Upstate Medical University recently received four accreditations from the Accreditation Council for Graduate Medical Education for pediatric-related residency and fellowship programs. The accreditations are for three existing programs and one new program, which is set to welcome its first fellow next year. The three reaccredited programs are Pediatric Residency, Pediatric Infectious Disease Fellowship and the Child Abuse Pediatrics Fellowship. The new accreditation is for the Pediatric Hospitalist Fellowship Program, which will train residents at Upstate in one of the fastest growing fields in medicine.

 

Pediatric Hospitalist Fellowship Program:

The newest pediatric fellowship program to receive ACGME accreditation is the Pediatric Hospitalist Fellowship Program. In the works for about 18 months, the match process for this fellowship will begin this year with a plan to have a pediatric hospitalist fellow working at Upstate in July 2022.

Pediatric hospital medicine is a newly recognized subspeciality and a fast-growing field, said program director Jennifer Myszewski, DO. Care for the hospitalized child has become more specialized and complex, Myszewski said. Pediatricians who practice outpatient care in a traditional medical office setting do not often come to the hospital to care for their patients, she said, so there is an increasing demand for pediatricians who specialize in treating non-ICU pediatric inpatients. 

About 60 institutions nationwide have created pediatric hospitalist fellowship programs, all of which have been working collaboratively to create the match program and develop curriculum.

“It’s been probably more collaboration than I’ve ever seen in medicine,” Myszewski said. “It’s just been a really cool thing to participate in.”

Myszewski and Pekarsky both stressed the support they have received from other departments, particularly among many faculty who are eager to participate in the residents’ and fellows’ ongoing training.

“We’ve had amazing support,” Myszewski said. “Everyone at Upstate has been very enthusiastic, which will allow us to give the residents and fellows exposure to a larger number of subspecialties.”

 

Child Abuse Pediatrics (CAP) Fellowship:

This three-year fellowship was established at Upstate in 2017 with the first fellow starting in August 2018. The fellows are part of the multidisciplinary team at the McMahon Ryan Child Advocacy center. Alicia Pekarsky, MD, became director of the CAP fellowship program last year, taking over from Ann Botash, MD.

Last year, in anticipation of the reinstatement of the Inpatient CAP consult service, the program applied to temporarily increase the number of fellows it's training. This was approved by ACGME and Upstate and the number of fellows was increased to two in September 2020.

“A small fellowship going from one to two fellows is a big deal,” Pekarsky said. “It allows for more teaching opportunities and it helps with covering in-patient services.” She said the program is interested in permanently expanding to two fellows and is exploring the opportunity with ACGME. Child abuse pediatricians, who specialize in the treatment of children who have been physically or sexually abused, are in high demand. Pekarsky said there are only 300 child abuse pediatricians and only 30 fellowship programs in the United States. Of those, only 21 programs offered spots with 19 people applying and 17 matching in 2020-2021.  

“The ratio of child abuse pediatricians to the number of abused children is really, really low,” she said. “In New York state there are only four practicing child abuse pediatricians outside of the New York metropolitan area. Our fellows are helping meet a great need.”

 

Pediatric Residency Program:

The Pediatric Residency Program at Upstate has been accredited for 84 years. The three-year residency program currently has 45 residents plus two chief residents; it is considered a medium-sized program compared to others. Residents work at Upstate Golisano Children’s Hospital, a variety of pediatric subspecialty offices and clinics as well as in the neonatal intensive care unit at Crouse Hospital, said program director Elizabeth Nelsen, MD.

The annual re-accreditation process involves a thorough review of the residents and their work. Nelsen said she’s been impressed with ACGME’s interest in residents’ mental health.

“The last couple of years they have been asking questions about what we’re doing to support resident wellbeing,” she said. “Residency is arguably the toughest period in your training so it’s a nice shift from a personal and professional standpoint that ACGME is identifying this and helping address systems changes to support our residents.”

Nelsen said Upstate is a “great place to work and train” and the long-standing annual ACGME accreditation speaks to that.

“Upstate is very interested in making where the residents work a better place,” she said. “Eighty four years shows we have consistently demonstrated a high level of training for residents and that is not just the work of one person.”

 

Pediatric Infectious Disease Fellowship Program:

The three-year subspecialty fellowship program is designed to prepare pediatricians for a career in academic pediatric infectious diseases with a focus on clinical care and research and was recently reaccredited by ACGME.

The first year of the fellowship is primarily dedicated to inpatient and outpatient clinical training. The second and third years focus on research training in either the clinical or basic sciences. The program emphasizes teaching skills with fellows given opportunities to develop educational portfolios and didactic skills. Fellows are expected to present their research data at national/international meetings and to publish one to two manuscripts in peer-reviewed journals.

“Investigative and clinical skills acquired during our training program distinguish our fellows as highly competitive for research funding and outstanding in clinical competence,” said Leonard B. Weiner, MD, director of the program. “The pediatric infectious disease fellowship program is the longest running continuous fellowship program in the department of pediatrics and one of the oldest in the institution.”

Caption: Child Abuse Pediatrics Fellows Iram Ashraf, MD, (at left), and Heather Ross, MD, (center) with fellowship program director Alicia Pekarsky, MD, at the McMahon Ryan Child Advocacy Center in Syracuse.