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Emergency Medicine

Pediatric Emergency Medicine Fellowship

General Fellowship Information

The Pediatric Emergency Medicine curriculum consists of roughly one year spent in the department, one year spent in research activities and one year spent in off service rotations which include: radiology, anesthesia/sedation service, adult ED, toxicology, ortho, PICU, Peds surgery, EMS/transport, trauma, child abuse, OB, psychiatry and one elective month. Within the department, PEM fellows have defined graduated levels of responsibility, unlike residents. PEM fellows are expected in their first year to begin initiating treatment independently as graduated pediatricians. They will be responsible for fielding referral calls, giving phone support to outlying facilities, and arranging for patient transport to the ED.

First year fellows are encouraged see all their cases through to completion, and are given time to do so. They are encouraged to perform all necessary procedures with the assistance of other sub-specialists (i.e. Bier block and reduction with the Ortho resident). They share procedure responsibility with second year fellows and residents during a code (i.e. line placement, femoral blood draws, ABG, thoracostomy tubes, etc.) Second year fellows are responsible for multiple patient cases simultaneously. They must learn to prioritize patient care in the event of multiple emergent cases. All emergent cases must be initially seen and stabilized by the second year fellow, and they must be aware of the patient's progress even if they do not pick up the case as their own.

Second year fellows field all EMS/flight radio calls. They also serve as preceptors for bedside teaching and procedures to the residents and first year fellows. Second year fellows are responsible for airway management during trauma and resuscitation cases.

Third year fellows control the flow of the emergency department and must be aware of every urgent and emergent patient present. With PEM faculty back-up they oversee the care of patients first evaluated by residents and junior level fellows. They are the trauma team and resuscitation team leader in the department.

Fellows are responsible for teaching and mentoring others within the department and assisting with the continuing education of nurses, paramedics and outlying residency programs. Through telephone consultation, PALS (Pediatric Advanced Life Support, offered by the American Heart Association), APLS (the pediatric emergency medicine course, offered by the American Academy of Pediatrics), and mini-lecture series, fellows are the face of PEM to the hospital and the outside community. All fellows are expected to take PALS and APLS in their first year and achieve PALS instructor status by their second year. Fellows provide lectures to the residents rotating through the department on a monthly basis and Mock Code practice for both the ED residents and the inpatient teams. Fellows serve as beside teachers and preceptors for mastered procedures and patient cases. Third year fellows function as junior faculty and provide teaching and patient care on that basis with faculty back-up. They also give lectures to EM residents and perform grand rounds presentations for the pediatrics department.

The recent addition of our PULSE simulation center http://www.archildrens.org/medical_services/pulse/default.asp has allowed our fellows occasion to train through rare or complicated scenarios on high fidelity mannequins. The staff at the center also employs trained actors to simulate patients or parents to further augment the experience. Whether it is combined nursing/physician mock codes, multidiscipline advanced procedure modules or video monitored OSCE, our PULSE center provides our fellows with an exceptional education opportunities.

A great deal of emphasis and protected time is given to fellow research in this program. Fellows have 11 months throughout their three years for research. Independent research must culminate in a first author paper submitted for publication in a peer reviewed journal prior to graduation. Two months of time are dedicated in their first year to identify a project and research mentor in an area of interest. Extramural funding grants are available for application and strongly encouraged. In addition to a formal research project, a smaller administrative project is also required which can involve some aspect of QA/QI for the hospital, or department, child advocacy, legislative affairs, systems-wide processing improvement, etc. Presentation at national meetings is both encouraged and funded.

Almost all rotations are done at Arkansas Children's Hospital, a level 1 trauma facility with an annual volume of 33, 000 per year and a total of 292 inpatient beds, and 123 ICU beds. The only exceptions are the three Adult ED months, Obstetrics and the trauma month which are done at our sister hospital, University Hospital on the UAMS campus 8 minutes away.

The University of Arkansas for Medical Sciences is an equal opportunity/affirmative action employer and has a Conrad 30 waiver program. Women and minorities are encouraged to apply.

