Pediatric Anesthesiology Fellowship

Kirk Lalwani
Dr. Kirk Lalwani Pediatric Anesthesiology Fellowship Program Director, Professor of Anesthesiology and Pediatrics

Thank you for your interest in our Pediatric Anesthesiology Fellowship program! We are the only academic health center and pediatric anesthesiology fellowship program in the state of Oregon. Our program was started in 2002, and currently offers three 1-year ACGME-accredited fellowship positions commencing in August every year. We accept applications from December 1st- August 31st of the preceding year via ERAS, and interviews are scheduled from March to August. Please note that we participate in the NRMP match process and applicants will have to register separately with NRMP for the fellowship match when permitted by NRMP, typically in the summer for a fall match.

Our department trains 13 residents a year and has accredited pain, regional, cardiac, ICU and pediatric fellowship programs. Our fellows enjoy a supportive and collaborative environment with personal attention and instruction from the 24 attending pediatric anesthesiologists both in clinical settings as well as during the didactic teaching sessions. Protected time is earmarked for weekly teaching sessions, departmental grand rounds, multidisciplinary conferences, PALS/NRP training, high-fidelity simulation, formal and informal ABA Oral Board Examination preparation and ACGME Competency Workshops run by Graduate Medical Education. We support fellows to attend the SPA Winter Meeting in March/April, and allow time off for the ASA Meeting in October.  We provide a generous CME allowance with five days of meeting time for this purpose.

OHSU is committed to integrating diversity within all areas of the University and all parts of our mission. Please visit the webpage of the Center for Diversity and Inclusion for more details.

Oregon Health & Science University Hospital (OHSU Hospital) is a 576-bed teaching hospital, biomedical research facility, and Level I trauma center located on the campus of Oregon Health & Science University (OHSU) in Portland in the U.S. State of Oregon. 

OHSU is also Portland's largest employer and a statewide economic powerhouse. Our operations include multiple campuses, adult and children’s hospitals, and clinics across Oregon. We also have state-of-the-art research facilities, including the 320,000-square-foot Knight Cancer Research Building.

U.S. News & World Report rankings:

  • Best hospital in Oregon (2021-22)
  • Health care national rankings in six adult specialties (2021-22) and five children's specialties (2021-22)
  • Education rankings in six programs and more than 10 specialties (2022)

To get a sense of community and campus, please see this video.

An exterior photo looking up at OHSU Doernbecher Children's Hospital from the street below.

This program aims to train fellows to provide outstanding perioperative clinical care to complex pediatric patients, in an environment of teaching, inquiry and scientific discovery. We strive to provide this in a supportive environment of wellness and inclusion, in alignment with departmental and institutional missions.

The Pediatric Anesthesiology Fellowship program aims to:

1) Research and plan the safe administration of anesthesia to pediatric patients of all ASA classifications, including management of premature neonates and older children with complicated disease processes and syndromes requiring routine or complex surgical procedures.

2) Understand the normal anatomical and physiologic differences between premature neonates, full term neonates, toddlers, adolescents, and young adults and their impact on anesthetic plans.

3) Understand and recognize abnormal pediatric development, disease processes, and syndromes that will impact anesthetic management.

4) Fellows will instruct and teach students and residents principles of anesthesia for infants and children in the operating room.

5) Create a sense of community and wellness to foster and support ongoing development of faculty and learners, including both faculty-learner and peer-to-peer interactions.

6) Encourage and support an environment of educational, clinical and quality scholarship among our trainees and core teaching faculty.

All clinical subspecialties are offered, including a busy Pediatric Sedation Service, cardiac, craniofacial, intraoperative MRI, pediatric critical care and multidisciplinary pain programs. The OHSU Simulation Center which is ABA-accredited is led by one of the pediatric anesthesiologists and facilitates crisis management training and ACLS certification for trainees. We are an A.C.S. Level I pediatric surgical center and Level I pediatric trauma center and provide tertiary referral services for Oregon, Idaho, Southwest Washington and Northern California. Our Pediatric Pain Center has been designated as a Center of Excellence by the American Pain Society.

