Extracorporeal Life Support Fellowship Program

Program overview

The Pediatric Extracorporeal Life Support (ECLS) Fellowship Program is a one-year clinical fellowship position with the goal of mentoring and specialty training board-certified/eligible pediatric intensivists and cardiac intensivists in ECLS. One trainee will be accepted per academic year (start date early July).

Program Leadership

Program Goals

The specific goals of the ECLS clinical fellowship include:

  1. To identify the indications and describe the procedures required for ECMO
  2. To identify and perform, when appropriate, the construction and priming of ECMO circuits.
  3. To understand and co-manage the ECMO cannulation procedure.
  4. To co-manage, in collaboration with other members of the medical team and under the supervision of attending physicians, patients on venovenous and venoarterial ECMO, including management of multiple organ systems.
  5. To identify the indications for and co-manage the ECMO decannulation procedure.
  6. To describe other forms of extracorporeal life support, including ventricular assist devices (VADs), renal replacement therapies (RRT), and plasmapheresis, including indications/contraindications, management, and complications with associated troubleshooting.
  7. To describe indications and manage anticoagulation and various blood product replacement of patients on different ECLS technologies.
  8. To describe key principles for developing and maintaining an academic ECMO program.

Eligibility

  • Board eligible/certified in Pediatric Critical Care Medicine or board eligible/certified in Pediatric Cardiology with additional 1-year Pediatric Cardiac Critical Care Fellowship
  • Board certified in General Pediatrics
  • USMLE certification or equivalent
  • PALS, ACLS certifications
  • Completion of CHOP core application materials
  • Visa eligibility for training, if needed

Accreditation

This is a non-ACGME accredited position.  There is no board certification following the completion of this one-year clinical fellowship.

Curriculum

Clinical experiences will primarily focus on techniques, management, and decision making surrounding the use of ECLS. The fellow will be supervised by Drs. Brunetti and Himebauch, but the fellowship curriculum and experiences will be both multidisciplinary and interdisciplinary, incorporating pediatric critical care, cardiac critical care, and neonatology physicians, as well as ECMO specialists, perfusionists, cardiothoracic surgeons, general surgeons, hematologists, nephrologists, palliative care experts, adult critical care experts, and simulation faculty. The fellow will have a clinical/academic mentor assigned within the first month of fellowship.  While the curriculum is outlined below, the fellowship will be tailored to meet the particular needs of the trainee.

Clinical Experiences: 36 weeks (70%)

  • PICU/CICU Senior Fellow (8 weeks)
  • NI/ICU ECMO Resource Team Fellow (2 weeks)
  • Adult ICU at the Hospital of University of Pennsylvania (4 weeks)
  • ECMO Core Team, including priming, maintenance, and troubleshooting of ECMO circuits as well as intra- and inter-hospital transports (6 weeks)
  • Dialysis Team (4 weeks)
  • Plasmapheresis Team, including Transfusion medicine (2 weeks)
  • Heart Failure/Ventricular Assist Device Team (2 weeks)
  • Perfusion and CV Surgery (2 weeks)
  • Thrombosis Team (2 weeks)
  • Palliative Care (2 weeks)
  • Elective(s) (2 weeks)

Educational/Administrative/Research: 12 weeks (22%)

  • Lead 4 ECLS-related lectures and/or case conferences at CHOP
  • Participate in 6 ECMO simulations in the CICU, PICU, NICU, and/or during fellow orientation
  • ECMO Core Team education attendance
  • Completion of a QI project (e.g.  develop an ECMO-related guideline)
  • Attendance at a national or international ECLS conference
  • Option to participate in clinical or translational research

Vacation: 4 weeks (8%)

Educational Activities

There are many ECLS resources available to support fellowship trainees. Fellows will participate in educational activities including but not limited to:

  • Exposure to pediatric clinical practice environments for hands-on training experiences including the PICU, CICU, N/IICU, ORs, adult ICU, dialysis team, plasmapheresis team, thrombosis team, perfusion team, and ECMO Core team
  • Participation in all didactic conferences within the Divisions of Cardiac Critical Care and Critical Care Medicine. In addition, the fellow may attend conferences within the Divisions of Nephrology, Hematology, Cardiology, Neonatology, and Palliative care as well as the Departments of Surgery and Pathology and Laboratory Medicine
  • Simulation training with the expectation to participate in 6 ECMO simulations in the CICU and PICU, and during ECMO orientation for first year PCCM, Cardiology, and Neonatology fellows
  • Prepare and lead 4 ECLS-related didactic lectures and/or case-based conferences at CHOP
  • ECMO Core Team education attendance
  • Monthly attendance and participation in the CHOP ECMO Center Operations Meeting
  • Completion of a QI project (e.g., develop an ECMO-related guideline)
  • Attendance at a national or international ECLS conference

Research and Academic Opportunities

Trainees will have access to faculty who are funded in basic science, translational, and clinical research focused on extracorporeal life support. Trainees will have access to faculty with expertise in clinical operations and safety and quality improvement.  We will work with the candidate to find research and academic opportunities specific to their interests.

How to Apply

Applications must be received by October 1 to be considered for the July start date of the following year. The application will be reviewed by ECLS Fellowship leadership.  

Application materials and process includes:

  • Common CHOP application
  • Three (3) Letters of Reference (LORs)
  • Current Curriculum Vitae
  • Personal Statement
  • Photograph
  • Interview with committee
  • The education coordinator will inform each applicant of decisions regarding whether and when an interview will be granted. The program director will communicate with applicants who are interviewed regarding the final decision of the fellowship committee on their application.

Application materials should be submitted via email to  Marissa A. Brunetti, MD (brunettim@chop.edu), Adam Himebauch, MD, MSCE (himebaucha@chop.edu), and Carmen Girona (girona@chop.edu).

Other Requirements

To carry out its mission, it is of critical importance for the Children’s Hospital of Philadelphia (CHOP) to keep our patients, families, and workforce safe and healthy and to support the health of our global community. In keeping with this, CHOP has mandated all workforce members (including trainees) on site at any CHOP location for any portion of their time be vaccinated for COVID-19 as a condition of employment.

This mandate also applies to workforce members or trainees performing work for CHOP at non-CHOP locations. Additionally, all workforce members based in or regularly scheduled to work at any New Jersey location are mandated to be both vaccinated and boosted for COVID-19, with booster timing consistent with applicable guidelines. The CHOP COVID-19 vaccine mandate is in alignment with applicable local, state, and federal mandates. CHOP also requires all workforce members and trainees who work in patient care buildings or who provide patient care to receive an annual influenza vaccine. Employees may request exemption consideration for CHOP vaccine requirements for valid religious and medical reasons. Please note start dates may be delayed until candidates are fully immunized or valid exemption requests are reviewed. In addition, candidates other than those in positions with regularly scheduled hours in New Jersey, must attest to not using tobacco products.

Children's Hospital of Philadelphia is an equal opportunity employer. We do not discriminate on the basis of race, color, gender, gender identity, sexual orientation, age, religion, national or ethnic origin, disability, protected veteran status or any other protected category. CHOP is a VEVRAA Federal Contractor seeking priority referrals for protected veterans.

CHOP is committed to building an inclusive culture where employees feel a sense of belonging, connection, and community within their workplace. We are a team dedicated to fostering an environment that allows for all to be their authentic selves. We are focused on attracting, cultivating, and retaining diverse talent who can help us deliver on our mission to be a world leader in the advancement of healthcare for children.

We strongly encourage all candidates of diverse backgrounds and lived experiences to apply.