Emergency Department at Arkansas Children's Hospital

Poised at the entrance of a state of the art pediatric facility, our busy department treats nearly 40,000 children each year. With 23 exam rooms, three trauma bays and a dedicated nursing staff, our physicians are equipped to handle the range of patient acuity we routinely see. From home, from their practitioner's office, from referring hospitals all over the state and neighboring states, patients present to our department expecting and receiving a standard of excellence that has earned our hospital national acclaim. 24-hour coverage with all pediatric specialties and an intensive care transport program enables us to provide Arkansas with around the clock access to comprehensive pediatric care. The ER faculty consists of nine board eligible/board certified PEM physicians and seven board certified pediatricians who staff the Emergency Department. Double coverage is present for 18-19 hours daily.

Department/Fellowship Updates: Facility Upgrade!
 
Our hospital will break ground this year on an exciting and necessary new addition which will provide the Emergency Department with much needed space and flow-design improvement. We will more than double the size of the department to 28,000 square feet. This additional space will allow for four trauma/resuscitation bays, 30 private exam rooms as well as specially equipped Orthopedic, CMS/Obstetric/Gynecologic and Psychiatric rooms. Also, a dedicated isolation room with showers for adults and non-ambulatory patients as well as wash stations for infants and toddlers will allow for a safe and comfortable decontamination area. While comprehensive radiography and laboratory capabilities will remain within close proximity, we will house a digital radiography suite and two point-of-care labs within the department. The department's pod type design will permit expansion and contraction of the facility with fluctuations in patient volumes.

Patients presenting to our new department will be ushered to one of four triage bays and then either placed directly into an exam room or one of two waiting rooms, based on acuity. For patients and physicians at outlying facilities, we will be equipped with telemedicine capabilities allowing for real-time video consultation, extending our assistance and influence through-out the state.

Both physician and nursing staff has had input into the design of the department and while layout has been finalized, faculty will continue to be involved as the individual room design evolves; architects and internal designers will have an opportunity to mock up exam room ideas and have medical staff work in these environments prior to their actual construction.

This is an exciting time for both our department and the hospital at large. Stay tuned for more developments.

The Hospital

Arkansas Children's Hospital is the only pediatric hospital in Arkansas, serving children from birth to age 21. We're also one of the largest pediatric hospitals in the United States. Our facility boasts an internationally renowned reputation for intensive treatments, unique procedures and forward-thinking research all dedicated to fulfilling our mission of enhancing, sustaining and restoring the health and development of children. In other words, we're changing children's lives for the better.

Arkansas Children's Hospital, a place of care, love and hope, is a non-profit, private hospital, dedicated to helping children live healthy and productive lives. It is the only pediatric hospital in Arkansas and one of the largest in the country. The staff consists of more than 500 physicians and a 3,500 member support staff. The campus spans 26 city blocks and has a floor space totaling over 1,200,000 square feet. In the last year, the emergency room, outpatient and specialty clinics had more than 250,000 visits from children, not only from Arkansas, but throughout the world. The hospital has many one-of-a-kind pediatric specialists and is licensed for 280 beds.

Arkansas Children's Hospital is a world leader in many areas of care, utilizing leading-edge treatments, state-of-the-art facilities and aggressive research and development.

Our physicians are consistently recognized for their outstanding performance and achievement in taking care of our young patients. In 2004, 91 doctors from Arkansas Children's Hospital were listed among The Best Doctors in America.* Our physicians also were included among the 2011 Top Doctors in America list, as well as the Arkansas Times selection of best physicians in the state.

ACH serves as the pediatric teaching affiliate of UAMS and is home to the Department of Pediatrics. ACH is the classroom where medical students study the pediatric component of all disciplines. In turn, UAMS shares its current medical breakthroughs and technological advancements. UAMS faculty on the ACH campus are practicing physicians as well as teachers to UAMS students in medicine, nursing, pharmacy and allied health.

