New Application: Pediatric Emergency Medicine
Review Committee for Emergency Medicine
ACGME
515 North State Street, Suite 2000, Chicago, Illinois 60654  312.755.5000  www.acgme.org
PARTICIPATING SITES
Provide the name and 10-digit program ID of the ACGME-accredited emergency medicine program
with which the fellowship program is associated. If the residency is not sponsored by the institution that
sponsors the fellowship program, describe the affiliation between the fellowship and the residency. In
addition, provide the name and 10-digit program ID of the affiliated reciprocal ACGME-accredited
pediatrics program. [PR I.A.1-2.]
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PROGRAM PERSONNEL AND RESOURCES
Program Director
1. Describe how the program director will ensure that fellows are mentored in their development of
clinical, educational, and administrative skills. [PR II.A.4.q)]
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2. Describe how the program director will monitor and document the procedural skills of the fellows.
[PR II.A.4.r)]
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3. Describe how the program director will ensure documentation of meetings that describe ongoing
interaction among subspecialty and core program directors. Specify the planned frequency of these
meetings. [PR II.A.4.p).(1) and II.A.4.s)-II.A.4.s).(1)]
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Consultants
List only those individuals who are available to the Pediatric Emergency Medicine program for
consultation and academic lectures: [PR II.B.2.c)-II.B.2.c).(1); II.B.5.f)]
Special Expertise
Medical Genetics
Child Neurology
Child and Adolescent Psychiatry
Surgery
Surgical Subspecialties (specify):
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Name
# of Consults
Annually
#
#
#
#
Name
Name
Name
Name
Qualifications
Qualifications
Qualifications
Qualifications
Qualifications
Name
Qualifications
#
Name
Name
Name
Qualifications
Qualifications
Qualifications
#
#
#
Pediatric Emergency Medicine
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 4/2015
Page 1 of 16
Special Expertise
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Name
Name
Name
Name
Name
Name
Name
Qualifications
Qualifications
Qualifications
Qualifications
Qualifications
Qualifications
Qualifications
# of Consults
Annually
#
#
#
#
#
#
Other Program Personnel
Using a bulleted list below identify the non-physician personnel who contribute to the delivery of care in
the ED and their planned interaction with the fellow: [PR II.C.]
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Resources [PR II.D.]
1. Provide the following information in full for each EM department with pediatric patients in which the
fellows will provide care. [PR II.D.-II.D.2.]
Pediatric Emergency Care Services
Site #1
Site #2
Site #3
Number of pediatric patient care
locations
Number of pediatric
critical/resuscitation rooms/beds
Average number of pediatric patients
seen in 24-hours
Operating suite/room available onsite 24-hours
Pediatric intensive care beds
available onsite
Comprehensive diagnostic imaging
services available 24-hours
Urgent care/Fast track that is part of
the emergency department
Observation beds (23 hour unit)
within the emergency department
Acute care facility
Comprehensive radiologic and
laboratory support system
#
#
#
#
#
#
#
#
#
☐ YES ☐ NO
☐ YES ☐ NO
☐ YES ☐ NO
☐ YES ☐ NO
☐ YES ☐ NO
☐ YES ☐ NO
☐ YES ☐ NO
☐ YES ☐ NO
☐ YES ☐ NO
☐ YES ☐ NO
☐ YES ☐ NO
☐ YES ☐ NO
☐ YES ☐ NO
☐ YES ☐ NO
☐ YES ☐ NO
☐ YES ☐ NO
☐ YES ☐ NO
☐ YES ☐ NO
☐ YES ☐ NO
☐ YES ☐ NO
☐ YES ☐ NO
2. If there is an urgent care/fast track area of the emergency department describe the role of the
fellows in caring for those patients below: [II.D.1.]
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3. If there are observation beds (23 hour unit) in the emergency department describe the role of the
Pediatric Emergency Medicine
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 4/2015
Page 2 of 16
fellows in caring for those patients below: [II.D.1.]
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4. Is the acute care facility:
a) Equipped to handle trauma? [PR II.D.1.] ................................................................ ☐ YES ☐ NO
b) Equipped with the full range of services (neonatal, pediatric, and adult intensive care; transport;
etc.), associated with residencies in pediatrics and emergency medicine? [PR II.D.1.]
