Pediatric Emergency Medicine Fellowship

Overview and mission

Thank you for your interest in the Pediatric Emergency Medicine (PEM) fellowship at The Children’s Hospital of Philadelphia (CHOP). This fellowship was one of the first in the nation and has been training leaders in PEM for more than 35 years. Our mission is to provide you with the experiences, education, support and guidance that will allow you to achieve your highest potential as a clinician, educator and researcher. Our faculty is committed to your training, and there is a robust clinical and research mentoring program in place. In addition, you will have opportunities to pursue master's degrees at the University of Pennsylvania if you choose to.

The fellowship program is based out of the Emergency Department (ED) at CHOP, a Level 1 Pediatric Trauma Center that provides care to more than 90,000 children each year. In addition, there are experiences in the pediatric ED of a community hospital, CHOP’s Poison Control Center, and adult rotations in the University of Pennsylvania Health System. We currently have 12 fellows in our program. We anticipate having positions for four fellows annually.

Program snapshot

Fellowship Program Directors
Richard Scarfone, MD
Megan Lavoie, MD

Contact information
215-590-1944
Pemedfellowship@email.chop.edu

Faculty: More than 50 full- and part-time attendings, board certified in PEM, jointly appointed by the University of Pennsylvania and The Children’s Hospital of Philadelphia

Number of fellows: 12

Candidates are accepted upon completion of training in ABP- or ABEM-approved programs in either Pediatrics or Emergency Medicine.

Unfortunately, we can’t accept applicants with J-1 Visas or those from residencies that are not ACGME approved.

Duration: Three years

Application deadline: August 31, application via Electronic Residency Application Service (ERAS)

Interviews: September and October

Special programs:

  • A one-year Emergency Bedside Ultrasound Fellowship is available to those who have already completed a PEM fellowship and is led by Aaron Chen, MD.
  • A combined PEM fellowship with Global Health track, led by Keri Cohn, MD. In this four-year program, candidates complete requirements for the PEM fellowship and are eligible for both the PEM board exam and the CTropMed® examination, with global health experience/research integrated throughout the four years. In addition to standard PEM training, individuals completing the program will acquire skills in clinical emergency tropical medicine (both at home and abroad), global health research training, academic work relating to global medicine, and additional exposure to global health learning opportunities, including a Diploma in Tropical Medicine and Hygiene. If you are interested in this track, apply to the general PEM fellowship via ERAS in the usual manner. If selected to interview, please indicate your interest in global health via email. During your interview, you will learn more about the program and meet Dr. Cohn.

About CHOP

The nation’s first pediatric hospital, CHOP has been providing exceptional healthcare for children since 1855. The Hospital’s mission is to advance pediatric healthcare worldwide through:

  • Excellence in patient care
  • Breakthrough research to cure pediatric diseases
  • Education for future generations of medical professionals
  • Advocacy for children’s health

CHOP is consistently ranked at the top in U.S. News & World Report’s survey of pediatric hospitals, which uses measures such as outcomes, research, patient-staff ratio and safety to evaluate a hospital’s quality. The Department of Pediatrics at CHOP is consistently recognized as one of the nation’s foremost departments of pediatrics in U.S. News & World Report’s survey of U.S. medical schools.

Curriculum overview

First year overview

The focus during your first year of training is to expand your knowledge and clinical skills in the care of patients in the ED. You will supervise pediatric, emergency medicine, and family medicine residents and nurse practitioners in managing acutely ill or injured children. These activities will occur under the direct supervision of a PEM attending physician. Other opportunities include developing your procedure and sedation skills, learning bedside ultrasound, simulation, teaching at resident conferences, and joining a quality improvement committee.

First year curriculum and rotations

Each year of the fellowship contains 13 four-week blocks. There are four weeks of vacation time per year. The first year includes experiences in:

  • Pediatric emergency medicine, including shifts in a community hospital pediatric ED (six blocks)
  • Adult emergency medicine
  • Trauma
  • Anesthesiology
  • Critical care
  • Child abuse
  • Bedside ultrasound
  • Research

Fellows trained in emergency medicine will have rotations in the NICU and subspecialty clinics in place of rotations in adult ED, adult trauma and bedside ultrasound.

Second year overview

During the second year of fellowship, you will continue to refine clinical, teaching and administrative skills and begin to develop a research project that will serve as your “scholarly activity” required by the American Board of Pediatrics.

You will be given progressive responsibility for patient care as you advance through the program. During the second year, you will serve as medical command physician for medical transports, with attending physician supervision. By the end of the second year, you will have the opportunity to serve as the attending physician in the CHOP ED.

Second year curriculum and rotations

The second year includes 13 four-week blocks, including:

  • Pediatric emergency medicine, including shifts in a community hospital pediatric ED (six blocks)
  • Elective/research (two blocks)
  • Transport medicine
  • Anesthesiology
  • Toxicology
  • Adult emergency medicine
  • Sports medicine

Third year overview and curriculum

During the third year, in the clinical realm you will transition to being the attending physician on your ED shifts. In that capacity, you will supervise trainees and be responsible for the management of the patients on your “team” within the ED. At all times, there will be at least one other ED attending physically present in the ED to assist you should the need arise. You will work approximately eight shifts per block in the CHOP ED. This will allow you to make significant progress with your academic project and allow those who are pursuing a master’s degree ample time to complete coursework. 

Regarding research, a goal of this final year of training is to complete patient enrollment or chart review and present your work at a national society meeting. Also, there are continued opportunities to teach this year, including providing didactic lectures at CHOP CME courses in Philadelphia and in Florida.