Mission

In order to enhance, sustain and restore the health and development of children, Arkansas Children's Hospital provides excellent clinical services, teaching and research. ACH is committed to working with others to achieve high quality, cost-effective, fully accessible services for Arkansas' most precious resource our children, without regard to race, religion or inability to pay.

The PICU

Dedicated on March 20, 2003, the Donald W. Reynolds Pediatric Intensive Care Unit at Arkansas Children's Hospital brings state-of-the-art facilities which allow for a more family-centered approach in pediatric care. Every element has been specially designed for the care and comfort of patients and their families.

Angel One Transport

Arkansas Children's Hospital Angel One is a state-of-the-art, intensive care medical transport system for bringing critically ill and injured infants, children, and adolescents as well as adult burn patients from throughout Arkansas and the surrounding states to ACH.  We also operate a high risk obstetric (HROB) transport program in partnership with the University of Arkansas for Medical Sciences.

We began operations in 1978 known as Arkansas Newborn Transport Service (ANTS), operating with one ambulance. A fixed-wing aircraft was leased from Central Flying Service in 1982 to accommodate longer distances. In 1985, helicopter operations were begun under the new name of Angel One, utilizing a Bell206-L-1 helicopter. This was upgraded to a light, twin engine helicopter, a Eurocopter BO-105 in 1987 and in 1992 a heavy twin engine Sikorsky S-76-A helicopter was added to the fleet. In 1999, ACH purchased a used Sikorsky S-76 A to replace the original Sikorsky helicopter. Both helicopters were replaced in 2002, and in recent years, we have added two more ground units to bring our fleet to a total of five plus the availability of a fixed-wing aircraft.

Angel One provides intensive care medical transportation for the entire state of Arkansas and the surrounding states, covering a radius of approximately 200 miles of Little Rock. With the ability to do mobile ECMO (Extracorporeal Membrane Oxygenation), this distance is extended to 300 Nautical Miles.

We currently make over 2,100 total transports per year with 1,200 by helicopter.  Between July 1, 2006 and June 30, 2007, we transported 2,103 patients, of which 918 were NICU, 925 were PICU and 11 were ECMO Transports. Angel One was the first to do mobile ECMO by helicopter and in 1996 became the first pediatric program accredited by the Commission on Accreditation of Medical Transport Services (CAMTS).

Recently, Angel One transitioned the aviation side and began operations under our own FAA Part 135.  This accomplishment further shows the dedication of Arkansas Children's Hospital to the Angel One program.

Arkansas Children's Hospital and Angel One are dedicated to providing Care, Love and Hope® at 180 miles per hour.

ANGEL ONE TRANSPORT
1-800-ACH-HELP

For more information, please visit the ACH website:  http://www.archildrens.org/medical_services/transport/about_angel_one.asp

Faculty Members


Meet the UAMS Pediatric Emergency Medicine Fellows

 
Megan_-_Emergency_Medicine_FellowMegan (PGY-6) is a second year fellow who went to college in Lancaster, PA at Franklin and Marshall College, where she studied biology and classical history.  She went to medical school at Vanderbilt, and then moved to Ann Arbor, Michigan for a four-year residency in Emergency Medicine.  This makes her unique in our program, and her perspective as an ER-trained physician is a welcome one.  Her clinical interests include education theory and simulation training.  She also enjoys scrapbooking, geocaching (whatever that is), SCUBA diving, and travel.

Lauren_-_Emergency_Medicine_Fellow
Lauren (PGY-4) is the program newbie.  She spent her impressionable years in Sacramento, CA.  She stayed in California for college at UCLA, but moved to Michigan for medical school at Michigan State University.  Her residency was spent at Children's National Medical Center in Washington, D.C.  She quite worldly, having taken trips to both African and South America.  Her research interests include injury prevention and international health (the trips to Africa and South America will come in handy for this).  She loves to read, travel, and watch movies, and secretly indulges in celebrity gossip and reality television.
 