............................................................................................................................... ☐ YES ☐ NO
5. Prehospital Care [PR II.D.1.]
a) Is the primary clinical site a 911 receiving site? ...................................................... ☐ YES ☐ NO
b) Are any of the participating sites paramedic base stations? ................................... ☐ YES ☐ NO
6. Is the acute care facility accredited by the Joint Commission on Accreditation of Healthcare
Organizations? [PR II.D.1.a)] ....................................................................................... ☐ YES ☐ NO
7. Research Resources [PR II.A.3.d)]
a) Does the program provide research laboratory space and equipment, if appropriate?
............................................................................................................................... ☐ YES ☐ NO
b) Does the program provide financial support for research?...................................... ☐ YES ☐ NO
c) Does the program provide computer and statistical consultation services? ............ ☐ YES ☐ NO
8. Patient Population [PR II.D.3-II.D.3.c)]
9. List of Diagnoses: Pediatric (<21 Years) [PR,II.D.3.b)-c); IV.A.6.d).(1)]
List 150 CONSECUTIVE Emergency Department visits to the PEDIATRIC EMERGENCY
MEDICINE service for four distinct time periods: beginning July 1, beginning October 1, beginning
January 1, beginning April 1 of the most recent academic or calendar year. Identify the time period
during which these visits occurred. The date range should occur within the same 12-month period
used in the patient population table. The dates must begin on the date the first patient on the list
was seen and end with the date the 150th patient was seen, e.g., July 1, 2013 through July 3, 2013.
Provide a separate list for each time period in each hospital that provides required rotations.
Hospital
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Name:
Inclusive Dates: From:
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#
1
2
3
Age
Pediatric Emergency Medicine
Primary Diagnosis
Pediatric Emergency Medicine
©2015 Accreditation Council for Graduate Medical Education (ACGME)
To:
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Secondary Diagnosis
(Include If Relevant)
Updated 4/2015
Page 3 of 16
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Age
Pediatric Emergency Medicine
Primary Diagnosis
Secondary Diagnosis
(Include If Relevant)
10. List of Diagnoses: Adult (> 21 Years) [PR II.D.3.b)-c); IV.A.6.d).(1)]
List 150 CONSECUTIVE Emergency Department visits to the ADULT EMERGENCY MEDICINE
service for four distinct time periods: beginning July 1, beginning October 1, beginning January 1,
beginning April 1 of the most recent academic or calendar year. Identify the time period during
which these visits occurred. The date range should occur within the same 12-month period used in
the patient population table. The dates must begin on the date the first patient on the list was seen
and end with the date the 150th patient was seen, e.g., July 1, 2013 through July 3, 2013. Provide a
separate list for each time period in each hospital that provides required rotations.
Hospital
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Name:
Inclusive Dates: From:
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#
31
Pediatric Emergency Medicine Primary
Age
Diagnosis
Pediatric Emergency Medicine
©2015 Accreditation Council for Graduate Medical Education (ACGME)
To:
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Secondary Diagnosis (Include If
Relevant)
Updated 4/2015
Page 4 of 16
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Age
Pediatric Emergency Medicine Primary
Diagnosis
Secondary Diagnosis (Include If
Relevant)
11. Provide patient data in the table below. If more than 3 Emergency Departments are used, copy this
page. Provide the requested information for the most recent 12-month period or academic year
using the same time-frame for all patient and procedural data provided on subsequent pages.
[PR.II.D.3.b)-c)]
Inclusive Dates:
From:
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TOTAL # ED patient visits (include urgent
care/fast track if part of the ED)
a) Total # of ED patients < 21 years
(include urgent care/fast track if part of
the ED)
b) Number of ED patients < 21 years
To:
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Primary
Clinical Site
Site #2
Site #3
#
#
#
#
#
#
#
#
#
Pediatric Emergency Medicine
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 4/2015
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Primary
Clinical Site
Site #2
Site #3
treated in urgent care
TOTAL number of pediatric and adult EM
patients by Clinical Condition. If the site(s)
sees both children and adults in the ED,
Peds
Adult
Peds
Adult
Peds
Adult
enter data in each column.
