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Program Overview

The Pediatric Emergency Medicine Fellowship Program at the Nemours Children’s Hospital, Delaware, in affiliation with Sidney Kimmel Medical College at Thomas Jefferson University (TJU), trains physicians in advanced skills in pediatric emergency medicine.

While the program emphasizes clinical skills, you’ll also receive comprehensive training in related areas — including research and teaching, as well as a thorough grounding in the practical and academic topics that surround emergency care for children.

Diversity and Inclusion Statement

Diversity is the richness of human differences. It is one of the foundational supports in Thomas Jefferson University’s Blueprint for Strategic Action, and is incorporated into the behaviors that sustain our core values. Inclusion is the active, intentional and ongoing engagement with diversity. At Sidney Kimmel Medical College (SKMC) at Thomas Jefferson University, we promote and cultivate an inclusive environment that embraces and celebrates the diversity of our people. SKMC believes that a diverse and inclusive environment is key to achieving excellence in our missions of patient care, education and research. We believe that our mission and values will create and nurture the physicians who provide compassionate and culturally-sensitive care to the diverse patient population that they serve.

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Diversity and Inclusion

Our Fellowship Program

With an emphasis on the care of acutely ill and injured children, the program‘s objective is to yield competent physicians who are capable of teaching pediatric emergency medicine, conducting high-quality research (a requirement for board certification in pediatric emergency medicine) and demonstrating responsible administrative skills.

Physicians in the program also learn about medical and legal issues, health care finances, hospital organizational structures, quality assurance, personnel management, patient services and child advocacy issues.

Rotations

Fellow Curriculum and Rotations

First year curriculum and rotations

  • Pediatric emergency medicine (20 weeks)
  • Anesthesia (4 weeks/longitudinal)
    • Fellows may spend time in the operating room 2-3 times per month after their initial rotation to practice airway management 
  • Critical care (4 weeks)
  • Toxicology (4 weeks)
  • Trauma (4 weeks)
  • Research (8 weeks)
  • EMS (2 weeks)
  • Ultrasound (2 weeks)
  • Vacation (4 weeks)

Second year curriculum and rotations

  • Pediatric emergency medicine (20 weeks)
  • General emergency medicine (8 weeks)
  • Research (16 weeks)
  • Electives (2 weeks)
  • Vacation (4 weeks)
  • Ultrasound (2 weeks)

Third year curriculum and rotations

Clinical time spent in the emergency department is in the role as the attending physician.

  • Pediatric emergency medicine (20 weeks)
  • Research (24 weeks)
  • Electives/Administration (4 weeks)
  • Vacation (4 weeks)

Conference Schedule

Weekly

  • Pediatric Emergency Medicine (PEM) – Friday morning resident conference
  • General Emergency Medicine and Simulation – Thursday/Friday (CCHS)

Bi-monthly

  • PEM Fellow lecture series
  • PEM business meeting

Monthly

  • ED Acuity conference
  • ED M&M conference
  • ED Ultrasound conference
  • Trauma conference
  • PEM Fellow board review
  • PEM Fellow research conference and journal club
  • PEM Fellow mock code

Annually

  • PEM Fellow procedure day
  • PEM Fellow skills course (first year)
  • PEM Fellow retreat
  • Fellows may also choose to attend the annual AAP National PEM Fellows’ Conference and/or BASE camp (put on by Cornell Medical College)

Electives

Electives in the program include, but are not limited to:

  • Plastic Surgery
  • Pediatric sports medicine
  • Cast clinic
  • Palliative care
  • Simulation 
  • Sedation service
  • Kidshealth, Nemours
  • Ultrasound
  • Child Advocacy Center, Nemours
  • Burn Center, Crozer Medical Center
  • Critical Care Transport Team, Nemours
  • Administration and Quality Improvement, Nemours
  • Emergency Ophthalmology, Will’s Eye
  • International Medicine. Prior fellows have spent rotations in Togo, Rwanda and Haiti.

Teaching Activities for Fellows

The Division of Emergency Medicine at Nemours Children’s Hospital, Delaware offers many teaching activities to help fellowship participants derive the most knowledge from the program.