Jon_-_Emergency_Medicine_Fellow
Jon (PGY - 4) grew up in Denver, Colorado before moving to the South for college and then med school in Arkansas.  It is there, at a summer camp, that he met his wife, and he has become an adopted Southener, and now enjoying black eyed peas, grits, greens and fried okra greatly.  He completed his residency on the beach in Charleston, SC, where it quickly became obvious to him that the ER was the place for him.  The energy unpredictability and ample opportunity for procedures attracted him.  His research interests include transport medicine, and bedside ultrasound.  Outside the ED, he enjoys soccer, bicycling and hanging out with his wife and two rescued mutts.
 
Renee_-_Emergencey_Medicine_FellowRenee (PGY-4) decided to pursue medicine after her attempts at stand-up comedy failed miserably.  She grew up in St. Louis, MO but came to Little Rock after completing her pediatric residency in Morristown, NJ, where she met and married her husband.  Her research interests include radiation from medical imaging and injury prevention.  She has a beautiful baby girl, Sofia, who is almost 1 year old and unarguably the most awesome baby in the world (in her unbiased opinion).  She enjoys playing the piano, hiking and playing with her daughter.
 
Dustin_-_Emergency_Medicine_Fellowship_CoordinatorDustin (Program Coordinator) is the go-to man for the fellowship.  If you need something done, he'll figure out a way to do it.  He graduated from the University of Arkansas at Little Rock with a degree in political science.  He has spent the five happiest years of his life at UAMS within the department of Pediatric Emergency Medicine.  He enjoys pretty much any sport as well as time in the great outdoors.


 
Support Staff
 
Melissa_Moore_-_Emergencey_Medicine_Fellowship_-_Office_ManagerMelissa Moore (Office Manager) -  Melissa was born and grew up right here in Little Rock, spending much of her childhood outdoors playing tennis, swimming, camping, boating or enjoying the great outdoors in some fashion.  She attended Ouachita Baptist University her freshman year, then transferred to UALR and graduated with a Bachelor of Science degree in Business Administration.  She has worked for UAMS since 1986, first in Admissions, then the Department of Psychiatry and now in Pediatric Emergency Medicine. In addition to working, she has three boys, a new puppy and a husband who keep her quite busy.  Her husband, David, also works at UAMS as the Associate Director of Radiology and serves as a part-time Associate Pastor at Asbury United Methodist Church.
 
Dave_English_-_Emergencey_Mediciine_Fellowship_Specialty_NurseDave English  (Specialty Nurse)Dave is the Emergency Department’s Specialty nurse.  Born in Forth Worth, TX, he received his BSN from TCU after serving in the Army as a medic during the Viet Nam era.  He came to ACH in ’83, move to the ER in ’89, and begin his role as Specialty Nurse in ’95.  He has enjoyed coaching soccer, serving as a Scout Master, and his time with the Reading Renaissance at our partner school, MLK Elementary.  These days he enjoys boating on Lake Ouachita during the camping season. 
 
Jennifer_Tarver_-_Emergency_Medicine_Fellowship_-_Admin_AssistantJennifer Tarver (Administrative Assistant) -  was born in Garland, Texas but grew up in Benton, AR, where she currently lives.  Jennifer attended the U of A in Fayetteville but now attends UALR, where she is finishing up her bachelors in Mathematics and Accounting.    Jennifer has worked for UAMS since 2003, in Family & Preventive Medicine, Pediatric Accounting, and now for Pediatric Emergency Medicine.   In addition to working and attending UALR, she is busy with her husband, Joe, raising a 2 year old daughter, a 7 year old step-son, and 3 dogs.  Her husband, Joe, is about to graduate from UALR with a bachelor’s degree in Wildlife Management and Conservation, so they will all be spending a lot of camping and kayaking. If she ever had spare time, she enjoys cooking and photography.

