The Washington University Division of Pediatric Surgery offers a two-year fellowship program for physicians seeking specialized training in pediatric surgery.
In order to be eligible for the program, applicants must first complete a general surgery residency program that has been approved by the Accreditation Council for Graduate Medical Education (ACGME). One applicant is selected for the two-year fellowship each year. He or she is based at St. Louis Children’s Hospital, where the Division of Pediatric Surgery averages approximately 1,750 surgical admissions and 9,500 inpatient days per year. In addition to clinical duties, the fellow has administrative responsibilities for residents in general surgery and pediatrics as well as for medical students on the service.
The fellow’s clinical responsibilities include the preoperative, operative and postoperative care of patients on the pediatric surgical service. He or she develops detailed knowledge of congenital, neoplastic, infectious and other acquired conditions of the gastrointestinal tract and of other abdominal organs, the diaphragm and thorax, endocrine glands, gonads and reproductive organs, head and neck, and blood and vascular system.
The fellow develops expertise in treating the following conditions:
- Major disease processes (congenital anomalies of the thorax and gastrointestinal tract, tracheoesophageal fistula, intestinal atresia, malrotation, anorectal malformation, inperforate anus and abdominal wall defects)
- Gastrointestinal problems (esophageal disorders, gastroesophageal reflux, hypertrophic pyloric stenosis, Meckel’s diverticulum, intestinal duplication, intussusception, necrotizing enterocolitis, appendicitis, Hirschsprung’s disease, inflammatory bowel disease, hepatobiliary problems and diseases of the pancreas)
- Abdominal wall abnormalities (gastroschisis, omphalocele, hernias and hydroceles)
- Undescended testes and ambiguous genitalia
- Pediatric oncology (Wilms’ tumor, neuroblastoma, pheochromocytoma, soft tissue sarcomas, germ cell tumors, lymphomas and Hodgkin’s disease)
- Head and neck masses (lymphadenopathy, congenital lesions of the neck, and thyroid and parathyroid disorders)
- Extracorporeal membrane oxygenation (ECMO) for pediatric and neonatal disease
The fellow also gains knowledge and experience in treating pediatric trauma and burn patients. This trauma care includes the management of cases where children have sustained injuries to multiple organs. The fellow not only provides surgical treatment of these patients, but also manages these patients in a nonoperative setting.
The fellowship includes rotations on the pediatric intensive care unit, neonatal intensive care unit, urology and otolaryngology services as well as outpatient and other areas.
The fellowship’s broad curriculum encompasses the electrolyte and nutritional needs of neonates and pediatric patients as well as the basic principles of cardiothoracic surgery, gynecology, neurologic surgery, orthopaedic surgery, otolaryngology, anesthesia, vascular surgery and transplant surgery.
Fellows participate in a series of conferences — both didactic and bedside — that also are attended by the house staff and medical students. The fellow helps prepare for grand rounds and other conferences.