Critical Care Team RoundingThe UAB Pediatric Critical Care Fellowship is a fully accredited three-year program that combines research and clinical experiences to prepare our trainees to become excellent intensivists who are ready to become successful in the academic setting. The 36-month curriculum includes 17.5 months clinical service, 18.5 months protected research time, and nine weeks of vacation. 

Clinical Services are housed in the new Children’s Benjamin Russell Hospital, a 750,000 square foot, $400 million expansion facility on the UAB health system’s downtown Birmingham campus.

Pediatric Intensive Care Unit (PICU)
- 10 months spent in PICU
- 22-bed multispecialty, combined medical surgical unit
- Approximately 1,300 admissions per year
- Wide variety of common and rare critical illnesses representing all subspecialties.
- Only level one pediatric trauma center in the state of Alabama, ensuring adequate preparation in caring for children with complex multiple traumas including those with serious traumatic brain injuries.

The Cardiac Intensive Care Unit (CVICU)
- 4 months spent in CVICU
- 20-bed service
- Approximately 250 cases of congenital heart disease that require cardiopulmonary bypass each year.
- Trainees are exposed to the care of neonates and infants with very complex heart defects including extracorporeal membrane oxygenation and mechanical assist devices.  

Additional clinical rotations
- Anesthesia
- Pulmonary
- Palliative care
- Cardiology/cath lab services. 

Fellows also devote time and effort to academic interests including research projects (clinical, translational, or bench research), and are able to select a research mentor from across all specialties on the UAB campus.  The critical care curriculum includes training in Quality Improvement with a one-day mini quality academy and a required QI project to be completed during the course of training.  Our faculty has developed a very extensive curriculum that is geared towards preparing our trainees to meet the challenges of being an excellent intensivist as well as facing the critical care boards successfully.

Program Information

  • Curriculum

    First Year

    • 4 months Pediatric Intensive Care Unit (PICU)

    • 2 months Cardiac Intensive Care Unit (CVICU)

    • 1 month Cath Lab / Cardiology

    • 1 month Anesthesia

    • 4 months Research


    Second Year

    • 3 months PICU

    • 1 month CVICU

    • 2 weeks Pulmonary/Palliative Care (one week on each service)

    • 2 weeks Sedation

    • 7 months Research


    Third Year

    • 3 months PICU

    • 1 month CVICU

    • 9 months Research


    Electives

    Rotations are available in Sedation, Critical Care Transport, Burn, Adult Critical Care, or any other critical care related rotations.

  • Conferences

    Weekly Conferences

    PICU Noon Conference- Case Conference held three times per month, and Morbidity and Mortality Conference held once per month.

    PICU Fellows’ Conference- The text, Fuhrman Pediatric Critical Care, 4th Edition, is used as the basis for the curriculum for this conference, with the entire textbook reviewed over a 3-year period.  Journal Club is also a part of the Fellows’ Conference, and is held 5-6 times each year.  Faculty facilitators assist fellows in selecting and presenting articles to be discussed at Journal Club. 

    Combined Fellows’ Conference- Includes fellows from Neonatology, Pulmonary, and Critical Care. Although physiology topics are covered, the conference is also used to cover core curriculum topics that are helpful to fellows across subspecialities. Topics include research issues such as gathering and analyzing date; QI topics; and risk management topics. 

    Grand Rounds- features speakers from various departments here at UAB and external speakers from academic medical centers around the U.S. 


    Monthly Conferences

    PICU/ED/Hospitalist Combined Fellow Conference- This is a combined conference for Critical Care, Emergency Medicine and Hospitalist fellows and covers topics such as shock, abuse, toxicology and respiratory cases.

    Child Health Investigative Forum (CHIF)- Organized to promote internal discussion of research related topics across division and departmental lines.  Presentations may cover any type of research related to child health, and can include research in the basic sciences, clinical investigation, public health, health systems research, medical humanities, or any other child-health related areas of interest to pediatrics and related subspecialties.

    Pediatric Fellow Core Educational Conference- Supplements individual divisional level educational efforts.  The primary focus is on topics that cross all fellowships such as library resources, contracts, leadership and mentorship.

  • Research Training

    The goal of the research experience is for the Critical Care fellow to learn sound methodology in designing and performing research studies and to learn how to correctly interpret and synthesize research data.  During this phase of training, the Critical Care Fellow will work under close guidance of the research mentor and the Scholarly Oversight Committee.  Fellows may choose any research mentor on the UAB campus – from clinical researchers, to translational researchers, to bench researchers.

    UAB IRB Training

    Fellows' Research Projects

    • Utilizing a delirium score in sedated intubated children in PICU

    • Improving sepsis through goal-directed algorithm

    • Long term PALS retention following RCDP

    • Hyperchloremic metabolic acidosis – Does it matter?

    • Effect of Noninvasive ventilation vs. supplemental oxygen therapy on reintubation in high-risk infants following congenital heart surgery

    • Monitoring Central Venous Pressure and its Relationship to Achieving Initial Therapeutic End Points and Fluid Overload in Patients with septic shock

    • Staphylococcous aureus severe invasive infections requiring admission to pediatric intensive care

    • Diurnal Sedation Variation and the Impact on Ventilation Liberation

    • Implementation of measures to increase palliative care utilization in the pediatric ICU

  • QI Training

    So What Is Quality Improvement?

