Pediatric Anesthesiology Fellowship

The Pediatric Anesthesiology Fellowship at Monroe Carell Jr. Children’s Hospital at Vanderbilt attracts physicians who are passionate about learning in an environment that promotes independence, clinical excellence, and compassionate, team-based care. Fellows work alongside other fellows, anesthesia residents, CRNAs, SRNAs and the perioperative team—each dedicated to providing the highest level of medical and supportive care to our patients.

Our one-year, ACGME-accredited fellowship provides comprehensive subspecialty education and training across all domains of pediatric anesthesiology. Training occurs at the PGY-5  level following successful completion of an ACGME-accredited residency in anesthesiology.

Clinical education focuses on the full spectrum of perioperative anesthesia care for both inpatient and outpatient populations. All training takes place at Monroe Carell, a premier children's hospital at our academic medical center that serves as both a primary care facility for local families and a regional referral center for complex pediatric conditions. Fellows gain extensive experience with a diverse range of procedures—from brief outpatient surgeries to complex neonatal, cardiovascular, orthopedic, transplant and neurosurgical cases. 

 

Clinical Training

The fellowship provides a broad and progressively challenging clinical experience. Fellows begin with routine case assignments and advance to managing patients with complex surgical procedures and multiple coexisting conditions. Training extends beyond the operating room to include sedation and anesthesia for patients undergoing MRI, cardiac catheterization, radiation therapy, PET scans, and other diagnostic or therapeutic procedures.

Our fellows consistently exceed ACGME case requirements and, by the end of the year, have the opportunity to develop their skills as supervising consultant pediatric anesthesiologists. Vanderbilt Children’s Hospital is a high-volume center for heart and liver transplants, and fellows also have the opportunity to participate in pediatric kidney transplants. For those with a specific interest in congenital heart disease, an advanced pediatric cardiac anesthesiology fellowship is available for sub-specialization.

Rotations

Fellows rotate through a broad range of clinical experiences to develop expertise across the full spectrum of pediatric anesthesiology. Rotations are offered in the following areas:

  • General and Advanced Pediatric Anesthesia (up to 6 months)
  • Pediatric Cardiac Anesthesia (2 months)
  • Pediatric Critical Care Unit (2 weeks)
  • Neonatal Intensive Care Unit (2 weeks)
  • Pediatric Acute and Chronic Pain Management (1 month)
  • Preoperative (PATCH) Clinic and PACU (1 month)
  • Supervision/Teaching Rotation (1 month)
  • Global Pediatric Anesthesia Elective (optional, 1 month)
  • Elective Time (2 weeks)

Research Opportunities

Up to 20 non-clinical days/year

The ACGME requires that all pediatric anesthesiology fellowships provide opportunities for active participation in research relevant to the field. In preparation for each academic year, our fellowship curates a portfolio of project concepts, ongoing studies, and scholarly initiatives that are shared with incoming fellows prior to their arrival.

Our Scholarship Committee partners with each fellow to identify interests, match them with available projects, and ensure access to the mentorship, resources, and protected time necessary to make a meaningful contribution. The goal is for every fellow to engage in scholarship that culminates in presentation and publication of results.

While becoming a dedicated research fellow within a single year is beyond the scope of this clinical fellowship, trainees interested in research-intensive careers are encouraged to pursue additional training opportunities at Vanderbilt, such as fellowships or graduate study in Clinical Investigation, Clinical Informatics, or Public Health.

All fellows are encouraged to submit abstracts to national meetings, including the Society for Pediatric Anesthesia (SPA) and the American Society of Anesthesiologists (ASA), with the aim of eventual publication in peer-reviewed journals.

International Service and Outreach

The Department of Anesthesiology at Vanderbilt is committed to providing meaningful global health experiences through the Vanderbilt International Anesthesia (VIA) program. Our fellows have the opportunity to participate in a one-month elective at AIC Kijabe Hospital in Kenya. This ACGME-approved clinical rotation is available to all fellows with an interest in global health. AIC Kijabe Hospital is a regional referral and graduate medical education center with a recently established anesthesiology residency program.
This rotation enhances fellows’ ability to deliver safe and effective pediatric anesthesia care in resource-limited settings, strengthens teaching and leadership skills, and provides valuable exposure to anesthetic techniques that are less commonly practiced in high-resource environments.

Monroe Carell Jr. Children’s Hospital at Vanderbilt also supports global outreach through faculty engagement in longitudinal capacity building, educational program development, and medical mission trips serving populations with limited access to trained pediatric anesthesiologists.

Through our partnership with The Shalom Foundation, the Department of Pediatric Anesthesia participates in biannual medical missions to Guatemala. Fellows are encouraged to join these short-term service trips, gaining hands-on experience in humanitarian care and global pediatric anesthesia.

Conferences and Scholarly Activities

Journal Club

Fellows receive instruction in the conduct of scholarly inquiry, including study design, statistical analysis, and interpretation of medical literature. Each fellow selects a journal article and leads a discussion with guidance from a faculty mentor.

All fellows receive Studying a Study and Testing a Test by Richard K. Riegelman, MD, MPH, PhD, as a resource for preparing and leading sessions.

Weekly Education Conference

A weekly didactic conference led by division faculty covers major topics from the ABA Pediatric Anesthesiology Content Outline over the course of the academic year. The curriculum includes:

  • General Pediatric Anesthesiology: 36 lectures led by faculty, with topics curated by the Program Director based on the ABA Pediatric Anesthesiology Examination Content Outline and the ACGME Pediatric Anesthesiology Program Requirements.
  • Pediatric Cardiac Anesthesia: 10–12 lectures curated and delivered by Pediatric Cardiac Anesthesia faculty.
  • Healthcare Economics: A focused session on pharmacologic cost considerations led by our OR pharmacists, providing perspective on the financial implications of perioperative decision-making.
  • Anesthesia Billing Practices: A two-part lecture series presented by a departmental billing specialist.

Each session integrates evidence-based literature review and discussion of clinical outcomes. Core readings are drawn from:

  • Cote’s A Practice of Anesthesia for Infants & Children (primary text)
  • Holzman’s Pediatric Anesthesiology Review: Clinical Cases for Self-Assessment (supplemental text)

Both texts are provided by the program. Monthly board review sessions run from July through May with a focus on oral exam preparation, followed by written subspecialty exam preparation during the remainder of the year.

Weekly "Art of Anesthesia" Conference

This informal roundtable fosters open discussion of complex issues encountered in pediatric anesthesia practice. The series includes monthly Monday morning PBLDs centered on cases that explore professionalism, ethical dilemmas, recognition and management of substance abuse, effective interpersonal communication, and strategies for navigating interactions with patients and colleagues.

Simulation Curriculum

Fellows participate in six simulation sessions each year, scheduled every other month, with three scenarios per session. These sessions provide a safe and structured environment to practice management of low-frequency, high-acuity events.

Division Morbidity, Mortality, and Improvement (MM&I) Conference

Held quarterly, this conference provides a confidential forum to review unanticipated perioperative events and ongoing quality improvement initiatives. Fellows are responsible for presenting one case or topic annually.

Society for Pediatric Anesthesia (SPA) Annual Meeting

All fellows are encouraged to attend the annual SPA meeting. Travel and lodging expenses are covered when presenting abstracts, PBLDs, or participating in workshops.

Southeast Pediatric Anesthesia Regional (SPEAR) Bootcamp

Fellows participate in up to two regional multi-institutional bootcamps each year:

  • Introduction to Pediatric Anesthesia (Early Fall)
  • Transition to Practice (Late Spring)

These interactive events provide hands-on learning, simulation-based training, and opportunities to network with peers and faculty from programs across the Southeast.

ABA Applied Examination Preparation

Fellows receive structured preparation for the American Board of Anesthesiology (ABA) Primary Certification Examination through a series of faculty-led sessions and simulations designed to build confidence and mastery of exam expectations.

  • Oral Board Overview: Preparation begins with a general review of exam format and strategies for outlining oral board stems.
  • Group Roundtable Sessions: Winter “roundtable” style sessions allow fellows to practice oral board cases in a collaborative setting.
  • One-on-One Oral Boards: Multiple individualized oral board examinations are scheduled 1–2 months prior to the ABA examination.
  • Formal Departmental Simulation: Fellows participate in a simulated oral board session conducted by the Department of Anesthesiology.
  • CELA Simulation Session: A formal session at the Center for Experiential Learning and Assessment (CELA) covers content from the Objective Structured Clinical Examination (OSCE) component of the primary certification exam.

These experiences provide comprehensive exposure to both the oral and OSCE components of the ABA Primary Certification Examination, reinforcing clinical reasoning, communication, and decision-making skills.
     
Vacation and Educational Leave

Fellows receive 15 days of vacation and 5 days of educational leave annually. Clinical schedules are adjusted in good faith to accommodate time-off requests whenever possible.

 

David Roberts
David Roberts, MD
Program Director, Pediatric Anesthesiology Fellowship
Assistant Professor of Anesthesiology

KN
Kelsey Neuhalfen, MD
Assistant Program Director, Pediatric Anesthesiology Fellowship
Assistant Professor of Anesthesiology

  • All applications for our Pediatric Anesthesiology fellowship are now accepted through April 16 in San Francisco Match (Program ID: 9888). We also request that you send your most recent ITE scores by email or U.S. post to our coordinator, Jillian Powell.

    Submit the following materials with your application:

    • A personal statement
    • A copy of your medical school diploma
    • A copy of your medical school performance evaluation
    • A reference letter from your Anesthesiology Residency Program Director
    • Two reference letters from colleagues
    • USMLE/ COMLES score reports
    • ABA in training exam performance report

    Also, if you have any questions regarding your application, contact:

    Jillian Powell
    Administrative Manager
    jillian.h.powell@vumc.org 

  • General Pediatric Anesthesia: up to 6 months

    Fellows are assigned to surgical cases spanning the full spectrum of pediatric anesthesia—from rapid-turnover outpatient procedures to complex airway reconstructions. Case complexity is tailored to each fellow’s experience and learning goals.

    After the first two months in the pediatric OR, fellows meet with the fellowship director to ensure the case mix aligns with their educational objectives. During the final four weeks of general pediatric anesthesia, emphasis shifts from hands-on clinical care to medical supervision of multiple operating rooms, fostering development toward independent consultant-level practice.

    Pediatric Cardiac Anesthesia: 2-month rotation

    This intensive rotation provides exposure to a wide range of congenital heart defects. Fellows gain expertise in advanced airway management, cardiopulmonary bypass, vascular access, and perioperative crisis management.

    Key learning areas include pediatric cardiovascular physiology and its alterations in congenital heart disease, advanced pharmacology, transfusion medicine, and cardiac lesions associated with syndromic conditions. The experience is both rigorous and rewarding.

    Pediatric Critical Care Unit: 2-week rotation

    During this rotation, fellows function as anesthesiologists supporting the general pediatric critical care unit. They participate in daily rounds and collaborate closely with the ICU team on medical decision-making, perioperative planning, and management of critically ill children. This experience strengthens fellows’ understanding of critical care principles and enhances their ability to provide comprehensive perioperative consultation.

    Neonatal Intensive Care Unit: 2-week rotation

    During this rotation, fellows participate in daily rounds with the Neonatal Intensive Care Unit team, engaging as consultant anesthesiologists in discussions of complex neonatal physiology and perioperative considerations. The experience provides exposure to a broad spectrum of neonatal pathologies—both surgical and medical—and emphasizes principles of ventilation, fluid and nutritional management, and perioperative optimization.

    Fellows gain familiarity with advanced ventilation techniques, including high-frequency jet and oscillatory ventilation, and develop a deeper understanding of how critical care management influences anesthetic planning. While fellows are not responsible for patient orders or documentation, they are encouraged to contribute their anesthesiology perspective, particularly in areas such as sedation, postoperative pain control, and intraoperative fluid management. This collaborative experience enhances fellows’ ability to care for neonates safely and effectively across the perioperative continuum.

    Pain Service: 1-month rotation

    Under the leadership of Dr. Andrew Franklin, fellows gain comprehensive experience in managing perioperative, acute, and chronic pain in infants, children, adolescents, and young adults. Working alongside dedicated pain service nurses and attending physicians, fellows serve as first-call consultants for the Pediatric Pain Service. They help develop individualized analgesic regimens and provide daily follow-up for patients receiving continuous regional anesthesia, such as epidural infusions or peripheral nerve catheters.

    During this rotation, fellows evaluate and manage acute pain in children with diverse surgical and medical conditions, gaining experience with multimodal pharmacologic approaches and non-pharmacologic pain management techniques. They also participate in interventional procedures including peripheral nerve blocks, fluoroscopically guided epidurals, and epidural blood patches.

    Fellows further develop skills in chronic pain management through participation in the Pediatric Pain Clinic. The clinic provides multidisciplinary consultative care for patients with headache, functional pain syndromes, oncologic pain, neuropathic pain, and complex regional pain syndrome. This experience allows fellows to deepen their understanding of long-term pain management strategies and interdisciplinary care in pediatric populations.

    Preoperative clinic and PACU: 1-month rotation

    In the Preoperative Assessment and Teaching for Children’s Hospital (PATCH) Clinic, fellows evaluate complex patients preoperatively, working alongside nurse practitioners and child life specialists. Early assessment allows identification and optimization of medical issues before surgery. Fellows serve as consultants to nurse practitioners while gaining experience evaluating patients with rare disorders requiring surgical procedures.

    This rotation also includes exposure to the PACU, which has over 25 beds. Fellows manage post-operative issues including airway complications, pain, nausea, emergence agitation, apnea, and discharge-related concerns. An attending anesthesiologist is always available for immediate consultation.

    Heart, Kidney and Liver Transplant

    Throughout the general and cardiac anesthesia rotations, fellows gain foundational knowledge of the pathology and pathophysiology of end-stage organ system failures. They actively participate in anesthesia care for patients undergoing heart, kidney, and liver transplants, including pre- and post-transplant procedures, providing exposure to the full perioperative spectrum of organ failure and recovery.

    Supervision: 1-month rotation

    During the final month of the fellowship, fellows transition from primarily providing hands-on anesthesia to supervising CRNAs, SRNAs, and residents. Attending faculty remain responsible for approving anesthesia plans and personally supervising all critical aspects of care, consistent with departmental and CMS policies.