These include:

  • Weekly resident didactic lectures
  • Evidence-based medicine journal club
  • Case management, procedure and acuity conferences
  • Mock codes
  • Monthly fellows’ seminars
  • Chapter review
  • Monthly divisional research meetings

Fellows are encouraged to become PALS instructors during fellowship. As third years, fellow are also invited to participate as lecturers and instructors for the multiple CME emergency medicine based conferences put on by the hospitals.

The Emergency Medicine Division

The Division of Emergency Medicine, part of the hospital's Department of Pediatrics, is staffed with board-certified pediatric emergency medicine physicians who supervise the Emergency Department (ED) 24 hours a day. In addition, pediatric, family and emergency medicine residents from various programs rotate through the unit. Our 5-zone, 42-bed ED is a 911-trauma level 1 facility that logs approximately 60,000 visits annually, exposing physicians to a wide scope of pediatric emergencies.

In addition to providing faculty for the emergency medicine fellowship, the division plays an active role in teaching residents and medical students and is an award-winning teaching division, as voted upon by the residents. Medical students from Sidney Kimmel Medical College rotate through the hospital for their pediatric training, in addition to an emergency medicine rotation.

Research Opportunities for Fellows

Early in the first year, emergency medicine fellows will participate in an education and research training course, along with other subspecialty pediatric fellows. This course provides training in biostatistics, study design, clinical and laboratory research methodology, preparation of IRB protocols, abstract and manuscript writing and ethical principles related to clinical research. Additional training is provided by the fellowship director during monthly research lectures. Prior fellows have also completed MPH degrees during their 3 year fellowship. Many current and former fellows have successfully advanced their projects to presentations at national meetings and publications.

Examples of fellow research projects include:

Poster and Platform Presentations

  • Hegamyer E. Treatment of Sepsis in Medically Complex Children Seen in the Pediatric Emergency Department. Pediatric Academic Societies Annual Meeting 2020; Philadelphia, PA (conference canceled due to SARS-COVID 19 pandemic).
  • Kazmierczak M. Outcomes of patients discharged from the pediatric emergency department with abnormal vital signs. Pediatric Academic Societies Annual Meeting 2020; Philadelphia, PA (conference canceled due to SARS-COVID 19 pandemic).
  • Riverso M. Identification of retinal hemorrhage on magnetic resonance imaging compared to dilated fundoscopic examination among suspected child abuse victims. Pediatric Academic Societies Annual Meeting 2020; Philadelphia, PA (conference canceled due to SARS-COVID 19 pandemic).
  • Kieffer J. Comparison of Paper and Electronic Medical Record for Trauma Activations in a Pediatric Trauma Center.  Pediatric Academic Societies Annual Meeting 2019; Philadelphia, PA.
  • Fong K. Impact of Early Insulin Administration on Critically Ill Patients in Diabetic Ketoacidosis. Society for Academic Emergency Medicine Annual Meeting 2019; Las Vegas, NV. 
  • Fong K. Quality Improvement Initiative to Reduce Door-to-Insulin Time for Diabetics in the Pediatric Emergency Department.  Pediatric Academic Societies Annual Meeting 2019; Philadelphia, PA.
  • Kusulas M. Are “Traumatic Taps” Truly Traumatic? Pediatric Academic Societies Annual Meeting 2016; Baltimore, Md.
  • Smith N. Ideal Observation Time after Racemic Epinephrine in the Pediatric Emergency Department for Those with Croup.Pediatric Academic Societies Annual Meeting 2016; Baltimore, Md.
  • Kelly S. The Effect of Subsidized Malaria Testing on Provider Treatment Patterns at a Togolese Mission Hospital. Pediatrics Academic Societies Annual Meeting 2016; Baltimore, Md.
  • Kusulas M. The Effect of Team Care Plan Meetings on Resident Education in the Emergency Department. The Eastern Society for Pediatric Research Annual Meeting 2015; Philadelphia, Pa.
  • Savage JS. Does the Role of a Rapid Triage Provider Improve Pain Control in an Academic Pediatric Emergency Department? Pediatric Academic Societies Annual Meeting 2015; San Diego, Calif.
  • Baghdassarian A. Pediatric Emergency Care: Knowledge Assessment of Pre-Hospital Emergency Physicians in Yerevan, Armenia. Pediatric Academic Societies Annual Meeting 2013; Washington, D.C.
  • Rogers BD. Correlation Between Unexpected Return Visits to a Pediatric Emergency Department and the Office Hours and Scheduling Times of the Primary Care Provider. American Academy of Pediatrics Annual Meeting 2012; New Orleans.
  • Sandelich S. A Clinical Decision Support System Improves the Evaluation and Management of Pediatric Victims of Sexual Abuse. Pediatric Academic Societies Annual Meeting 2017; San Franciso, Calif.
  • Mayo M. Impact of Rapid Serum Lyme Testing on the Management of Monoarticular Arthritis in the Pediatric Emergency Department.  Pediatric Academic Societies Annual Meeting 2017; San Francisco, Calif.
  • Fugok K. The effect of telemedicine on resource utilization and hospital disposition in critically ill pediatric transport patients. Society of Critical Care Medicine's Annual Congress 2016; Orlando, Fla.
  • Kennedy T. The Utility of Peripheral White Blood Cell Count for Non-Diagnostic Ultrasound and Non-Contrast Magnetic Resonance Imaging Studies in Suspected Pediatric Appendicitis. Pediatric Academic Societies Annual Meeting 2018; Toronto, Canada.
  • Kennedy T. Pediatric Heatstroke Fatalities Caused By Being Left In Motor Vehicles. Pediatric Academic Societies Annual Meeting 2018; Toronto, Canada.

