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Fellowship Programs

Fellowship

Our Division is committed to training one fellow in pedatric surgery annually. The program has been cooperatively provided by the Johns Hopkins Medical Center and the University of Maryland for over 30 years. Both divisions of Pediatric Surgery perform more than 3,200 operations annually and have a staff of 10 pediatric surgeons. 

For any questions relating to the Fellowship program, contact Irma Silkworth at (410) 955-2717.

General Description
Clinical Faculty and Staff
Housestaff
Research Facilities and Staff
Clinical and Research Facilities, University of Marylan Hospital, Affiliated for Six Month Rotation
First Year of Traning Program, Senior Resident in Pediatric Surgery
Second year of Training Program, Chief Resident in Pediatric Surgery
Third year of Training Program (OPTIONAL)

General Description

The post-doctoral training program in Pediatric Surgery at The Johns Hopkins Hospital and University of Maryland Hospital is unique in concept because it utilizes the clinical population of two large university services for a broad clinical experience in pediatric surgery over the prescribed two years. In addition, an optional third year of research training is offered to residents who complete the required clinical program and who wish to develop research skills necessary for independent investigation in basic and clinical pediatric surgical research. This additional research experience is offered for a continuing career in academic surgery.

Completion of the basic two year program will qualify the trainee to take the examination for a “Certificate of Special Competence in Pediatric Surgery,“ which is given by the American Board of Surgery.

Candidates for the two year program are selected through the Pediatric Surgery Resident Matching Program established by the American Pediatric Surgery Association. Selection is made approximately thirteen months prior to beginning the two year program. Prerequisites for post-doctoral training in pediatric surgery include:

  1. Anticipated successful completion of an accredited general surgery residency, which qualifies the candidate for certification in general surgery by the American Board of Surgery.
  2. A completed ERAS application.
  3. Four letters of recommendation.
  4. Personal interviews with the staff at Johns Hopkins and University of Maryland.
  5. Participation in the Matching Program in Pediatric Surgery.

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Clinical Faculty and Staff

The Johns Hopkins Hospital occupies approximately fourteen acres in East Baltimore adjacent to The Johns Hopkins University School of Medicine and School of Public Health and Hygiene. This 1100-bed complex includes a Children's Center with approximately 160 beds. Patients from age 0-21 are admitted to the Children's Center. The facility is equipped for all aspects of general pediatric care, with a 20-bed intensive care unit (PICU), a 34-bed neonatal intensive care unit (NICU), laboratory and radiology facilities. In addition, the facility is the Maryland State Regional Pediatric Trauma Center and a newborn surgical referral center. A pediatric medical and surgical oncology ward (14 beds), psychiatric wards and general pediatric age-determined wards complete the inpatient facility. A suite of 6 operating rooms for children's surgery and a pediatric recovery room adjacent to the PICU are utilized by pediatric general surgery, urology, orthopedics, neurosurgery, and otolaryngology services. The Johns Hopkins Outpatient Center has a 2 room outpatient pediatric surgery area utilized for approximately 1500 children per year. The Outpatient Center also houses the clinical facilities for outpatient visits (approx. 45,000/year). The Park Building, adjacent to the Children's Center, has a pediatric emergency room, oncology and hematology clinics, and a perfusion center.     

The pediatric surgical staff at the Johns Hopkins Hospital is under the direction of Paul M. Colombani, M.D., the Robert Garrett Professor of Pediatric Surgery and the Hospital's Children's Surgeon-in-Charge. There are also full-time specialty surgeons in pediatric orthopedics, urology, neurosurgery, otolaryngology, plastic and cardiovascular surgery.      

To complement the surgical staff, the medical staff comprises all subspecialties, including pediatric intensive care and neonatology at the Johns Hopkins Children's Center.

The Johns Hopkins Hospital and the Children’s Center are internationally recognized as leaders in state-of-the-art care and research for children’s medical and surgical problems.  The Hospital has ranked in the annual US News and World Report as the best hospital in the United States for the last twenty years.  The hospital is consistently rated third for pediatrics (behind Boston Children’s and Children’s Hospital of Philadelphia) with no other close competitors.  The pediatric residency program has also been chosen the number one training program in the USA. 

The Johns Hopkins University School of Medicine is also rated in similar polls as the top ranked research and teaching institution in the United States.

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Housestaff     

Housestaff coverage for the pediatric surgery service includes the Chief Resident (year 2) and Senior Resident (year 1) in pediatric surgery, two senior general surgery residents and two general surgical interns. In addition, third year medical students rotate as clinical clerks in pediatric surgery and fourth year medical students may elect a sub-internship in pediatric surgery.