    Quality Improvement is a systematic, data-driven, iterative problem solving process that can be adapted to local context. 

    Systematic: use of a standard methodology that ensures we do not “cut corners” when identifying, defining, measuring, and analyzing a problem. In other words, QI is not a NIKE project (“just do it”).

    Data-driven: use of efficient and effective data gathering, measuring and analyzing techniques during baseline data collection as well as after implementation of an improvement. 

    Iterative: small tests of change when implementing a proposed solution are key to learning quickly about potential success.

    Adapted to local context: we must recognize that the local culture (of the unit, organization, etc.) and needs of our “customers” require us to adapt a solution for best fit.

    This passage by Paul Batalden (Qual. Saf. Health Care 2007;16:2-3) is a good summary: The combined and unceasing efforts of everyone – health care professionals, patients and their families, researchers, payers, planners, administrators, educators – to make changes that will lead to

     - Better patient outcomes
     - Better system performance, and
     - Better professional development

    Below is a table comparing some of the more popular QI methodologies with the approach we take at UAB.

    Comparison of Different Quality Improvement Models
    PICUQI Chart

    All residents and fellows at UAB/COA are provided a standard curriculum in QI and Patient Safety, through our Mini Quality Academy (MQA). This training provides the top 12 tools and skills needed to be an effective member of a robust QI team. It is offered in an adult-learning environment during a one day (8 hour) course. We are fortunate to additionally offer more in-depth training for those who wish to pursue a career in QI, Patient Safety, or Outcomes Research. These curricula include a Graduate Certificate Program in Healthcare Quality and Patient Safety, and a Master’s Degree in Healthcare Quality and Safety. Both of these programs are offered through the UAB School of Health Professions, and are excellent opportunities for our fellows to pursue during their training here.

     The general outline for our fellows’ QI activity spans the 3 years of fellowship. A typical timeline for this work:

    Year 1

    •  Attend the MQA

    •  Make observations about processes within critical care that need improvement

    •  Meet with QI mentor twice to begin to identify a candidate project


    Year 2

    •  Fully define QI project

    •  Identify team members for QI project

    •  Data collection, measurement, and analysis

    •  Continue regular meetings with QI mentor


    Year 3

    • Implementation of improvement

    • Ongoing monitoring of the change

    • Preparation for publication of project


Our Team

Priya Prabhakaran, M.D.

Priya Prabhakaran, M.D.

Fellowship Program Director

Letter from the Director

Thank you for your interest in the UAB Pediatric Critical Care Medicine Fellowship Program.  Our fellowship website contains information about the fellowship program, the Critical Care Division, and the tremendous facilities we enjoy here at UAB and Children’s Hospital of Alabama. 

BRHFC campus shot 500 pxOur fully accredited three-year program combines research and clinical experiences that makes our graduates eligible and prepared for the American Board of Pediatrics Subspecialty Board examination in Pediatric Critical Care Medicine.  The goal of the Pediatric Critical Care Medicine Fellowship Program is to provide trainees with the education, clinical experience, research training, and technical skills necessary to become excellent intensivists who are ready to become successful in the academic setting. The 36-month curriculum includes 17.5 months clinical service, 18.5 months protected research time, and nine weeks’ vacation. 

Clinical service takes place in the busy 22-bed multispecialty Pediatric Intensive Care Unit (10 months) and the 20-bed Cardiovascular Intensive Care Unit (4 months). The Pediatric Intensive Care unit is a combined medical surgical unit. With approximately 1,400 admissions per year, our trainees are exposed to children with a very wide variety of both common and rare critical illnesses representing all subspecialties. Children’s of Alabama is the only level one pediatric trauma center in the state of Alabama, and this ensures adequate preparation in caring for children with traumatic injuries, including those with serious traumatic brain injuries. The Cardiac intensive care unit is a busy service with approximately 250 cases of congenital heart disease that require cardiopulmonary bypass each year. Trainees are exposed to the care of neonate’s and infants with very complex heart defects including extracorporeal membrane oxygenation and mechanical assist devices.  Both of these units are housed in the new Benjamin Russell Hospital for Children, a 750,000 square foot, $400 million expansion facility on the UAB health system’s downtown Birmingham campus.  Fellows also complete clinical rotations with anesthesia, pulmonary, palliative care and cardiology/cath lab services. 

Fellows devote time and effort to academic interests including research projects (clinical, translational, or bench research), and are able to select a research mentor from across all specialties on the UAB campus.  The critical care curriculum also includes training in Quality Improvement with a one-day mini quality academy and a required QI project to be completed during the course of training.  Our faculty has developed a very extensive curriculum that is geared towards preparing our trainees to meet the challenges of being an excellent intensivist as well as facing the critical care boards successfully.

Priya Prabhakaran, M.D.

Professor of Pediatrics
Director, Critical Care Medicine Fellowship


 

Vanessa Snider

Vanessa Snider

Fellowship Program Coordinator

vsnider@peds.uab.edu