(Jo) Mary Jo Dollins (Billing Specialist) -  was born in Guymon, Oklahoma and relocated to Arkansas in 1981.   Attended school in Guymon, OK and Panhandle State College.  Single again, she has 3 adult children and enjoys spending time with them as often as possible.    She has worked for UAMS since 1987, first in cardiology and switched to Emergency Medicine in 1990. In her spare time, she is a licensed representative for Modern Woodman of America, which is an insurance, annuities and financial investment company.   Activities include working in my yard, canoeing, riding bikes, walking and very involved in church activities and activities with friends.

Recently Graduated Fellows

Robert S. Williams, MD
PGY6 - Fellow - Pediatric Emergency Medicine
Medical School - St. George's University School of Medicine, Grenada, West Indies, May 2002
Residency - UAMS/Arkansas Children's Hospital, Little Rock, AR, July 2005
Research - ATV Safety Video in Hunter Education Course: an Effective Mode of Information Dissemination  
Clinical interest - Advanced airway management and pediatric procedural sedation

Greg M. Dupuis, MD
PGY5 - Fellow - Pediatric Emergency Medicine
Medical School - Louisiana State University Health Sciences Center, School of Medicine in New Orleans, May 2003
Residency - UAMS/ Arkansas Children's Hospital, Little Rock, AR, July 2006
Research - Simulation education for pre-hospital providersClinical Interest - Asthma management in the ED, pediatric procedural sedation

Tomas A. Murillo-Valtierra, M.D.
PGY5 - Fellow - Pediatric Emergency Medicine
Medical School - University of Texas, Southwestern, 2003
Residency - UAMS/ Arkansas Children's Hospital, Little Rock, AR, July 2006
Research - Infectious disease, sports medicine
Clinical Interests - Sports Medicine, Transport Medicine, Anesthesia/sedation, Trauma, Marine Medicine, Critical Care Medicine

Matthew W. Jaeger, MD
PGY4 - Fellow - Pediatric Emergency Medicine
Medical School - University of Alabama School of Medicine, 2003
Residency - UAMS/ Arkansas Children's Hospital, Little Rock, AR, July 2006
Research Interests - Emergency Ultrasound; use of ultrasound to measure optic nerve diameter as predictor of increased intracranial pressure
Clinical Interests - Emergently ill children

Michelle Hall-Smoot, MD
PGY4 - Fellow - Pediatric Emergency Medicine
Medical School - Louisiana State University Health Science Center in Shreveport, May 2004
Residency - UAMS/ Arkansas Children's Hospital, Little Rock, AR, July 2007
Research Interests - Objective and subjective measures of fatigue in CPR rescuers Clinical Interests - Emergency medicine and emergency procedures.

How to Apply

Application to our fellowship is accomplished through the National Residency Match Program (NRMP) and its Electronic Residency Application Service (ERAS).  Information on our program can be obtained at anytime, but formal inquiries and evaluation for interview selection begins each August. Deadlines for ERAS participation may vary each year but are outlined at the NRMP website, http://www.aamc.org/students/erasfellow/timeline/start.htm. However, our program will consider applications through November for interview and will base our ranking decisions on merits of applicant education, research and professional experience as well as interview impression. We welcome any inquiries to our program.

Links

For more information on the NRMP and ERAS go to:
http://www.aamc.org/students/erasfellow/start.htm

For a comprehensive, up-to-date listing of programs participating:
http://www.ama-assn.org/vapp/freida/srch

Contact Us

If you wish to inquire about our program, please do not hesitate to contact us by phone, mail or email:

Tonya Thompson, M.D.
Associate Program Director
Emergency Medicine Fellowship Program
Department of Pediatrics
University of Arkansas for Medical Sciences
Arkansas Children's Hospital
1 Children's Way, Slot 512-16
Little Rock, AR 72202
Phone: (501) 364-1089
E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Dustin Foster
Program Coordinator
Emergency Medicine Fellowship Program
Department of Pediatrics
University of Arkansas for Medical Sciences
Arkansas Children's Hospital
1 Children's Way, Slot 512-16
Little Rock, AR 72202
Phone: (501) 364-1089
E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

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