Rotations & Conferences
Clinical rotations are designed to provide the optimal experience for the fellows with regards to operative case experience, autonomy in management, and exposure to faculty clinical expertise. Fellows lead a large clinical team typically consisting of a fourth-year resident, a third-year resident, a second-year resident, 3-4 interns, 2-3 medical students, nurse practitioners, and physician assistants.
On any given day, the team manages 40-50 inpatients including 15-25 neonates. Fellows are expected to be the primary point of care for the service and responsibilities include evaluating patients, constructing their surgical and medical management plans, and developing collaborative relationships with consultants and other services within the hospital.
Children’s Memorial Hermann Hospital (CMHH) is the primary teaching hospital for the service. This is a high volume program that consists of acute care general pediatric surgery, neonatal and pediatric critical care, pediatric trauma, pediatric burns and elective general pediatric surgery. Fellows are offered independence in the operating room, as deemed appropriate by the staff, as well as taking junior residents through cases. In addition, fellows gain additional exposure to complex pediatric surgical oncology at the Children’s Cancer Hospital at MDACC.
General pediatric surgery clinic is held daily throughout the week and fellow participation is expected at least once per week. In addition to daily general pediatric surgery clinic, several sub-specialty programs exist including oncology, colorectal, vascular anomalies, chest wall deformities, short-gut and intestinal rehabilitation, congenital diaphragmatic hernia, and high-risk neonatal care. Fellows are encouraged to participate in these subspecialty clinics to gain exposure to the breadth of outpatient pediatric surgery.
During the first year, fellows participate in core off-service rotations including Neonatal Intensive Care Unit and Pediatric Intensive Care Unit. The second year consists of ten months as the senior pediatric surgery fellow at CMHH and MDACC and two elective months. Second year electives are chosen with the program director to enhance career interests and goals. In years past, senior fellows have rotated with pediatric urology, fetal surgery, pediatric CV surgery, pediatric CV anesthesia, pediatric intensive care unit, and ambulatory pediatric surgery. In addition, a research elective is available, however, there are no formal research requirements to graduate from the fellowship program. The pediatric surgical faculty are involved in basic science, clinical and health services research and fellows are welcome to participate in ongoing clinical projects during their fellowship.
There is an educational curriculum that includes weekly case conferences with various pediatric services, didactic fellows’ education conference, and morbidity & mortality conference.
Conferences
The pediatric surgery fellows’ conference schedule:
| Tuesdays: | Fetal conference (weekly) |
| Wednesdays: | Surgery/GI (monthly, 1st Wednesday) |
| Surgery/NICU(monthly, 2nd Wednesday) | |
| Surgery/Pathology/Radiology/Tumor (monthly, 3rd Wednesday) | |
| Thursdays: | Fellows Conference (weekly) |
| Pediatric Surgery M&M (weekly) | |
| Journal Club (monthly) |
Required core conferences
Fetal Conference
Surgery/GI Conference
Monthly conference with pediatric surgery and gastrointestinal faculty and fellows. Each service presents interesting cases for open discussion regarding medical and surgical management of common Gl diseases. This multidisciplinary conference often results in interesting consults and problem-solving discussions of complex clinical scenarios.
Surgery NICU Conference
Surgery/Pathology/Radiology/Tumor Conference
This is a monthly, multidisciplinary conference attended by pediatric pathologists, pediatric radiologists, pediatric surgical faculty, fellows, residents and students. Interesting cases are presented and discussed.
Pediatric Surgery Fellows’ Conference
Weekly topic and case-based, this is a fellow-led conference covering all major topics in pediatric surgery over a 2-year curriculum that includes ethics. The lead fellow is responsible for a board-oriented, literature-based topic review, a conference pre-test, and preparing cases to be presented with designated faculty in an oral board format. This conference can also include video sessions where rarely performed procedures are presented and discussed by fellows and faculty.
Pediatric Surgery M&M
The Morbidity and Mortality conference is held weekly in the Department of Pediatric Surgery. Students, residents, fellows, and faculty attend, where surgical cases from the previous week are listed and reviewed, as are complications and deaths occurring during that week. The information gleaned from this teaching conference is invaluable in achieving the education goals of the program.
Journal Club
Chat with Chair
The pediatric surgery fellows meet individually with Dr. Lally on a weekly basis. This is an informal meeting where each resident is provided the opportunity to discuss the program, projects, upcoming events, career goals and any problems they may be experiencing.
Monthly Meeting with Program Director and Assistant Program Director
The pediatric surgery fellows meet individually with Dr. Tsao and Dr. Austin on a monthly basis. This is an informal meeting where each resident is provided the opportunity to discuss any elective rotation interests, issues they may be experiencing running our service or any topic they would like to discuss.
Other conferences:
Fellows are also highly encouraged to attend the weekly Department of Surgery Grand Rounds and M&M, Pediatric Trauma M&M, ECMO rounds, and other multi-disciplinary conferences offered by MD Anderson Cancer Center and Memorial Hermann Hospital.