Children's Intensive Care Unit (CICU)
The KK Women’s and Children’s Hospital (KKH) is an 830-bedded tertiary referral centre that offers a full range of services for neonates, children and women.
The fellowship programme in paediatric critical care is administered by the Children’s Intensive Care Unit (CICU). This is a 12 months training with an option to extend another 12 months for advanced intensive care training. The Children’s Intensive Care Unit is a tertiary, multidisciplinary paediatric intensive care unit with the nursing capability to support 16 beds with about 1700 admissions a year. Both negative and positive pressure isolation beds are available. There are separate facilities for cardiac step down patients and an intermediate care area that supports both medical and surgical patients.
The unit operates in an open collaborative manner, with all patients being managed by the CICU team. There are seven senior staff, and they provide consultant coverage at all times. A medical officer and a registrar are always resident on the unit. The unit (and the hospital) provides tertiary subspecialty paediatric care to the whole of Singapore. In addition, a significant number of international patients seek medical care here. We have available the full spectrum of advanced CICU monitoring and therapeutic technologies, including high frequency oscillatory ventilation (HFOV), continuous renal replacement therapy (CRRT), therapeutic plasma exchange (TPE), extra-corporeal membrane oxygenation (ECMO) support, inhaled nitric oxide, cardiac output measurement, intracranial pressure and continuous EEG monitoring. There are also extensive opportunities to care for patients following cardiac surgery.
Other services provided by the CICU team include:
The Children's Hospital Emergency Transport Service This is operated in collaboration with the neonatal intensive care unit (NICU) to transfer critically ill patients. The service performs 80 to 100 missions a year.
Paediatric Code Blue Team The CICU team leads the emergency resuscitation team for in-hospital paediatric arrests and assists the surgical team in responding to major trauma patients.
HomeCare Service This is a multi-disciplinary team that facilitates the care of technology dependent children in their own home and participates in their outpatient management.
Central Venous Access The CICU staff responds to referrals from other disciplines, inserting central venous catheters or peripherally inserted central catheters to facilitate administration of drugs, parenteral nutrition, autologous stem cell harvesting and chemotherapy.
The objective of the paediatric critical care fellowship is to train physicians to develop the knowledge, skills and attitudes necessary to practice as a paediatric critical care specialist. After completing the paediatric critical care fellowship programme, fellows will be competent in:
There are several components to the formal education programme for ICU fellows. The paediatric critical care fellowship programme covers the following:
*Please refer to the
assessment and evaluation guidelines for further information about the course contents.
Fellows will provide and co-ordinate care for all patients in the unit, supervising the resident medical officers and working alongside the registrars/senior residents. 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 opportunities 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 mentioned 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.
Target Audience and Expected Competencies
The preferred group of fellows to apply for this fellowship programme should have a recognized post-graduate degree in paediatrics, emergency medicine or anaesthesia and have significant experience in acute paediatric medicine. Some experience of paediatric critical care would be desirable.
The paediatric critical care fellowship programme currently has 2 intakes in a year, commencing in January and July.
To be eligible for this fellowship programme, interested applicants must:
Fellows will need to demonstrate their proficiencies based on the following competencies:
(A) Patient Care
Fellows must provide patient care that is compassionate, appropriate and effective including the treatment of health problems and the promotion of health for children and all stages of illness
(B) Medical Knowledge
Fellows must demonstrate medical knowledge of established and evolving biomedical, clinical, epidemiological, social-behavioral sciences and the application of medical knowledge to patient care.
Fellows must demonstrate and apply their medical knowledge on the following elements:
(C) Practice-Based Learning and Improvement
Fellows must demonstrate their ability to investigate and evaluate evidence, both in appraisal and assimilation of scientific evidence required for patient care in current and evolving practice settings, including diagnosing and treating health problems and promotion of health
Fellows must demonstrate life-long learning skills and continuous self-assessment based on reflection and feedback required for patient care in current and evolving health care settings
Fellows must demonstrate teaching and learning skills and perform research to contribute to medical education of health professionals
(D) Interpersonal and Communication Skills
Fellows must demonstrate commitment and professional attributes adhering to ethical principles including:
(F) Systems-Based Practice
Interested applicants will need to take note of the following information on areas related to course materials.
Certificate of fellowship will be awarded
upon completion of the fellowship programme (Please refer to table 2 on the critical care assessment and guidelines page)
Course fee will be determined upon application
If you have any questions about the fellowship application process, please contact the:
The paediatric critical care fellowship programme is managed by the following experts.
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