< 21 yrs > 21 yrs < 21 yrs > 21 yrs < 21 yrs > 21 yrs
a) Trauma
#
#
#
#
#
#
b) Surgical (non-trauma)
#
#
#
#
#
#
c) Medical
#
#
#
#
#
#
d) Obstetrical/Gynecological
#
#
#
#
#
#
e) Psychiatric
#
#
#
#
#
#
Percentage of patients hospitalized
following treatment (excluding pediatric ED
#%
#%
#%
#%
#%
#%
observation beds)
Percentage of ED patients admitted to
CRITICAL CARE following treatment
#%
#%
#%
#%
#%
#%
(excluding step-down units)
Percentage of ED patients taken directly to
the operating suite following treatment
#%
#%
#%
#%
#%
#%
Number of deaths in ED (exclude patients
who are DOA)
#
#
#
#
#
#
12. Describe how the Pediatric Emergency Department is part of an organized system for trauma care.
[PR. II.D.1.]
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13. Resuscitations [PR II.D.3.c)]
Indicate the estimated average number of resuscitations by the time of graduation.
Number of
Resuscitations*
Site #1
Site #2
Site #3
<2 Years
#
#
#
2-18 Years
#
#
#
>18 Years
#
#
#
*Count cardiac and respiratory arrests, patients in respiratory distress who require intubation, those in shock
who require large amounts of IV fluids or pressors, patients in status epilepticus who require airway
management, patients with multi-system level I trauma that require a coordinated evaluation that includes
airway control, etc.
FELLOW APPOINTMENTS
Will fellows be informed in writing as to the length of their curriculum before they begin the fellowship?
[PR III.A.2.] ........................................................................................................................ ☐ YES ☐ NO
EDUCATIONAL PROGRAM
Pediatric Emergency Medicine
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 4/2015
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Goals and Objectives
Place an ‘X” in the box before the applicable response. [PR IV.A.2.]
Are there goals and objectives for all training experiences?
☐ YES ☐ NO
Are they rotation and level specific?
☐ YES ☐ NO
How are they distributed?
☐ Hard Copy
☐ Electronic or web-based
If not web-based, when are they distributed to fellows?
☐ Prior to Each Rotation
☐ Once in Handbook
☐ Annually
☐ Other
If not web-based, when are they distributed to faculty
members?
☐ Prior to Each Rotation
☐ Other
☐ Annually
If web-based, do you send out reminders to access them?
☐ YES ☐ NO
If yes, when do you send them?
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Conferences
1. List regular subspecialty and interdepartmental conferences, rounds, etc., that are a part of the
fellowship program. Identify the "SITE" by using the corresponding number as appears in ADS.
Indicate the frequency, e.g., weekly, monthly, etc., and whether conference attendance is required
(R) or optional (O). List the role of the fellow in this activity (e.g., conducts conference, presents
case and participates in discussion, case presentation only, participation limited to Q&A component,
etc.). Add rows as necessary. [PR IV.A.3.a)-IV.a.3.a).(3)]
Conference
Site #
Frequency
R/O
Role of the Fellow
2. Describe the mechanism that will be used to ensure fellow attendance at required conferences.
State the degree to which faculty member attendance is expected, and how this will be monitored.
