PEM Curriculum

Our fellowship program offers four major kinds of experiences:  clinical, teaching, administrative and research.

Our state-of-the-art 13,000 square foot 28 bed Emergency Department serves approximately 50,000 patients each year. It is staffed primarily by pediatric and emergency medicine residents, supplemented by family practice and transitional residents on regular rotations. Supervision is provided by full-time Pediatric Emergency Medicine faculty and fellows 24 hours a day.   Pediatric/ Trauma surgical attendings are in-house 24/7 and they, along with their upper level residents and the pediatric EM fellows/ attendings, comprise the trauma team for our highest level trauma activations.  All other pediatric surgical sub-specialists are readily available for consultation.

A major component involves supervising and teaching residents and students in the Emergency Department.  Fellows receive specific instruction in lecture design and delivery, and participate as speakers in a variety of formal and informal settings.  Multiple opportunities exist for improving teaching skills.

Fellows learn the principles of administration in monthly administrative meetings and by involvement in the day-to-day operations of the emergency department.  Fellows participate as active members on various hospital committees broadening their administrative exposure.

During the first year of training all fellows attend a "boot camp" and receive formal teaching on principles of epidemiology, statistics, and study design and methodology.  This provides fellows with a framework for understanding clinical research. With faculty supervision, fellows are expected to design and execute one or more independent research projects culminating in an original manuscript suitable for publication and presentation.  Our department has a dedicated biostatistician who will aid with research design, data analysis, and IRB submission.   In addition to the “research boot camp” all fellows participate in an asynchronous EBM/ research design course during year 1 and a biostatistics course during years 2 and 3.


State-of the Art Educational Curriculum

"The eye does not see what the mind does not know.” – D.H. Lawrence

Educational Conferences / Didactics
Our educational conferences are second to none!  Utilizing web based technology as well as the expertise of our faculty, our fellows’ conference meets weekly for 3-4 hours to review a core curriculum of topics applicable to pediatric emergency medicine.  In addition to the core curriculum (which repeats itself every 3 years), these conferences are also utilized to review interesting cases, discuss controversies within the field, review interesting EKG and radiology findings, discuss medical-legal issues, and practice board review questions. The learning continues asynchronously throughout the week as well.  Fellows receive clinical practice review articles each month via email and will listen to numerous downloadable audio/video lectures dedicated to pediatric emergency over the course of their 3 years. By the time you graduate from our program you have had a formal didactic on nearly every aspect of pediatric emergency medicine! We know of no other fellowship educational curricula which can compare to ours—it is intense, comprehensive, and fun.

Evidence Based Medicine
An integrated evidence based medicine curriculum is incorporated into the training program.  Principles of study design and research methodology are taught throughout the three year program empowering fellows to carry out their own research projects as well as critically appraise published materials.Fellows can attend formal lectures on biostatistics and epidemiology as part of an integrated program through the EVMS School of Public Health.  Interested fellows will be able to complete course work and earn an MPH (tuition and fees fully covered by the division).

Simulation Laboratory
We utilize high fidelity computerized mannequins in a state of the art pediatric simulation lab for our simulation experiences.  Simulation training includes acute care, mock codes, difficult airway scenarios, and procedural training. Fellows and faculty run a procedure workshop for medical students every 8 weeks and fellows gain experience in teaching using simulation models and partial task trainers.  We offer a 1 year Simulation in Medical Education Fellowship.

Ultrasound Training
Fellows receive a full morning of pediatric emergency ultrasound didactics with hands on bedside training every 6-8 weeks from faculty sub credentialed in Emergency Ultrasound. We believe our pediatric emergency medicine ultrasound curriculum to be the most comprehensive in the nation for PEM trainees. Fellows also participate in several formal ultrasound courses throughout their three years starting with a basic ultrasound course during orientation. In addition, the division pays for fellows to attend a 3 day advanced EM procedural ultrasound course during the beginning of their second year to further refine their ultrasound skills. During the 2nd year all fellows will also complete a 2 week formal emergency ultrasound rotation where they can be credentialed to perform various bedside ultrasounds.

PEM fellows who want to make point of care ultrasound a major niche area of future expertise can work in a regular and longitudinal manner with our emergency ultrasound faculty/fellows.  This advanced program is not easy and the number of requisite scanning hours are substantial, but it is achievable and upon program completion you will have essentially done a mini-fellowship within a fellowship and are afforded the opportunity to obtain the ARDMS Pediatric Sonography Certification.

Journal Clubs
Journal Clubs are utilized to review current literature and review principles of evidence based medicine.  Divisional as well as joint journal clubs with the EVMS Department of Emergency Medicine are held throughout the year.  Many of the past critically appraised topics (CATs) we have discussed can be found at

Paid Participation at National Conferences
The division pays for all fellows to attend the national PEM Fellows’ Conference during either the first or second year of fellowship.  Fellows also attend a Practical Emergency Airway course in Baltimore, MD which focuses on the mastery of the difficult airway utilizing a unique cadaveric setting.  All fellows attend another cadaveric course in Critical EM Procedures during their PGY5 or PGY6 training year.