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Research Facilities and Staff      

A significant part of pediatric surgery at the Johns Hopkins Hospital is devoted to basic science and clinical research. We have a molecular biology laboratory staffed by three post-doctoral positions, four research fellows, and full-time research technicians. Residents and medical students are also involved with laboratory projects.

The Research Building houses a large animal facility for general use with equipment and veterinary support for the pre-operative, intra-operative and post-operative care required for sophisticated fetal surgical research. The Blalock Building houses a “state of the art” minimally invasive surgery lab for use by the surgical sciences. The Ross Building also houses a cell culture and immunology facility exclusively used by the Division of Pediatric Surgery.

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Clinical and Research Facilities, University of Maryland Hospital, Affiliated for Six Month Rotation

The University of Maryland Hospital is a 1600-bed facility located near the Baltimore Harbor, with approximately 120 beds devoted to the care of children. Facilities include a pediatric intensive care unit (12 beds), a neonatal intensive care unit (35 beds) and age-determined wards (annual ER visits of 15,276 and annual outpatient visits of 39,023).      

Pediatric Surgery at Maryland is a section in general surgery under the direction of Dr. Roger Voigt with Dr. J. Laurance Hill, Dr. Eric Strauch, and Dr. Sam Alaish providing general and thoracic pediatric surgical supervision. Drs. Voigt, Hill, Strauch and Alaish have joint academic appointments at The Johns Hopkins University School of Medicine. In addition, there are surgical subspecialists in children's urology, plastics, cardiovascular and neurosurgery, and full-time subspecialists in pediatrics, neonatology, oncology, cardiology, neurology, anesthesia, pediatric radiology and pathology.      

The first year resident in Pediatric Surgery is the Chief Resident on the pediatric surgical service at the University of Maryland for six months. His/her team consists of a general surgery resident, surgical intern and a senior pediatric resident.      

Research facilities that are housed in the Preclinical Teaching Facility provide for the care of small and large animals as well as the sophisticated equipment necessary for fetal and newborn surgery in animals.

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First Year of Traning Program, Senior Resident in Pediatric Surgery

The first year of the training program is designed to expose the resident to general pediatric surgery and a number of surgical and pediatric subspecialties.        

The first two months are spent at Johns Hopkins Hospital with a July rotation in the neonatal intensive care unit.  Six months are spent as the Chief Resident in pediatric surgery at the University of Maryland Hospital under the supervision of Dr. Voigt and staff.

Patients admitted to the pediatric surgical service are evaluated and treated under the Chief Resident’s direction. Care of surgical patients in the pediatric and neonatal intensive care units is the responsibility of the surgical housestaff under the supervision of this Chief Resident in pediatric surgery. This resident is the initial contact for all surgical and pediatric consultations.      

At the University of Maryland, the Chief Resident is responsible for housestaff and student teaching on rounds and in the operating room. He/she organizes the weekly pediatric surgery conference and professors walk rounds as well as presentation of patients at the weekly General Surgical Morbidity and Mortality Conference, monthly Pathology Conference and monthly Nutrition Conference.

The pediatric surgery faculty at the University of Maryland have active clinical and laboratory research projects and the Chief Resident is encouraged to participate in ongoing research or guided to begin an independent project.      

During the last four months, the first year Resident returns to The Johns Hopkins Hospital as the Senior Resident in pediatric surgery. During this time, the senior resident may elect to rotate on the pediatric urology service under the supervision of Dr. John Gearhart, Chief of Pediatric Urology, on the pediatric gastroenterology service under the supervision of Dr. Kathy Schwarz, Chief of Pediatric Gastroenterology, or on other subspecialty services as elective at the time.   The Senior Resident will otherwise assist the Chief Resident in clinical care on the ward.      

The Senior Resident alternates night call with the Chief Resident, attends ward rounds and, in general, assists the Chief Resident in the management of the clinical pediatric surgical service. During this first year of training, the resident is encouraged to initiate and/or collaborate in clinical research activities.

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Second year of Training Program, Chief Resident in Pediatric Surgery

The second year of the two-year program is a diverse clinical year as Chief Resident. The responsibility of the Chief Resident is to supervise and coordinate pre-operative and post-operative care of all children with surgical conditions in the Johns Hopkins Children's Center. The Chief Resident renders direct surgical care to patients with problems in general pediatric, gynecologic, and all non-cardiac thoracic surgery. The Chief Resident coordinates patient care in the statewide regional pediatric trauma center and thus supervises the initial neurosurgical, orthopedic, plastic surgical and critical care for more than 1000 severely injured children each year.      

He/she provides surgical consultation services for all divisions of the Children's Center and is thus involved in the general management of patients on the medical and surgical subspecialty services. He/she is the consultant for most surgical problems in the pediatric emergency room and outpatient clinics, particularly in the comprehensive child care clinic where more than 18,000 children are seen annually.      