[PR IV.A.3.b)-c)]
Limit the response to 50 words
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Patient Care and Procedural Skills
1. Indicate the settings and activities in which fellows will demonstrate competency in each of the
following areas of patient care. Also indicate the method used to evaluate competency. [PR
IV.A.5.a).(1)]
Pediatric Emergency Medicine
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 4/2015
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Competency Area
Perform a history and physical
examination, make diagnostic
and therapeutic decisions,
develop and carry out
management plans, counsel
patients and families, and use
information technology to
optimize patient care
[PR IV.A.5.a).(1).(a)]
Provide initial evaluation and
treatment to all kinds of
patients. Fellows must evaluate
the patient with an
undifferentiated chief complaint
and diagnose whether it falls in
areas traditionally designated
medical, surgical or
subspecialty. Fellows must
perform such evaluations
rapidly, with simultaneous
stabilization of any life
threatening process, and to
proceed with appropriate lifesaving interventions before
arriving at a definitive diagnosis
[PR IV.A.5.a).(1).(b)]
Perform and interpret the
results of laboratory tests and
diagnostic procedures for use in
patient care
[PR IV.A.5.a).(1).(c)]
The skills appropriate to a
supervisor, teacher, and
decision maker in pediatric
emergencies in the final year of
education
[PR IV.A.5.a).(1).(d)]
Leadership responsibility for the
pediatric emergency
department
[PR IV.A.5.a).(1).(e)]
Providing supervision and
consultation to other residents
caring for patients in the
emergency department
[PR IV.A.5.a).(1).(f)]
Compassionate understanding
of the stress associated with
sudden illness, injury, and
Settings/Activities
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Method(s) Used to Evaluate
Fellow Competency*
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Pediatric Emergency Medicine
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 4/2015
Page 8 of 16
Method(s) Used to Evaluate
Competency Area
Settings/Activities
Fellow Competency*
death so that they are
responsive to the emotional
needs of patients, their families,
and the emergency department
staff
[PR IV.A.5.a).(1).(g)]
Prioritizing and managing the
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emergency care of multiple
patients
[PR IV.A.5.a).(2).(a)]
*Examples of evaluation methods for competence may include: direct observation, global
assessment, multisource assessment, practice/billing audit, patient survey, record/chart review,
review of patient outcomes, simulations/models, structured case discussion, in-house written
examination, In-training examination, oral examination and computer-based learning.
2. Identify the added responsibilities for patient care as the fellow progresses through the program.
Include opportunities given to the fellow to demonstrate the skills appropriate to a supervisor,
teacher, and a decision maker in pediatric emergencies. Use a bulleted list with a heading for year
1, year 2 and year 3. [PR IV.A.5.a).(1).(d)]
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3. Procedures [PR IV.A.5.a).(2).(c)]
For each procedure listed below, specify the method(s) that will be used to teach the procedure and
the method(s) that will be used to assess resident competency in the performance of the procedure.
Procedure
Abscess Incision and
Drainage
[PR IV.A.5.a).(2).(c).(i)]
Arterial Catheterization
[PR IV.A.5.a).(2).(c).(ii)]
Arthrocentesis
[PR IV.A.5.a).(2).(c).(iii)]
Artificial Ventilation
[PR IV.A.5.a).(2).(c).(iv)]
Cardiac Pacing: external
[PR IV.A.5.a).(2).(c).(v)]
Bag-Valve-Mask-Ventilation
[PR IV.A.5.a).(2).(c).(vi)]
Cardiopulmonary pediatric
medical resuscitation <2
years
[PR IV.A.5.a).(2).(c).(vi).(a)]
Method(s) for Teaching the
Procedure
(d=didactic, s=simulation,
c=observed clinical care,
o=other, specify)
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Method(s) of Competency
Assessment*
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Pediatric Emergency Medicine
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 4/2015
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Procedure
Cardiopulmonary pediatric
medical resuscitation 2-18
years
[PR IV.A.5.a).(2).(c).(vi).(b)]
Cardiopulmonary adult
medical resuscitation >18
years
[PR IV.A.5.a).(2).(c).(vi).(c)]
Cardiopulmonary pediatric
