clearly standardize the fellowship experience in order to ensure practice readiness of these uniquely qualified surgeons.

Levels of evidence: Level V.