Educational opportunities

Throughout fellowship there is a focus on developing your skills as a teacher and on creating an educational “portfolio.” Fellows and attending physicians co-facilitate our weekly, monthly and annual teaching conferences. Our ED conference curriculum involves focus on both clinical care and research conferences. As a fellow, you are protected from clinical duties every Wednesday in order to be present for teaching and education. Our Wednesday divisional teaching conferences encompass a broad array of topics: clinical conferences such as morbidity and mortality, clinical case presentations, and “invite the subspecialist.” At these conferences, fellows will be both the teachers and the intended audience. Fellows are also encouraged to attend ED division simulation training, resuscitation and trauma reviews, emergency bedside ultrasound conference, and toxicology grand rounds throughout the month. Our research conference curriculum is made up of a research in progress series, our critical appraisals (an advanced journal club), and presentations of research within our division.

Starting in your second year, if you are interested, you will have the opportunity to pursue a master’s degree in your chosen field at the University of Pennsylvania. The cost for this education will be significantly subsidized by the Division of Emergency Medicine and Department of Pediatrics, resulting in minimal out-of-pocket expenses to you. Previous PEM fellows have pursued degrees in fields as diverse as clinical epidemiology, public health, health policy research and human anthropology. For those who don’t pursue a master’s degree, individual courses in biostatistics, epidemiology, and database management are offered that lead to a certificate in the Clinical Research Certificate Program. This program, which is designed primarily for School of Medicine residents, fellows and faculty, is offered through the Center for Clinical Epidemiology and Biostatistics of the University of Pennsylvania.

In addition to the above listed teaching opportunities, all fellows will have the opportunity to participate in annual teaching conferences within our division: the resident suture and splint workshop, Resident Resuscitation Day, and the annual CHOP ED CME conference. First-year fellows attend Base Camp, a multidisciplinary, simulation-based workshop held in New York. Fellows also attend the annual National PEM Fellows’ conference. Also, all fellows will be provided training in Advanced Cardiac Life Support (ACLS), Advanced Trauma Life Support (ATLS), and Pediatric Advanced Life Support (PALS).

Mentorship

Soon after starting fellowship, you will be paired with both a clinical and research mentor, who will remain your mentors throughout your fellowship. These mentors, who are faculty within the Division of Emergency Medicine, are dedicated to assisting you in achieving your goals. 

Your clinical mentor will:

  • Assist you in acquiring and mastering clinical, procedural and teaching skills.
  • Be available to preview/edit your lecture or case conference material.
  • Help foster clinical questions to direct your research interests.
  • Facilitate your ability to achieve work/life balance.
  • Share with you areas for improvement and offer formative feedback.
  • Serve as a role model for your career development.

Your research mentor will:

  • Assist you in identifying an important clinical question and designing a research project to address that question.
  • Guide you in every phase of the project including IRB submission, data collection and analysis, and writing a manuscript.
  • Assist you in preparing to present initial research ideas or results at the annual National PEM Fellows’ Conference or at a national society meeting.

Research opportunities

  • The members of our Division of Emergency Medicine are active in clinical research. This includes multi-institutional research as one of about 20 national members of PECARN (Pediatric Emergency Care Applied Research Network).
  • The fellowship will prepare you to acquire and develop skills in research methodology and critical evaluation of the medical literature.
  • The Division of Emergency Medicine has weekly research seminars and monthly seminars in critically appraising the medical literature. You will have the chance to be both a student receiving this instruction and a facilitator leading one or more of these sessions.
  • You will obtain individualized research education from a faculty research mentor or advanced academic training in education curriculum development or quality improvement.
  • All fellows are required to complete a research project or other academic endeavor, such as curriculum development or a quality improvement project, to qualify to take the Pediatric Emergency Medicine board exam.

How to apply

Our three-year fellowship seeks physicians who will have completed three years of training in an accredited residency program in pediatrics or emergency medicine. Our fellowship program participates in the National Resident Matching Program and the ERAS universal application process. We will not accept fellows outside of the NRMP.

For an application and to upload documents, please visit www.aamc.org/eras.

Program requirements

  • Completed online application
  • Current photograph (released only after interview is offered)
  • Personal statement
  • Three letters of recommendation
  • Dean's letter
  • Medical school transcript
  • Parts 1, 2 and 3 of the USMLE, taken within the seven-year time frame as required by the Commonwealth of Pennsylvania, or equivalent scores
  • If a graduate of a medical school outside the United States, Canada or Puerto Rico, valid ECFMG certificate or one that does not expire prior to the start of the fellowship

Deadline for applications

The deadline for completed applications is August. 31. The fellowship directors will review completed applications, and selected candidates will be invited to interview during the months of September and October.

Tobacco-free hiring policy

To help preserve and improve the health of our patients, their families and our employees, The Children’s Hospital of Philadelphia has a tobacco-free hiring policy. This policy applies to all candidates for employment (other than those with regularly scheduled hours in New Jersey) for all positions, including those covered by the Collective Bargaining Agreement.

Job applicants who apply after July 1, 2014 will be expected to sign an attestation stating they’ve been free of nicotine or tobacco products in any form for the prior thirty (30) days. They will also undergo a cotinine test as a part of the Occupational Health pre-placement drug screen administered after the offer of employment has been accepted but before the first day of hire.

Exemptions: Attending physicians (excluding CHOP physicians in the Care Network), psychologists, principal investigators and/or Penn-based faculty are exempt from this process to better align with our colleagues at the University of Pennsylvania Perelman School of Medicine.

More information

For information or questions about the Pediatric Emergency Medicine Fellowship, please contact Marciel Gonzalez at 215-590-1959 or via email.