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Duration |
Description |
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3 – 6 months (observer)
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2 weeks attachment to Paediatric Anaesthesia
2 weeks attachment to Neonatology
Remaining period in CICU
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| 1-year posting |
- 2 weeks posting in Paediatric Anaesthesia; training in airway management, line insertion and observation of major surgeries
- 2 weeks in Children’s Emergency: observation of resuscitation and emergency care
- 2 weeks in Neonatal ICU as observer
- Remaining period in CICU, with possible attachment to related services like Cardiology and Respiratory Medicine.
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Objectives
The objective of the fellowship is to train physicians in paediatric critical care medicine. Fellows will develop skills in:
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Multidisciplinary holistic critical care
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Pathophysiology and management of critical illness in children and neonates
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Ethical issues associated with critical illness
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Family and child-centered care
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Management of chronically ill, technology dependent children
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Use of advanced technology in critical care
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Clinical Research, quality assurance and audit
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Teaching students, as well as medical and nursing staff, including resuscitation training
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Formal presentations
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Administrative issues associated with the delivery of critical care
Eligibility Criteria
Applicants for the Fellowship programme should have a recognised post-graduate degree in paediatrics, and significant experience in acute paediatric medicine. Some experience of paediatric critical care would be desirable.
The candidate should be fluent in English. Doctors from medical schools where the medium of instruction is not English should have passed a recognized English proficiency test, e.g. TOEFL or IELTS.
The fellow must have a valid registration with the Singapore Medical Council, either ‘Temporary’ or ‘Conditional’. For postings of more than 6 months ‘Conditional’ registration is required.
Description and Overview
The Fellowship provides training for physicians in Paediatric Critical Care Medicine, in a modern, tertiary PICU with the full range of facilities. Educational opportunities are available for clinical, research-based, academic and administrative training. There are mandatory and elective attachments. The exact programme will vary depending on the experience of the Fellow and the length of the Fellowship.
Clinical Training
Fellows will provide and coordinate care for all patients in the unit, supervising the resident medical officers and working alongside the registrars. They will attend and conduct ward rounds, be available throughout the day for admissions and to assist in the delivery of care. There will be plenty of opportunity to learn and perform skills relevant to invasive procedures involving airway management, vascular access, resuscitation and emergency management. Fellows will present cases to consultants on daily rounds, and are expected to participate in the call roster for nights and weekends. In addition, after suitable experience and training, fellows will be expected to participate in the other services offered by the unit, as detailed above.
The schedule of normal clinical work is usually a five-day week, starting at 8am. Fellows and Registrars usually do 5 to 7 in-house calls a month on average, covering for nights and weekends. During these calls they will have a medical officer resident on the unit as well.
Formal Education
There are several components to the formal education programme:
This weekly series of lectures is primarily aimed at the medical officers who are preparing to sit for their postgraduate examinations in paediatrics. Although the fellow will have obtained their postgraduate qualifications attendance is strongly encouraged as there may be facets of fundamental critical care which the senior staff are expected to be familiar with.
These sessions are targeted at the fellows and registrars and are conducted on a small-group, informal basis. Staff are expected to have read around the subject prior to the session and on occasion present topics.
This lecture series is designed primarily for the paediatric intensive care nursing diploma. Nevertheless many of the topics, especially those regarding the basic sciences and pathophysiology are very relevant to the fellowship.
These weekly sessions involve the presentation and discussion of an interesting or educational case from the CICU. Experts from other disciplines are invited to participate in the discussion and sometimes give a lecture. Fellows will be expected to present cases in this forum.
This occurs monthly and is led by the CICU team. Fellows will be expected to participate in the discussion.
This occurs fortnightly. During these sessions, all CICU staff take turns to present a journal article or research in progress.
This programme serves to increase training and readiness for resuscitation. Fellows will be expected to participate fully, initially in order to be trained, but after some time as instructors and evaluators.
There are a number of workshops and courses available throughout the year. All fellows are expected to attend and pass the Advanced Resuscitation in Children, and the Fundamentals of Critical Care Support courses. Other optional courses include Advanced Trauma Life Support, Advanced Cardiac Life Support, Fundamentals of Disaster Management, Hazardous Materials, Aeromedical Transport, Tracheostomy care, Non-invasive ventilation, and Haemodialysis.
Research
All fellows attached to the CICU for 6 months or more are expected to complete at least one research project. It is expected that the fellow will submit completed work to conferences and scientific meetings. Research will be conducted under the supervision of the faculty who will also help source for funding if needed.
Teaching Activity
Fellows are expected to participate in the teaching activity carried out by the unit for junior medical staff, medical students and nurses. This includes lectures, bedside tutorials, and hands-on sessions with technology. Formal presentations at departmental, division and hospital meetings will be strongly encouraged and supported. Fellows that are with the unit for >1 year will be expected to contribute some learning material, such as sections in the CICU handbook, and lectures or worksheets for the medical officers.
Evaluation and Mentoring
Each fellow will have a member of the senior staff assigned as a supervisor and mentor. They will meet regularly with the fellow to ensure progress in training, identify problems and address possible solutions. All senior staff will participate in the evaluation of the fellow as an on-going process. Feedback will be provided by the supervisor in informal sessions, as well as certification at the end of the posting.
Quality Asssurance, Audit and Administration
Fellows will be expected to participate in ongoing quality assurance programmes that are in place in the CICU. In addition they may initiate further audits in areas which they are interested in. Such a project should ultimately result in a poster or free paper at a scientific meeting. Guidance and supervision for this process will be available from the faculty. Fellows that are with the unit for a substantial period of time (>1 year) can be expected to gain some experience in the administrative issues in the unit. They will be expected to participate in the development of some component of service delivery.
Structure of the Fellowship
The majority of the programme will be spent in the CICU. There are mandatory and optional rotations for all fellows. The duration of the individual components will depend on the length of the fellowship.
All fellows will have to spend time with the departments of Paediatric Anaesthesia and Neonatology.
Rotations to Children’s Emergency, Cardiology, Respiratory Medicine and and other sub-disciplines of Paediatric Medicine can be arranged.
Teaching Faculty
Dr Loh Tsee Foong, Senior Consultant and Head of Service
Dr Chan Yoke Hwee, Consultant
Dr Janil Puthucheary, Consultant
Dr Loh Lik Eng, Associate Consultant
Nurse Clinician Ong Lim Liew
(Further teaching on subspecialty topics will be arranged with relevant faculty)
Funding and Logistics
Fellows are encouraged to source for their own funding. Funding may be available on a case-case basis, subject to availability. In all cases this issue should be discussed with the head of service as part of the application process.
Fellows will be provided with desk space and access to a computer with internet access. There is a medical library available in the hospital and a number of on-line resources.
The fellows must source for and arrange their own accommodation and transport. An on-call room with bed and attached bathroom is available for use during night and weekend duty, and there is plenty of food available in the hospital cafeteria and restaurants. There will be additional payment for any night/weekend calls and international transfers performed by the fellow, regardless of the status of funding for the fellowship as a whole.
As hospital staff fellows will be expected to comply with policies and procedures that are in place, covering, for example, confidentiality, security, dress codes, computer use and documentation.
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