Overall management of surgical patients in the pediatric ICU and neonatal ICU is the primary responsibility of the Chief Resident and pediatric surgical housestaff working with the attending pediatric surgeons, staff intensives and neonatologists who attend in these units.

Surgical patients in the pediatric intensive care unit (PICU) remain on the pediatric surgery service and are cared for by an integrated housestaff. The responsibility for moment-to-moment ventilator adjustment and respiratory support is delegated to the pediatric intensive care residents, but the overall responsibility for the writing of medication orders and patient management, including cardiorespiratory support, remains with the pediatric surgery housestaff.  The physician of record is the Staff Pediatric Surgeon.      

Neonatal surgical patients are managed in a combined medical and surgical newborn intensive care unit (NICU), which is supervised by full-time neonatologists. The surgical patients in this unit remain on the pediatric surgical service and the responsibility for their management is in the hands of the Chief Resident in pediatric surgery. The physician of record is the staff surgeon. Direct patient management is rendered by the pediatric surgical service working with the pediatric housestaff assigned to a particular surgical patient in the NICU. The pediatric surgical team is responsible for daily management decisions on these patients. There is consultative input from the neonatologists in the management of these patients and they serve in an important teaching capacity for the pediatric surgical housestaff.      

Teaching responsibilities of the Chief Resident include a weekly Morbidity and Mortality Conference, Pediatric Surgery Grand Rounds and combined Surgery/Neonatology Rounds.  Additional conferences include a monthly Trauma, Basic Science, Pathology and Radiology Conference, Prenatal Conferences (with the Neonatology, OB-GYN and Sonography personnel), weekly Pediatric Grand Rounds, Surgery Grand Rounds, Neonatal Grand Rounds, a Surgery Research Conference, a Pediatric Morbidity and Mortality Conference and Pediatric Nutrition Rounds.      

Both the Chief Resident and Senior Resident share teaching responsibilities with the full-time surgical staff. Housestaff and student teaching on afternoon ward rounds, as well as weekly formal discussions for students, are the responsibilities of the residents in pediatric surgery.      

To meet the individual training needs of the fellow in pediatric surgery, elective time can be arranged during either the first and/or second year in a number of disciplines. Both The Johns Hopkins and University of Maryland Hospitals are Level II burn facilities and the pediatric surgery residents are involved in the management of ambulatory burn patients with less than 20% second and third degree burns. If more intensive experience in pediatric burn treatment is desired, the resident can arrange for a rotation at the Maryland Regional Burn Center, a Level I burn facility at the Bayview Campus of Johns Hopkins, which cares for both adult and pediatric burn patients. Inhalation injuries secondary to thermal injury in patients under the age of two years are initially managed in the pediatric intensive care unit at The Johns Hopkins Hospital under the direction of the general pediatric surgery service. Urology experience during the regular training program includes renal/adrenal tumors, genitourinary trauma, hernia/hydrocele, undescended testicle, testicular torsion and the initial management of cloacae exstrophy. One month intensive experience in pure pediatric urology (cystoscopy, diversion/undiversion and urethral surgery) can be scheduled with Dr. John Gearhart, Chief of Pediatric Urology, during the first year of training. Extended experience can be arranged beyond this rotation during the pediatric surgery residency.

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Third year of Training Program (OPTIONAL)

Following the required two years of the basic clinical training program, each Resident in pediatric surgery is eligible to take the examination for a Certificate of Special Competence in Pediatric Surgery given by the American Board of Surgery. The Chief Resident may elect, in addition, to remain at the Johns Hopkins University as the Robert Garrett Pediatric Surgery Research Fellow for a third year of research in pediatric surgery or related basic science fields. The position carries a full-time academic appointment as an Instructor in Pediatric Surgery with admitting privileges to The Johns Hopkins Hospital and University of Maryland Hospital to facilitate clinical research. Clinical activity that is sufficient to maintain surgical skills is available and will vary with the interests of the trainee. The trainee may continue his/her own research or take advantage of the breadth and depth of expertise at the Johns Hopkins University School of Medicine, School of Hygiene and Public Health or the University of Maryland School of Medicine. For example, a past pediatric surgery fellow chose to take his third year in transplantation immunology and was accepted as a Senior Research Fellow in oncology with full research funding and an appointment as full-time Instructor in Pediatric Surgery. Depending on the interests of the trainee, post-doctoral research projects may be initiated with preceptors in gastroenterology, oncology, immunology, transplantation biology, molecular genetics, developmental anatomy, biochemistry, physiology, pharmacology, and epidemiology to name a few of the disciplines akin to pediatric surgery.

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