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Altieri Pediatric Emergency Medicine Fellowship Frequently Asked Questions

How Old Is the Fellowship?

The fellowship was founded in 1993 as a training program for emergency medicine trained residents.

Who Is Dr Altieri?

Dr. Michael F. Altieri was a pediatrician and one of the earliest fellowship trained pediatric emergency medicine physicians. He founded the program.

What Is Staffing Like? Are There Pediatric Emergency Medicine Faculty in the ED?

The Peds ED is fully staffed with 24-hour PEM attending coverage and double attending coverage during the evening hours. Fellows work alongside the faculty at peak pediatric hours, so there is ample supervision.

Almost all the faculty are subspecialty trained in Pediatric Emergency Medicine. Roughly half were EM residency trained, and half were pediatric trained, and some are double boarded in Pediatrics and EM. This is great for learning. Board-certified general emergency medicine also work in the Peds ED, and the fellows in the PED track spend time with these faculty while on rotation in the adult unit.

Is the Program Accredited by the ACGME?

The program is fully accredited through the Pediatrics RRC, but we train both Emergency Medicine and Pediatric residency trained fellows.

If I Am an EM Graduate, How Long Is My Training?

Length of training for graduates of EM programs is 2 years. The curriculum can be tailored to individual learning needs (beyond what is required by the ACGME).

NOTE: A research/scholarly activity project is required.

Application for the board exam for EM diplomates is through the American Board of Emergency Medicine.

What Are the Duty Hours Like?

The shifts are ten hours long.

First year ED fellows can expect to work about 40 clinical hours a week, with protected time for research and scholarship. Average hours worked per week approaches 30 clinical hours as a junior fellow.

Will I Have to Take Call?

Some rotations require call or night float, such as ward pediatrics (EM only) and PICU, as well as trauma surgery (ped track only). Duty hours approach 80/30 on these rotations.

How Many Conferences Are There?

Lots! Pediatric Emergency Medicine Conference is held every Thursday. Fellows receive protected time before conference and days devoted to research. While fellows are on inpatient or pediatric subspecialty rotations, Core pediatric lectures on Tuesdays are required. Other general topics, such as medical legal issues, customer service, sleep deprivation and cultural competency, are provided at Institutional Educational Grand Rounds.

Does the Faculty Attend Conference? Who Else Is There?

Faculty provide supervision at all conferences. Learners also include (Inova and visiting) residents and medical students. This is a specially designed learning experience, allowing ample opportunity to teach and be taught.

What Are the Salary and Benefits?

Salaries are based on mid-Atlantic averages. Benefits include health insurance, malpractice, etc., through Inova.

Is Moonlighting Allowed?

Moonlighting privileges may be granted for fellows beyond the first six months in the first year, if in good academic and clinical standing and with permission from the program director. Moonlighting hours must be included in duty hour documentation. Fellows should also be aware that Inova does not cover malpractice for moonlighting positions in or out of the institution.

EM trained fellows who are board certified in emergency medicine may request credentialing to moonlight in an ED with the expressed written permission of the program director. Fellows must be in good academic and clinical standing via the SOC/CCC.

Pediatric trained fellows who are board certified in pediatrics do not have permission to moonlight as a PEM attendings anywhere during the first year of training. Fellows may take call as hospitalists and must apply for hospitalist privileges to do so. After the first year of training, a fellow in good academic and clinical standing via the SOC/CCC will be permitted to request credentialing to moonlight in an ED setting.

Is There Protected Time for Research?

The Research Curriculum begins in the first year. Protected time includes dedicated research months, and dedicated “shifts” for research and scholarly activity during clinical months.

Structured Mentorship occurs through the Scholarship Oversight Committee.

Fellows will work the equivalent of one clinical weekend (3 day weekend) and one day during research months to maintain clinical skills.

What Makes This Program a Great Place to Train?

Our community-based program has been called a "mom and pop shop" by many.

Our mission is to train PEM specialists that are knowledgeable, resourceful, and who feel comfortable to practice anywhere. Program curricula are carefully designed and tailored to fit individual needs. The curricula are constantly under renovation. Fellow input is key to this developmental process. Fellows are involved in educational programs within the fellowship and pediatric residency; fellows' presentation skills are also scrutinized during time in the program. Inova Fairfax Hospital has long been a site of graduate medical education and with its proximity to the DC metro area, provides a truly unique backdrop for all kinds of disease presentations and prevention.

“From a curriculum standpoint, the advanced digital electronic and traditional modalities gave me the extra edge with respect to my knowledge base and ability to learn and teach effectively."
“Coming from an emergency medicine background, I had different educational needs than the majority of fellows that come from a pediatrics background. The EM specific curriculum, and the adjustments we made to the curriculum based on my personal experience and knowledge gaps coming out of residency meant that rotations outside the ED were as relevant and useful as possible."
“I received support for any endeavour in setting up electives that were not traditional to the curriculum, and as a result, felt that my personal goals were valued and fostered. Most importantly, I still miss my INOVA family and am grateful for the lifetime relationships that I developed there."
"Since graduating from fellowship I have been in a hybrid academic/community Pediatric Emergency Room. At Inova, coming from a Peds residency, I was ecstatic about the varied backgrounds of our PEM attendings from both Gen Peds and Gen EM backgrounds. This allowed me to tap into each of their fortes, whether as simple as navigating difficult parents to doing more invasive procedures. This made for bedside learning that I have not seen replicated at any institution that I've come thru since."
"In the ED, I worked with attendings who had taken every different route to PEM, and were very flexible in helping me meet my educational needs."
"Team based learning, and the significant level of involvement fellows had in our educational conferences have made me a more efficient and flexible educator. Tonight, I am putting together a "one pager" for the fellows I work with in my new position, something I never thought I would have done if you asked me 2 years ago!"
"The high expectation for involvement in creating educational materials and presentations for our conferences was a significant time commitment. I was definitely forced out of my comfort zone at times."
"The fellowship training goes far beyond the standard core curriculum and truly aims to instill its fellows with the clinical expertise, analytical thinking capability, and leadership skills to practice in any environment. I personally found the greatest benefit with regards to maturing as a leader both in the clinical setting as well as academics."
"The fellow-driven and faculty supported conference curriculum centers around a flipped classroom model whereby each fellow contributes to the education of their peers as well as faculty, residents and medical students. This is perhaps most evident in the robust medical simulation sessions which occur in our newly designed, high-fidelity simulation center. It is by participating in and ultimately leading and designing these scenarios that I have gained confidence in leading my clinical team in critical resuscitation in the department as an attending."
"This program is ideally suited for well-rounded and self-motivated individuals seeking a rigorous but high-caliber academic experience."