Duke University Hospital Program

Duke University Medical Center offers a prestigious ACGME-accredited Pediatric Cardiothoracic Anesthesiology Fellowship Program, well-regarded for its educational excellence within the field of pediatric cardiothoracic anesthesiology. This one-year fellowship, which commenced in August 2023, provides specialized training to fellows in a clinical environment recognized nationally for its high standards of care, particularly in pediatric cardiology and congenital heart disease management 1.

The program stands out due to its association with the Duke Pediatric and Congenital Heart Center, which has been ranked #2 in the nation by US News & World Report. As a fellow, you will engage in high-level cases from preoperative assessments through to intraoperative and postoperative management, gaining exposure across diverse clinical settings 1.

Curriculum and Rotations

Structured into several key areas, the fellowship's curriculum focuses on comprehensive education and clinical experience. The primary sites for rotations include operating rooms and intensive care facilities at Duke University Medical Center. The main rotations within the fellowship include:

Pediatric Cardiac Rotation

This constitutes the core of the fellowship, providing exposure to a wide spectrum of congenital heart defects. Fellows will participate in procedures addressing various conditions, from basic repairs such as atrial septal defect (ASD) to complex surgeries like transposition of the great arteries repair. Additionally, the experience includes involvement with pediatric heart transplants and extracorporeal membrane oxygenation (ECMO) management 1.

Pediatric Cardiac Catheterization Suite Rotation

The Pediatric Catheterization Suite features a diverse array of interventional and electrophysiological procedures, with hands-on experience guiding anesthesia management for a patient population ranging from premature infants to adults with congenital heart disease. This includes training on cardiac arrhythmias and pacemaker management, with one day a week dedicated to rotations in this suite 1.

Imaging (MRI/TEE) Rotation

In collaboration with pediatric cardiologists, fellows shadow echocardiographers and gain hands-on experience in various imaging modalities, including transesophageal echocardiography (TEE) and cardiac MRI. This rotation is vital for understanding cardiovascular imaging implications in anesthesiology 1.

Pediatric Cardiothoracic Critical Care Rotation

This rotation allows fellows to manage critical care for children with congenital heart defects, providing insights into postoperative recovery and long-term management strategies for complex conditions 1.

Research Opportunities

Duke University Medical Center fosters a strong research culture. During the fellowship, you will be assigned a faculty mentor and encouraged to engage in clinical or basic science research. Opportunities exist to present findings at national or international conferences. An extensive research infrastructure supports fellows, ensuring they have the resources required for successful completion of research projects 2.

Unique Aspects of the Program

Fellows are an integral part of a multidisciplinary team, promoting effective communication among cardiac surgeons, nurses, and perfusionists. The program promotes actively participating in weekly Congenital Cardiac Care Conferences, where comprehensive treatment approaches are discussed 1.

Application Process and Competitiveness

Admission to the fellowship is competitive. Required qualifications include having completed an ACGME-accredited pediatric anesthesiology or adult cardiothoracic anesthesiology fellowship, with at least one month of pediatric anesthesiology experience. Additional details regarding special application requirements are as follows:

• International Medical Graduates (IMG) and DO candidates are considered.
• Visa support is provided, with the program typically sponsoring J-1 visas for international fellows.

Educational Environment and Fellowship Structure

Throughout the fellowship year, fellows will engage in didactic lectures, simulation sessions, and journal clubs, all designed to enhance the learning experience and clinical skills 2. Continuous evaluation and formative feedback contribute to personal and professional growth. Furthermore, fellows will have an educational stipend and a laptop provided to support their learning efforts.

Community and Support

Duke's commitment to cultivating an inclusive academic culture aligns with the institution's core mission of improving health and well-being across diverse populations. This supportive environment extends beyond just clinical training, emphasizing social justice in healthcare 2.