trauma resuscitation <2
years
[PR IV.A.5.a).(2).(c).(vi).(d)]
Cardiopulmonary pediatric
trauma resuscitation 2-18
years
[PR IV.A.5.a).(2).(c).(vi).(e)]
Cardiopulmonary adult
trauma resuscitation >18
years
[PR IV.A.5.a).(2).(c).(vi).(f)]
Cardioversion/Defibrillation
[PR IV.A.5.a).(2).(c).(vii)]
Central Venous
Catheterization
[PR IV.A.5.a).(2).(c).(viii)]
Closed Reduction and
Splinting
[PR IV.A.5.a).(2).(c).(ix)]
Conversion of
supraventricular tachycardia
[PR IV.A.5.a).(2).(c).(x)]
Cricothyrotomytranslaryngeal ventilation
[PR IV.A.5.a).(2).(c).(xi)]
Dislocation/Reduction
[PR IV.A.5.a).(2).(c).(xii)]
Endotracheal Intubation
[PR IV.A.5.a).(2).(c).(xiii)]
Foreign Body Removal
[PR IV.A.5.a).(2).(c).(xiv)]
Gastric Lavage
[PR IV.A.5.a).(2).(c).(xv)]
Gastrostomy Tube
Replacement
[PR IV.A.5.a).(2).(c).(xvi)]
Method(s) for Teaching the
Procedure
(d=didactic, s=simulation,
c=observed clinical care,
o=other, specify)
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Method(s) of Competency
Assessment*
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Pediatric Emergency Medicine
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 4/2015
Page 10 of 16
Procedure
Intraosseous access and
fluid administration
[PR IV.A.5.a).(2).(c).(xvii)]
Laceration Repair
[PR IV.A.5.a).(2).(c).(xviii)]
Lumbar Puncture
[PR IV.A.5.a).(2).(b)]
Pericardiocentesis
[PR IV.A.5.a).(2).(c).(xix)]
Nasal Packing
[PR IV.A.5.a).(2).(c).(xx)]
Peritoneal Lavage
[PR IV.A.5.a).(2).(c).(xxi)]
Rapid Sequence Induction
[PR IV.A.5.a).(2).(c).(xxii)]
Rapid Sequence Intubation
[PR IV.A.5.a).(2).(c).(xxii)]
Regional Nerve Blocks
[PR IV.A.5.a).(2).(c).(xxiii)]
Sedation and Analgesia
[PR IV.A.5.a).(2).(c).(xxiv)]
Slit Lamp Examination PR
IV.A.5.a).(2).(c).(xxv)]
Tracheostomy Tube
Replacement
[PR IV.A.5.a).(2).(c).(xxvi)]
Thoracostomy (tube)
[PR IV.A.5.a).(2).(c).(xxvii)]
Umbilical Vessel
Catheterization
[PR IV.A.5.a).(2).(c).(xxviii)]
Vaginal Delivery
[PR IV.A.5.a).(2).(c).(xxix)]
Method(s) for Teaching the
Procedure
(d=didactic, s=simulation,
c=observed clinical care,
o=other, specify)
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Method(s) of Competency
Assessment*
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*Examples of evaluation methods for competence may include: direct observation, global assessment,
multisource assessment, practice/billing audit, patient survey, record/chart review, review of patient
outcomes, simulations/models, structured case discussion, in-house written examination, In-training
examination, oral examination and computer-based learning.
Medical Knowledge
Indicate the ways in which fellows will demonstrate knowledge of the clinical and basic sciences as they
relate to pediatric emergency medicine. Also indicate the method(s) that will be used to assess fellow
knowledge in this area. [PR IV.A.5.b).(1)]
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Pediatric Emergency Medicine
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 4/2015
Page 11 of 16
Practice-based Learning and Improvement
Describe the activities and settings in which fellows will be given opportunities to develop knowledge in
the following topics and evaluation methods used.
CORE CURRICULUM
Teach by conducting lectures,

seminars, and clinical
conferences and by preparing
written reports and teaching
materials
[PR IV.A.5.c).(9)]
Participate in clinical and/or

professional quality improvement
activities. Evidence of selfevaluation, incorporating faculty,
peer, and patient assessments,
must be demonstrated in the
fellow’s development of his or
her individual learning plan
[PR IV.A.2.c).(10)]
Teach and participate in

undergraduate, graduate, and
continuing education activities,
as well as assume some
departmental administrative
responsibilities
[PR IV.A.2.c).(11)]
Settings/Activities
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Method(s) Used to Evaluate
Fellow Competency*
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
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
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*Examples of evaluation methods for competence may include: direct observation, global assessment,
multisource assessment, practice/billing audit, patient survey, record/chart review, review of patient outcomes,
simulations/models, structured case discussion, in-house written examination, In-training examination, oral
examination and computer-based learning.
