Clinical Experience

The patient population includes children of all ages from premature infants to young adults. Children's Mercy has a level IV NICU, PICU and CICU. The fellows participate in high acuity pediatric patients and cases.

The year will be divided into the following 12 four-week blocks and 2 two-week blocks:

• 7 rotations in the ORs consisting of a graded clinical experience that will include patients undergoing general, ENT, ophthalmologic, orthopedic, GI, dental, plastic, neurosurgical and urological surgery. Fellows will also participate in procedures in the Fetal Health Center including fetal surgery and EXIT procedures.
  
  
• 2 rotations in the cardiac ORs providing anesthesia for patients with congenital heart disease undergoing bypass, non-bypass and cath lab procedures. The Heart Center at Children’s Mercy Hospital is an STS High-volume center, with around 300 bypass cases a year ranging from single ventricle repairs to arterial switches to heart transplantation.  During the rotation, fellows manage complex cardiac physiology and sharpen skills in difficult vascular access, including central venous catheter and arterial line placement under ultrasound guidance.  Fellows also have the opportunity to provide regional anesthesia, such as erector spinae plane blocks on coarctation of the aorta repairs in the smallest of patients.
  
  
• 1 rotation will be with our comprehensive pain management service. This will include consulting on patients scheduled for surgery that may require complex pain management, caring for postsurgical and medical patients in the inpatient setting, and evaluating and treating patients presenting to the chronic pain clinic. In addition, the fellows assist with the peripheral nerve blocks and neuraxial anesthesia in the operating room.
  
  
• 1 rotation will be spent providing care to children in the PICU and CICU. The fellows will have direct patient care responsibilities for medical and cardiothoracic patients, including preparing them appropriately for surgical procedures and managing postoperative issues.
  
  
• 1 two-week out of OR rotation will allow fellows to administer anesthetics in radiology, GI clinic, fracture clinic and the burn unit.
  
  
• 1 elective two-week rotation on a particular area of interest, such as cardiac anesthesia, pain management, regional anesthesia, research or quality improvement.