Publications

  • Kazmierczak M, Thompson AD, DePiero AD, Selbst SM. Outcomes of patients discharged from the pediatric emergency department with abnormal vital signs. Am J Emerg Med 2022;57:76-80.
  • Kieffer JC, Thompson A, Elwell S, DePiero A. Comparison of paper and electronic documentation for trauma activations in a pediatric trauma center. Am J Emerg Med 2021;50:719-723.
  • Hegamyer E, Thompson A, Smith N, Depiero A. Treatment of suspected sepsis and septic shock in children with chronic disease seen in the pediatric emergency department. Am J Emergency Medicine 2021;44:56-61.
  • Cully M, Thompson AD, Depiero AD. Is lactic acidosis predictive of outcomes in pediatric diabetic ketoacidosis?  Am J Emerg Med 2020;38:329-332.
  • Meghpara, M, Bender, B, Attia, M. A Unique Presentation of a Critically Ill Infant Secondary to Covid-19. Medical Society of Delaware. May 2020.
  • Cully M, Treut M, Thompson A, Depiero A. Exhaled end-tidal carbon dioxide as a predictor of lactate and pediatric sepsis. Am J Emerg Med 2020; 38:2620-2624.
  • Cully M. Spontaneous brain arteriovenous malformation rupture with atrioventricular block in a pediatric patient. Am J Emerg Med 2020;38:409.
  • Cully M, Attia M. Young Child With Dyspnea and Vomiting. Ann Emerg Med 2020;76:680-694.
  • Kazmierczak M, Albahri A, Mull C. A Call to Restore Your Calling: Self-care of the Emergency Physician in the Face of Life-Changing Stress. Part 6 of 6: Trainee Burnout. Ped Emerg Care 2020;36:257-261.
  • Hammett DL, Kennedy TM, Selbst SM, et al.  Pediatric heatstroke fatalities caused by being left in motor vehicles.  Ped Emerg Care 2020: Epub ahead of print. 
  • Kennedy T, Thompson AD, Choudhary A, Caplan R, Schenker K, Depiero A. Utility of applying white blood cell cutoffs to non-diagnostic MRI and ultrasound studies for suspected pediatric appendicitis. Am J Emerg Med 2019;37:1723-1738.
  • Fugok K, Slamon NB. The effect of telemedicine on resource utilization and hospital disposition in critically ill pediatric transport patients. Telemedicine and e-Health 2018;24(5).
  • Smith N, Giordano K, Thompson AD, et al. Failure of Outpatient Management with Different Observation Times After Racemic Epinephrine for Croup. Clin Peds 2018;57:706-710.
  • Kusulas M, Eutsler EP, Depiero AD. Bedside ultrasound for the evaluation of epidural hematoma after infant lumbar puncture. Pediatric Emergency Care 2018; Epub ahead of print
  • Savage J. An Unusual Case of Limp in a Toddler. Ann of Emerg Med 2016;67:296-306.
  • McLean L, Elwell S, DePiero A. Assessment of the electronic medical record in documenting trauma resuscitations in the pediatric ED. Am Journal Emerg Med 2015;33:589-590.
  • Giordano K, Rodriguez E, Green N, Armani M, Richards J, Shaffer TH, Attia, M. Pulmonary Function Tests in Emergency Department Pediatric Patients with Acute Wheezing/Asthma Exacerbation. Pulmonary Medicine 2012.
  • Green NA, Durani Y, Brecher D, DePiero A, Loiselle J, Attia, M. Emergency Severity Index Version 4 – A Valid and Reliable Tool in Pediatric Emergency Department Triage. Ped Emerg Care 2012;28:753-757.
  • Zomorrodi A, Bennett JE, Attia MW, Loiselle J, Rogers KJ, Kruse R. Consistency of Emergency Department and Orthopedic Physicians’ Diagnosis and Treatment of Distal Fibular Salter Harris I Fractures. Ped Emerg Care 2010;27:301-303.
  • Durani Y, Brecher D, Loiselle J, Walmesly D, Attia MW. The Emergency Severity Index (Version IV): Reliability in Pediatric Patients. Ped Emerg Care 2009;25:504-507.
  • Patel PB, Diaz MC, Bennett JE, Attia MW. Bacterial Conjunctivitis in Children. Acad Emerg Med 2007;14:1-5.
  • Pitone ML, Attia MW. Pattern of Injury Associated with Routine Childhood Falls Children. Ped Emerg Care 2006;22:430-435.
  • Learn More About Research at Nemours

