In accordance with American Board of Pediatrics requirements, the PEM fellowship program for graduates of pediatric residencies is of three years duration.

Each year consists of 13 four-week blocks. The table below lists the various rotations that make up each year of fellowship.

Year 1	Year 2	Year 3
PEM 5.5 Blocks	PEM 6.5	PEM 6
Research 2	Research 2	Research 3
Adult EM 1	Adult EM 1	Adult EM 1
PICU 1	Child Abuse 1	EMS 1
Trauma 1	Toxicology 1	Elective 2.5
Anesthesia 1	Labor and Delivery 0.5
Hand 1	Ophthalmology 0.5
Ultrasound 0.5	Ultrasound 0.5

Each year of fellowship includes about six months in the pediatric ED spent refining diagnostic and management skills. These months are spread throughout the year in order to maximize the fellow’s exposure to the entire spectrum of illness and injury.

• During the first year, the fellow will primarily be seeing patients on their own and presenting to the attending.
• During the second year, the fellow takes on a larger role in the department and will begin precepting residents and medical students.
• The third year of training is for consolidation of skills and increasingly independent practice in the ED. During the third year, fellows will begin doing solo overnight shifts (two per PEM block).

Adult/general emergency medicine rotations occur at Hartford Hospital and Saint Francis Hospital in Hartford. There is one block of adult emergency medicine per year of fellowship. Hartford Hospital was the first Level I Trauma Center in Connecticut and has an annual ED census of greater than 100,000. Saint Francis Hospital has an annual ED census of over 90,000 patients, including a small volume of children.

PICU rotation occurs here at Connecticut Children’s. Our PICU has 18 beds and offers the full range of critical care services including ECMO.

The Trauma rotation is based at Hartford Hospital. PEM fellows function as a member of the Surgery-based Trauma Service and respond to ED trauma consults and activations.

Anesthesia rotation is split between Connecticut Children’s and Manchester Memorial Hospital and is focused on honing airway management skills.

Hand Surgery rotation is based at Hartford Hospital and Connecticut Children’s where they are responsible for ED and inpatient consults for the hand service and rotate with surgical, orthopaedic, and plastic surgery residents.

The Ultrasound rotation experience is split into two weeks in the first year and two weeks in the second year. While on the Ultrasound rotation the fellows have daily supervised scanning sessions in the ED at Hartford Hospital or Connecticut Children’s. In addition, they participate Ultrasound Quality Assurance sessions and educational image review sessions the Ultrasound team at Hartford Hospital.

Child Abuse rotation is based at Connecticut Children’s where the fellow functions as a member of the Suspected Child Abuse and Neglect (SCAN) team. Fellows assist with ED and inpatient consults, as well as participate in outpatient SCAN clinic activities.

Toxicology rotation is based at the Connecticut Poison Control Center at UConn Health in Farmington, CT.

Labor and Delivery rotation (two weeks) is based at Hartford Hospital and is focused on gaining greater experience with deliveries and obstetric emergencies.

Ophthalmology rotation (two weeks) is based at Children’s Eye Care (members of Connecticut Children’s Specialty Group) in Farmington, CT and Glastonbury, CT and is focused on honing their pediatric ophthalmologic exam skills and seeing a range of pediatric ophthalomogic pathology.

During the Emergency Medical Services (EMS) rotation (two weeks), the fellow has the opportunity to participate in field transports with local EMS crews and may accompany LIFE STAR, the first and only air ambulance system in Connecticut. In addition, during this rotation fellows meet with EMS leaders in the region and may attend various EMS meetings.

Fellows have 10 weeks of elective time in the third year. In recent years, fellows had used elective time for rotations in: Ultrasound (additional to core Ultrasound rotation), Simulation, Radiology, Sedation, Orthopaedics, and Dental.

During second and third years, fellows will do one to two shifts per PEM block at Saint Mary’s Hospital in Waterbury, CT, caring for children in a community hospital ED supervised by on-site PEM-trained emergency physicians. This unique experience has been a part of our curriculum for many years and has been very well received by our fellows, offering them greater exposure to other varieties of PEM practice available after fellowship. In addition, the experience of practicing outside of a tertiary care academic medical center allows them the examine their own practice and hone and expand their skills in different ways.

Fellows will dedicate a significant portion of fellowship to scholarly activity. This typically takes the form of a mentored research project though other forms of substantive scholarly exploration are acceptable. Two to three blocks of each year of the program are formally dedicated to this scholarly activity, though this work also occurs throughout fellowship in a longitudinal fashion. In addition to their primary scholarly activity, fellows will develop and conduct a quality improvement project within the Pediatric ED with the goal of impacting the quality of care provided in the ED. The PEM Faculty includes research mentors with experience in point-of-care ultrasound, simulation, injury prevention, behavioral health, sedation, pre-hospital medicine, transport, disaster preparedness, quality improvement, medical education, child abuse, forensic medicine, and toxicology. In addition, fellows have collaborated with mentors in other subspecialties at Connecticut Children’s. Research support available to fellows includes access to professional medical librarians at UConn Health in Farmington, CT, statistical support through UConn Health and the Connecticut Children’s Research Office, and research assistants through the Undergraduate Research Assistant Program (URAP). URAP students are undergraduates at UConn who are physically present in the ED to assist with prospective study enrollment and are also available to help with retrospective study data extraction.

Fellows at Connecticut Children’s across all pediatric subspecialties participate in a research course “Introduction to Principles and Practice of Clinical Research” based on a curriculum developed by the NIH, as well as a “Core Curriculum” covering topics such as medical ethics, professionalism, risk management, and teaching development.