The rapid proliferation and adoption of extracorporeal therapies is driving a concomitant demand for professionals with greater experience with these technologies than they normally receive during a subspecialty fellowship in pediatrics or pediatric surgery. In the spring of 2019, Texas Children’s inaugurated its ECLS fellowship program. The objective of the program is to train pediatric subspecialists (intensivists, neonatologists, pediatric surgeons) in the principles and practice of different extracorporeal support modalities, including ECMO (VV or VA), ventricular assist and Impella VAD for cardiac and respiratory disease. When they finish the training, graduates of the fellowship will possess the competencies to join a high-functioning ECMO team at any leading children’s hospital or start a new ECMO program from scratch at an institution wanting to establish one.
Although called a “fellowship,” the 1-year training program is not ACGME-sanctioned. Approved trainees are appointed as Instructors in the Department of Pediatrics (or Pediatric Surgery) at Baylor College of Medicine, and provide attending-level coverage within their respective disciplines (pediatric critical care, neonatology, or pediatric surgery) during 6-10 weeks of their year.
The fellowship is designed to be tailored to the particular needs of our trainees. Our first three fellows were pediatric intensivists who spent 8 weeks in adult ECMO rotations here in Houston and conducted several ECMO transports. Our fourth fellow, also a pediatric intensivist, will receive similar broad-based training that includes rotations on adult ECMO services at collaborating institutions, ECMO transport (ground and air), priming, maintenance and troubleshooting of extracorporeal circuits, training in renal and liver replacement therapies, transfusion medicine, imaging and supervised cannulations.