Interpersonal and Communication Skills
Indicate the ways in which fellows will develop competence in the unique roles of the consultant, team
leader, and team member. [PR IV.A.5.d).(6)]
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Professionalism
Indicate the ways in which fellows will develop high standards of professionalism and a commitment to
continued improvement. [PR IV.A.5.e).(6)]
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Systems-based Practice
1. Indicate the ways in which fellows will competence in the economics of health care and current
health care management issues including cost-effective patient care, practice management,
preventive care, quality improvement, resource allocation, and clinical outcomes [PR IV.A.5.f).(7)]
Pediatric Emergency Medicine
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 4/2015
Page 12 of 16
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2. Indicate the ways in which fellows will competence the prevention of medical errors [PR
IV.A.5.f).(8)]
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Curriculum Organization and Fellow Experiences
1. Indicate whether fellows will be certified as: [PR IV.A.5.a).(2).(c).(vi).(a)-(f)];
PALS/APLS
ACLS
ATLS
Provider
☐ YES ☐ NO
☐ YES ☐ NO
☐ YES ☐ NO
Instructor
☐ YES ☐ NO
☐ YES ☐ NO
☐ YES ☐ NO
2. Reciprocal Training
a) Describe the four (4) months of reciprocal training in an ACGME Pediatrics Program for an
emergency medicine graduate. Copy and paste in the space below the contents of the letter of
agreement between the pediatric emergency medicine program and pediatric program. [PR
IV.A.6.a); IV.A.6.c).(1)]
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b) Describe the four (4) months of reciprocal training in an ACGME Emergency Medicine Program
for a pediatrics graduate. Copy and paste in the space below the contents of the letter of
agreement between the pediatric emergency medicine program and the adult emergency
medicine program. [PR IV.A.6.a).; IV.A.6.c).(2)]
Click here to enter text.
3. Program Design
Describe the process for increasing responsibility for patient care as the fellow progresses through
the program. [PR IV.A.6.d).(3)]
Click here to enter text.
a) Identify the training sites (hospital #) and learning activities (clinical experience, conference
series, journal club, tumor board, etc.) which will be used to address the required core
knowledge area. [PR IV.A.6.d).(5)-(6)]
CORE CURRICULUM
Settings/Activities
Core Medical Knowledge [PR IV.A.6.d).(4)-(6)]
Trauma, including blunt  Settings/Activities
and penetrating
Pediatric Emergency Medicine
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Method(s) Used to
Evaluate Fellow
Competency*
Year(s) of
Training
 Methods
 Years
Updated 4/2015
Page 13 of 16
Method(s) Used to
Evaluate Fellow
Competency*
 Methods
CORE CURRICULUM
Settings/Activities
Significant gynecologic  Settings/Activities
and obstetrical
emergencies
Psychiatric emergencies  Settings/Activities
 Methods
of the adolescent
EMS Children
 Settings/Activities
 Methods
Administration
 Settings/Activities
 Methods
Legal issues
 Settings/Activities
 Methods
Procedures
 Settings/Activities
 Methods
Patient safety
 Settings/Activities
 Methods
Medical errors
 Settings/Activities
 Methods
Ethics and
 Settings/Activities
 Methods
professionalism
Cardiopulmonary
 Settings/Activities
 Methods
resuscitation
Disaster and
 Settings/Activities
 Methods
environmental medicine
Transport
 Settings/Activities
 Methods
Triage
 Settings/Activities
 Methods
Sedation
 Settings/Activities
 Methods
Emergencies arising from the following [PR IV.A.d).(6)]:
Toxicologic causes
 Settings/Activities
 Methods
Obstetric causes
 Settings/Activities
 Methods
Gynecologic causes
 Settings/Activities
 Methods
Allergic/immunologic
 Settings/Activities
 Methods
causes
Cardiovascular causes  Settings/Activities
 Methods
Congenital causes
 Settings/Activities
 Methods
Dermatologic causes
 Settings/Activities
 Methods
Dental causes
 Settings/Activities
 Methods
Endocrine/metabolic
 Settings/Activities
 Methods
causes
Gastrointestinal causes  Settings/Activities
 Methods
Hematologic/oncologic
 Settings/Activities
 Methods
causes
Infectious causes
 Settings/Activities
 Methods
Musculoskeletal causes  Settings/Activities
 Methods
Neurologic causes
 Settings/Activities
 Methods
Ophthalmic causes
 Settings/Activities
 Methods
Psychosocial causes
 Settings/Activities
 Methods
Pulmonary causes
 Settings/Activities
 Methods
Renal/genitourinary and  Settings/Activities
 Methods
surgical disorders
Pediatric Emergency Medicine
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Year(s) of
Training
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Updated 4/2015
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CORE CURRICULUM
Surgical disorders
Physical and sexual
abuse
Settings/Activities
 Settings/Activities
 Settings/Activities
Method(s) Used to
Evaluate Fellow
Competency*
 Methods
 Methods
Year(s) of
Training
 Years
 Years
*Examples of evaluation methods for competence may include: direct observation, global assessment,
multisource assessment, practice/billing audit, patient survey, record/chart review, review of patient
outcomes, simulations/models, structured case discussion, in-house written examination, In-training
examination, oral examination and computer-based learning.
b) Describe how the program emphasizes the fundamentals of assessment, diagnosis, and
management. [PR IV.A.6.d).(8)]
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c) Describe how fellows will receive the instruction and experience to acquire the necessary
procedural skills and to develop an understanding of laboratory tests and diagnostic procedures,
indications, risks, and limitations. [PR IV.A.6.d).(9)-(10)]
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d) Will fellows be exposed to the following [PR IV.A.6.d).(11)]:
1) Academic debate .............................................................................................. ☐ YES ☐ NO
2) Intensive research review ................................................................................. ☐ YES ☐ NO
3) Interaction between the specialties of pediatrics and emergency medicine ...... ☐ YES ☐ NO
e) Describe how the program includes bioethics, including attention to physician-patient, physicianfamily, physician-physician/allied health professional, and physician-society relationships.
[PR IV.A.6.d).(14)]
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f)
Briefly describe the planned fellow education in each of the following: [PR IV.A.6.d).(15)]
1) Curriculum design
Click here to enter text.
2) Information delivery in clinical settings and classrooms
Click here to enter text.
3) Provision of feedback to learners
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4) Assessment of educational outcomes
Click here to enter text.
5) Development of teaching materials
Pediatric Emergency Medicine
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 4/2015
Page 15 of 16
Click here to enter text.
g) Instruction in Program Administration
1) Will fellows be provided with formal sessions on the following [PR IV.A.6.d).(16).(a)]:
a. Organizing teaching programs .................................................................... ☐ YES ☐ NO
b. Medical writing ............................................................................................ ☐ YES ☐ NO
c. Oral presentation ........................................................................................ ☐ YES ☐ NO
2) Describe how fellows will receive instruction and experience in administrative and
management skills, including quality improvement principles, necessary to oversee a
division or department. [PR IV.A.6.d).(16).(b)]
Click here to enter text.
h) Will fellows receive instruction in current health care management issues, such as the following
[PR IV.A.6.d).(17)]:
1)
2)
3)
4)
5)
6)
7)
Economics of health care ................................................................................. ☐ YES ☐ NO
Cost-effective patient care ................................................................................ ☐ YES ☐ NO
Practice management....................................................................................... ☐ YES ☐ NO
Preventive care ................................................................................................ ☐ YES ☐ NO
Quality improvement......................................................................................... ☐ YES ☐ NO
Resource allocation .......................................................................................... ☐ YES ☐ NO
Clinical outcomes ............................................................................................. ☐ YES ☐ NO
i)
Will fellows receive didactic instruction and experience in the prevention of medical errors? [PR
IV.A.6.d).(18)] ......................................................................................................... ☐ YES ☐ NO
j)
Does the program offer a specific EMS rotation? [PR IV.A.6.d).(5)] ........................ ☐ YES ☐ NO
k) Will fellows participate in disaster planning and drills? [PR IV.A.6.d).(5)] ................ ☐ YES ☐ NO
l)
Will fellows take calls for ground or air units requesting transport? [PR IV.A.6.d).(5)]
............................................................................................................................... ☐ YES ☐ NO
PROGRAM EVALUATION
Will the following be components of the annual program evaluation? [PR V.C.3.a)]
1.
2.
3.
4.
5.
Participating site contributions ................................................................................ ☐ YES ☐ NO
Financial and administrative support of the program .............................................. ☐ YES ☐ NO
Volume and variety of patients available for educational purposes ......................... ☐ YES ☐ NO
Teaching staff performance .................................................................................... ☐ YES ☐ NO
Quality of fellow supervision ................................................................................... ☐ YES ☐ NO
Pediatric Emergency Medicine
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 4/2015
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