A Survey of Pediatric Neurocritical Care Fellowship Training in North America.

Background: Pediatric neurocritical care (PNCC) has emerged as a field to care for children at the intersection of critical illness and neurological dysfunction. PNCC fellowship programs evolved over the past decade to train physicians to fill this clinical need. We aimed to characterize PNCC fellowship training infrastructure and curriculum in the United States and Canada.
Methods: Web-based survey of PNCC fellowship program leaders during November 2019 to January 2020.
Results: There were 14 self-identified PNCC fellowship programs. The programs were supported by Child Neurology and/or Pediatric Critical Care Medicine divisions at tertiary/quaternary care institutions. Most programs accepted trainees who were board-eligible or board-certified in child neurology or pediatric critical care medicine. Clinical training consisted mostly of rotations providing PNCC consultation (n = 13) or as a provider on the pediatric intensive care unit-based neurointensive care team (n = 2). PNCC-specific didactics were delivered at most institutions (n = 13). All institutions provided training in electroencephalography use in the intensive care unit and declaration of death by neurological criteria (n = 14). Scholarly activity was supported by most programs, including protected time for research (n = 10).
Conclusions: We characterized PNCC fellowship training in the United States and Canada, which in this continuously evolving field, lays the foundation for exploring standardization of training going forward.
Competing Interests: Declaration of competing interest Mark Wainwright reports board membership with Pediatric Neurocritical Care Research Group (PNCRG) and payment for participation in the Clinical Advisory Board of Sage Therapeutics. Sue Hong reports co-chair for the PNCRG Education Committee, grant from the NIH, and consulting fees from the Chicago Department of Public Health. Jennifer Erklauer reports a co-chair for the PNCRG Education Committee. Nicholas Abend reports grant funding by PCORI and Wolfson Foundation paid to his institution, book royalties paid by Demos Publishing, and payment for expert testimony. Kristin Guilliams reports board membership on the PNCRG and payment for expert testimony by Wiseman Ashworth Law Group for pediatric stroke expertise. Andrea Pardo reports grant funding by the Patrick G and Shirley W. Ryan Foundation, UCB Biosciences, NIH/NINDS, and NIH CSR paid to her institution. Jose Pineda reports board membership for the PNCRG, consulting fees from the NIH, honoraria from the American Board of Pediatrics, and participation in the NINDS Data Safety Monitoring Boards. Brian Appavu reports grants or contracts from the US Department of Defense, American Heart Association, and Innovators for Neuroscience in Kids Foundation and honoraria from Natus. Alexis Topjian reports grants from the NIH, payment for medical legal consulting, and participation in a Data Safety Monitoring Board for ESETT. Anne-Marie Guerguerian reports grants or contracts from the Canadian Institutes of Health Research and Garry Hurwitz Center for Brain and Mental Health, Health Outcomes, participating on the FAST Data Safety Monitoring Board, and leadership or fiduciary role for the Heart and Stroke Foundation of Canada and the American Heart Association.
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