From the Guidelines
Emergency medicine fellowships that are clinically based include critical care, toxicology, emergency medical services (EMS), pediatric emergency medicine, sports medicine, ultrasound, wilderness medicine, disaster medicine, hyperbaric medicine, and international emergency medicine. These fellowships provide specialized training beyond the standard emergency medicine residency, focusing on direct patient care in specific areas. For example, critical care fellows learn advanced management of critically ill patients, while toxicology fellows develop expertise in poisonings and overdoses 1. EMS fellows train in pre-hospital care and medical direction, and pediatric emergency medicine fellows specialize in treating acutely ill or injured children.
Key Features of Clinical Fellowships
- Typically last 1-2 years
- Involve hands-on patient care, procedural skills development, and clinical decision-making in their respective subspecialty areas
- Fellows spend significant time in clinical settings, managing patients and developing expertise that can be applied directly to patient care upon completion of their training Some of the key areas of focus for these fellowships include:
- Advanced airway management
- Resuscitation
- Critical care
- Vascular access
- Monitoring
- Pharmacology
- Pain management
- Training and supervised practice in all levels of procedural sedation 1 It's worth noting that the financing of graduate medical education in emergency medicine is crucial to ensure an ample supply of residency-trained emergency medicine specialists 1. Additionally, the use of emergency ultrasound has become an indispensable tool for evaluation of patients in the emergency department, and many fellowship programs now exist, providing advanced training for interested physicians 1.
From the Research
Clinically Based Emergency Medicine Fellowships
- Pediatric emergency medicine fellowships are clinically based, with a focus on clinical education and experience 2
- These fellowships typically require a significant amount of clinical time, with emergency department time varying between three and nine months each year 3
- The structure of the fellowship curriculum has become more standardized over the years, with numerous core rotations required by most programs 4
- Clinical fellow supervision has increased significantly over the years, with most fellows working under supervision in the emergency department 4
- Recent pediatric emergency medicine fellowship graduates have reported spending 70% of their work time on clinical duties, indicating a strong clinical focus in their careers 5
Key Attributes of Clinically Based Fellowships
- Amount of clinical time required: varies between programs, but typically includes a significant amount of emergency department time 3, 4
- Elective rotations: often available, allowing fellows to tailor their training to their interests and career goals 3
- Didactic medical education: typically included as part of the fellowship curriculum 3
- Research experience: often required, with many programs offering protected research time 3, 4
- Administrative and teaching experience: may be included as part of the fellowship curriculum, but may not be as heavily emphasized as clinical training 3, 5