Salary & Benefits

Salary

  • PGY 4: $70,715
  • PGY 5: $73,573
  • PGY 6: $76,652
  • PGY 7: $79,390
  • PGY 8: $80,615

An additional $2,000 is available to fellows for CME and scholarly activity. Additional travel stipends are available for scholarly presentations upon Department approval.

Optional moonlighting at the discretion of the fellowship director is allowed starting in the first year of fellowship.


Time Off

4 weeks of paid vacation time per year


Benefits

  • Office space with personal computer, online access and secretarial support
  • Standard benefits including malpractice, life and disability insurance
  • 6 weeks paid parental leave
  • Paid short-term disability insurance
  • Financial support for equired courses (PALS, ATLS, ACLS)
  • Financial support for licensing
  • On-site gym

About Our Hospital in Delaware

The Nemours Children’s Hospital, Delaware is a multispecialty, tertiary care teaching institution located on a 300-acre estate in the scenic Brandywine Valley in Wilmington, Del.

Among the hospital’s amenities for all staff are:

  • Free parking
  • Park-like setting
  • Gym/fitness center
  • On-site child care center for children of staff
  • Massage therapy
Learn More About Our Children's Hospital

Living in Delaware Valley

Because of our location in the tri-state area of Delaware, New Jersey and Pennsylvania, we offer unique living/working opportunities. For example, you can choose to live in the downtown Philadelphia area and easily commute to our park-like hospital campus in Wilmington.

Explore Wilmington

Train With Recognized Leaders

If you’re looking for a rewarding program built on academic excellence and family-centered care, Nemours Children's offers outstanding medical, surgical, pharmacy, nursing, therapy and psychology programs. Train with faculty who are respected leaders in their fields, a patient care model that stands apart and access to groundbreaking research. 

Meet Our Clinical Leadership

Apply Today

Application Requirements

Deadline: August 31, 2022

A completed application consists of the following:

1. Eras Application  

2. Curriculum vitae

3. Personal statement describing the development of your career plan and your specific interests and goals in pediatric emergency medicine.

4. Current passport-sized photograph

5. Three letters of recommendation, one of which should be from the program director of your residency program. 

6. Original scores of USME

7. Original medical school manuscript

Questions About Applying?

Debbie Campbell
Program Coordinator
(302) 651-4296
debbie.campbell@nemours.org

Andrew DePiero, MD
Program Director
(302) 651-4296
andrew.depiero@nemours.org

Amy Thompson, MD
Associate Program Director
(302) 651-4296
amy.thompson@nemours.org