Pediatric Surgery Fellowship Program

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The global objective of the Pediatric Surgery program is to teach fellows the skills necessary to become well-rounded pediatric surgeons. In addition, it is our interest to align our training program with modern career objectives. Throughout the fellowship, the resident is given graded responsibility, both in and outside the operating room. The rotation schedule for the fellowship is designed to achieve this global objective, while at the same time permitting some flexibility.

Length of Program: 2 Years

Number of Positions: 1 per year

Year 1

During the first year, the fellow's time will be divided between the Pediatric Surgery, one month each in the Neonatal Intensive Care Unit (NICU), Pediatric Intensive Care Unit (PICU), and on Pediatric Urology. There is also the opportunity to do an elective rotation on another service; cardiothoracic surgery, gynecology, neurological surgery, orthopedic surgery, otolaryngology, anesthesia, vascular surgery, transplant surgery, urology, and the management of burns.

Pediatric Surgery

The Pediatric Surgery service is divided into two teams, trauma and acute care surgery (TACS) and pediatric specialty surgery (PSS). The TACS service includes trauma and burn patients but also patients with acute surgical problems like appendicitis, cholecystitis, bowel obstructions, foreign bodies, etc. and manages all surgical patients in the PICU. The PSS service includes neonatal surgical patients, children with solid tumors, inflammatory bowel disease, thoracic disorders (e.g., pectus, lung lesions, empyema) and a variety of non-urgent pediatric surgical problems. The fellow will be responsible for the preoperative evaluation of patients and will learn the risks and benefits of the operations and how to counsel patients appropriately. Primary responsibility for postoperative care will be provided by the fellow with the supervisory oversight of the attending pediatric surgeon. Over the course of the fellowship, the fellows will acquire graded responsibilities as primary surgeon.

Neonatal Intensive Care Unit (NICU)

The fellow will rotate in the NICU for one month where he/she will participate in multispecialty team to manage babies in the neonatal intensive care unit following surgical procedures and with non-surgical problems. Specifically, the fellow will acquire competence in the surgical care of the critically-ill infant or child requiring cardiopulmonary resuscitation, fluid and inotrope management, nutritional support (parenteral and enteral), ventilator management and extracorporeal membrane oxygenation (ECMO). The fellow will function as an integral member in the care team especially for critically ill neonatal surgical patients in order to acquire knowledge, skills, and competence in the pre-, intra-, and post-operative care of infants. The fellow must document care of at least 20 neonatal surgical patients.

Pediatric Intensive Care Unit (PICU)

The fellow will rotate in the PICU for one month where he/she will develop competence in the management of surgical, trauma, and other intensive care patients. The Pediatric Surgery fellow will be integral members of the patient care/rounding team, making decisions about patient care, and in particular, the surgical care of the patient. The fellow should develop competence in their knowledge of invasive and non-invasive monitoring techniques and interpretation. The fellow will acquire the medical knowledge and experience required to manage pediatric surgery patients who require TPN, ECMO, fluids/vasopressors, and ventilators. The fellow must document the care of at least 10 critically-ill pediatric surgical patients.

Urology

The fellow will rotate for one month on the pediatric urology service. The objective is to develop knowledge and understanding of the basic principles applicable to pediatric urology; including pre-operative evaluation, making provisional diagnoses, initiation of diagnostic procedures, formation of preliminary treatment plans, and recommendations for outpatient follow-up care of pediatric urologic surgical patients. The fellow will participate in clinic, on the wards and in the operating room under the supervision of the pediatric urology attending.

By the end of the first year, it is the expected that the fellow is fully capable of performing straightforward pediatric surgery procedures with minimal assistance. Virtually all general pediatric surgery cases are performed by the fellow with faculty assistance.

Year 2

Pediatric Surgery

The second-year fellow will function as a chief fellow and serve as leader of the pediatric surgery service. He/she will lead the team of fellows, residents, interns and students. It is the senior fellow's responsibility to organize and participate in the formal pediatric surgery conferences, including quality improvement and/or patient safety conferences. Additionally, the fellow has a responsibility for teaching junior residents and medical students. The senior fellow should provide consultative role for the pediatric surgery service to primary pediatric patient care teams, multispecialty teams in the Emergency Department and to neonatologists and intensivists. The fellows will have a leadership role in patient care, under the supervision of pediatric surgery faculty members, including the pre-, intra-, and post-operative care of such patients. The fellow must acquire an appropriate breadth, volume, and balance of operative experience graded responsibilities for more complex pediatric surgical problems. When the fellow's operative experience justifies, he/she should function as primary surgeon; including at least 50 cases as teaching assistant.

It is our ultimate goal to prepare our fellows not only to satisfactorily pass the ABS certification examination, but to excel beyond that to a level of expertise that will allow the fellow to become a future leader in their area of specialty. To assist in this endeavor, we have many educational activities which include:

• Pediatric Surgery Grand Rounds Conference
• Pediatric Surgery SCORE Curriculum Conference
• Surgical Gastrointestinal Conference
• Subspecialty Conference
• Surgical Critical Care Conference
• Surgery Pathology Radiology Conference
• Journal Club Conference
• Case Presentation Conference
• Research Conference
• Morbidity and Mortality Conferences
• Multidisciplinary Trauma Lecture Series
• Department of Pediatrics Grand Rounds
• Neonatal Grand Rounds Conference
• Department of Surgery Grand Rounds
• General Surgery Residency Core Curriculum Conference
• Department of Surgery Biology Dialogues
• Research opportunities allowing residents exposure to national meetings

Applications should be made through the Electronic Residency Application System (ERAS) by completing the appropriate forms and submitting the required supporting material. After review of this material, candidates are selected for in-person interview. Our interview season runs from February through March. Candidates will be contacted by e-mail regarding their application status. Pediatric Surgery then matches with one fellow candidate each May, who will begin a two-year fellowship rotation the following August.

Candidates must have successfully completed an ACGME-accredited General Surgery Residency. We have no minimum USMLE Step I score requirement; however, scores above the 220 level are advantageous. We require three letters of recommendation and accept no more than four.

The Division of Pediatric Surgery will hold interviews on Friday January 31, 2025, and Monday February 3, 2025.

Fellows in our program must be a U.S. citizen or lawful permanent resident to train at the University of Colorado School of Medicine.

Questions about the fellowship program can be directed to Jaymie Donner: