Division of General Pediatrics

The goal of this fellowship is to prepare fellows for academic leadership careers. The curriculum teaches skills necessary to become effective clinicians, creative teachers, and knowledgeable and productive researchers.

The General Academic Pediatrics Fellowship provides training in the broad field of general academic pediatrics over a period of two to three years, and is part of the Harvard-wide collaborative program to develop General Internal Medicine and General Pediatrics faculty who can conduct research relevant to primary care.

The goals of this fellowship are:

• To prepare fellows for academic leadership careers by providing them with the requisite skills to become effective clinicians, creative teachers, and knowledgeable and productive researchers in the field of general academic pediatrics
• To provide fellows with an understanding of how biologic, psychological, and social factors inter-relate and determine patterns of childhood morbidity
• To ensure that fellows develop organizational and management skills and an understanding of medical administration

The first year of fellowship is primarily clinical, and includes six clinical or precepting sessions per week in general pediatrics and related specialties. Fellows will also identify a research project and mentor during their first year. During the second and third years, fellows’ clinical responsibilities will decrease, and they will actively work on their research projects. They will also participate in a structured educational program such as a master’s in public health degree at the Harvard T.H. Chan School of Public Health.

Training includes the development of analytical skills sufficient to conduct independent clinical or health services research, and teaching skills appropriate for different learners and settings encountered by primary care faculty. Fellows will also gain a deeper understanding of the needs of special populations such as the medically undeserved. In addition to the goals set out above, fellows are supported to meet one or more of the following objectives:

• To develop quantitative and/or qualitative research skills that would enable them to work independently in research within an academic environment
• To develop expertise in the areas of clinical teaching and supervision, curriculum development, and research in medical education
• To develop expertise in advocacy in the fellow’s area of interest and to undertake an advocacy project at the local, state, or federal level

All General Academic Pediatric fellows provide clinical care in a primary setting, either in the community or at the Children’s Hospital Primary Care Center (a large continuity clinic with over 42,000 visits per year).

Fellows participate in ongoing research and are required to identify a research question and formulate their own research projects. They may choose to undertake clinical, advocacy, quality improvement, or educational projects. Opportunities to teach residents and medical students are available in multiple locations, including the Harvard Medical School patient-doctor and preventive medicine courses, and the Boston Combined Residency Program.

The curriculum includes a component on advocacy which aims to foster the development of pediatricians who recognize the complex array of factors affecting the health and well-being of children.

Fellows have the opportunity to enroll in an MPH degree program at the Harvard School of Public Health.

Fellows participate in primary care programs located at Boston Children’s Hospital and in community sites. The primary care clinic within Boston Children’s Hospital is the Boston Children’s Hospital Primary Care Center, which combines a faculty practice with the continuity practice of the hospital’s 80 residents. This primary care center also includes several specialty clinics focused on general pediatric conditions such as asthma and headaches. Located outside the hospital in Jamaica Plain is Martha Eliot Health Center, a community site where fellows may also see patients. Fellows also participate in a multi-disciplinary clinic through the Division of Gastroenterology, Hepatology and Nutrition, with the potential for other clinical experiences based on individual interests.

• Advocating Success for Kids (ASK) Program: Primary care-based consultative program for patients with developmental, school and behavioral concerns.
• Young Parents Program: A teen-tot program that won the Ambulatory Pediatrics Association national award for best clinical program.
• Asthma Action Team: A specialty program within the primary care center for patients with asthma.
• Rapid Assessment of Skin Health (RASH) Clinic: A primary-care based program for patients with dermatologic complaints.
• Complex Care Service: Consultation and care coordination program for patients with special healthcare needs.
• Growth and Nutrition: Multi-disciplinary clinic based in the Division of Gastroenterology that provides diagnostic and management services for children with poor weight gain.
• Headache Clinic: A specialty program within the primary care center for patients with headaches.

Fellows will acquire research skills in design, methods, and analysis through bimonthly seminars and journal clubs, as well as formal coursework. Fellows will identify a research mentor and question of interest during their first year, and will further develop and implement their projects during the following two years. The projects may be clinical, educational, or advocacy related. Fellows will present their scholarly work at biannual Works in Progress sessions with faculty advisors.

Fellows have the opportunity to enroll in a master’s of public health degree program at the Harvard T.H. Chan School of Public Health or in other appropriate programs. Fellows will also be asked to complete several research and career development courses through the Clinical Research Center and the Offices of Fellowship Training and Graduate Medical Education.

Examples of previous fellowship projects include:

• Relationship of parental behaviors to child sleep duration
• Impact of developmental screening in primary care on referral patterns
• Development and implementation of an electronic referral form
• Development of an algorithm for management of acute otitis media
• Referral and treatment patterns among primary care eczema patients
• Maternal depression and patient resource utilization
• Resident experience with primary care transformation
• The association of urbanicity with infant sleep duration
• The Online Advocate: Health related social problems and children's diet quality
• Healthy Habits, Happy Homes: Randomized trial to promote home routines for childhood obesity prevention

Medical education is an important component of the clinical training program. Fellows receive didactic training through clinic seminars and hospital-wide curricula. In addition, fellows participate in precepting residents and medical students in primary care and subspecialty settings. Fellows have the opportunity to enroll in a master’s of public health degree program at the Harvard School of Public Health. Fellows will also be asked to complete several research and career-development courses through the Clinical Research Center and the Offices of Fellowship Training and Graduate Medical Education.

Fellows will participate in bi-monthly career-development seminars as well as monthly clinical lectures. They will also present their research ideas and progress on a regular basis to allow for feedback and mentorship.

• Fellowship Seminars: Bi-monthly conferences on career-development topics such as mentorship, teaching, and time management. Several research topics will also be introduced on the subjects of research design and methodology as well as quality improvement. Fellows and faculty members will also present ongoing research projects.
• Clinical and Community Pediatrics Lecture Series: Presentations of current issues in common primary care conditions, chronic illness, poverty and social disparities in health, environmental health, and advocacy.
• Journal Club: Fellows and faculty meet regularly throughout the year to discuss articles relevant to clinical care and research.

Fellowship director:
Corinna Rea, MD, MPH
Corinna.Rea@childrens.harvard.edu

Fellowship coordinator:
Anna Schlemmer
Anna.Schlemmer@childrens.harvard.edu