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Clinical Experience

Pediatric Critical Care Medicine Fellowship

Clinical rotations occur in four-week blocks. All call is in-house with a critical care attending. First-year fellows typically have six to seven calls per block; second- and third-year fellows have five calls per month during their scholarly blocks and two calls per month during their clinical blocks.

Total Clinical Weeks 82 weeks
Total Research Weeks 74 weeks


PICU Weeks

Other Clinical Weeks

Research Weeks

Total Weeks
















Competency-based objectives for the rotations are available: first yearsecond year, third year.

Pediatric Intensive Care Unit (PICU)


Dr. Ashley Daniel examining a patient in the CICU.

Our ICU capacity has grown to include 43 PICU beds and a 24-bed CICU. Since 1997, the pediatric critical care faculty has provided 24-hour in-house coverage.

We have an active congenital heart disease program and pediatric cardiac transplant program that includes a VAD program with more than 350 cardiovascular surgeries per year.

Advanced practice nurses work alongside physicians on the CICU teams. Advanced practice nurses and intensive care hospitalists are incorporated into the PICU teams as well.

The ECMO program in the pediatric intensive care unit began in 2007 with 40-50 cases and 500-600 patient days annually, utilizing both VV and VA modalities.

We have a busy trauma surgery service with the only Level-1 Trauma center in a free standing children’s hospital in our geographic area. We are working towards becoming an American Burn Association certified center. We co-manage all trauma and burn patients admitted to the PICU.


Fellows will rotate in the department of anesthesiology for two months during the first year of training. Advanced airway skills, vascular access and the physiologic response to general anesthetics are emphasized. During the second month, fellows will spend time in the cardiovascular operating room, becoming familiar with the anesthetic nuances of children with congenital heart disease and gaining exposure to cardiopulmonary bypass. Third-year fellows may spend an additional two weeks learning the skills of procedural sedation outside of the pediatric intensive care unit.


First-year fellows will spend four weeks focused on the care of children with congenital and acquired heart disease. The rotation includes exposure to the cardiac catheterization lab; interpretation of cardiac waveforms; basic echocardiogram imaging and interpretation; arrhythmia classification and treatment; and surgical correction or palliation.



Dr. Jennifer Ruiz  working with members of Children’s Mercy’s critical care transport team.

Fellows participate in a four-week rotation during their first year with the transport team, participating in local and regional transports by ground transport, rotor wing and fixed wing aircraft. The in-house transport team, comprised of an advance clinical nurse and respiratory therapist serves a 150-mile radius and transports more than 5700 patients per year with medical direction provided by the intensivist.

During the third year of training, fellows gain experience communicating with referring physicians and guiding the transport team in the care of the children we transport.

Children's Mercy Critical Care Transport in Kansas City, Mo. is a 24-hour a day dedicated pediatric- and neonatal-critical care transport program, and winner of the Transport Program of the Year, sponsored by the Association of Air Medical Services.

Children's Mercy Critical Care Transport has earned the Fixed Wing Award of Excellence and the Critical Care Ground Award of Excellence.

Specialty opportunities at Children’s Mercy


Dr. Nathan Lavoy teaching the multidisciplinary team on rounds in the PICU.

Have an interest in cardiac ICU as a career? The Pediatric Critical Care Fellowship at Children's Mercy provides the maximum ACGME allowed CICU rotations, 6 blocks over 3 years. Fellows additionally take 6 months of CICU call. With this experience, graduating fellows are well positioned for a career in the CICU after the cardiac exposure in our program.

Want to dual board eligible in cardiology and critical care? We have a two-year program we recruit for in even number years for trainees who will successfully complete a cardiology fellowship.

Have a clinical pharmacology interest? We have the only accredited training program in the country. T32 programs are available and would represent a 4th year of training. Learn more by visiting our Pediatric Clinical Pharmacology Fellowship page.

Have a global health interest? We are one of few pediatric critical care programs with access to a global health program. The engagement in this work can vary based on level of interest. Learn more by visiting our Global Health page.

Have a health care administration interest? With administrative positions continually growing, there is increasing opportunity for physicians in these roles. Learn more about the one additional year fellowship and note the degree eligibility requirements. Visit our Administrative Fellowship page.