Our clinical case load can easily support all our trainees while providing plenty of experience with index cases for the fellows. The total number of cases each fellow provides anesthesia care for during their year of training at OHSU (~550-600) regularly approaches or exceeds the 90% percentile (577) for all pediatric anesthesiology fellowship programs in the country, based on the case logs submitted to ACGME. Similarly, the number of neonates as well as other index cases tracked by ACGME falls between the 70%-90% percentile for all programs. We do not 'double-up' trainees for cases (i.e., a resident and a fellow claiming credit for the same case). We are able to achieve this in our practice by having one fellow rotate through Pain, Pediatric Sedation, Pediatric and Neonatal Intensive Care, and Pediatric Cardiothoracic Anesthesia for several months of the year, and by having only 2 CRNA’s as a part of our care-team model. We also allow trainees flexibility to tailor the fellowship to their individual needs or interests by choosing an elective month in a subspecialty of interest. In the second half of the program, graduated teaching opportunities are provided, where the fellow will take on the role of attending to guide residents through appropriate cases with faculty supervision.

Rotations involve all surgical specialties, including 2 months of cardiac anesthesia plus additional cases between rotations, pediatric pain, our pediatric sedation service, the Casey Eye Institute on campus, NICU, PICU and an elective/supervision/OR Charge rotation. We do not have a specific regional rotation as our fellows do all the PNB’s and epidurals in younger children for the entire year of the program, which leads to a robust number of blocks over the course of the year. We also have 1-week electives in critical care transport as part of the PICU rotation, adult regional (for certain blocks less common in children), and echocardiography. During the NICU rotation, our NRP-certified fellows will participate in the Neonatal Resuscitation Team along with NICU providers for delivery room resuscitations. Our fellows’ call volume is minimal, and restricted to anesthesia call only even when rotating through the NICU and PICU.

Dr. Jamie Rubin (our Associate Program Director) directs our fellows’ Simulation experience and POCUS workshops. In addition, we hosted fellows from Seattle Children’s and Vancouver BC Children’s Hospitals for our inaugural “Pediatric Anesthesiology NW International Bootcamp” weekend in 2022 at OHSU, which was a resounding success. We plan to add an Educational Skills Workshop to the Fall Fellowship Retreat to complement the monthly professionalism teaching sessions for all our department’s specialty fellows in the 2023-24 academic year.

Portland in fall from the Tram

The Bob and Mary Jane Stewart Fund provides funding for our fellows to accompany our faculty on a pediatric anesthesia mission trip to a low-income nation during the course of their fellowship training. This is an exciting opportunity that we are able to offer our fellows as a result of the generous support from the fund. Expenses will be covered for volunteering on the mission trip. Typically, the department applies to the ABA with sufficient lead time for approval so that these trips are classified as normal clinical training time and as such there is no requirement to use vacation, CME or academic time to participate. Many faculty, fellows, residents and medical students from OHSU have been to Northern Peru with a charitable organization called FACES started by an OHSU surgeon, but fellows may choose other options too. Check out their website for photos of our fellows and faculty on previous trips.

Fellows are required to participate in at least one academic research project during the course of their fellowship year for which academic days will be allocated and mentorship will be provided. The research project could involve participation in an ongoing clinical or basic science research project, initiation of a new project, or educational research related to resident education and/or simulation, and is expected to result in a fellow presentation at a national scientific meeting, such as the ASA or SPA. Review articles, systematic reviews, medical informatics projects or other outcomes research projects are also suitable. Candidates with strong research interests and planned or ongoing projects are encouraged to pursue their scholarly projects during training. Following individual review of academic goals and scholarly project/s, we may increase the usual amount of non-clinical academic time (typically 2 days a month) for incoming fellows in order to facilitate achievement of academic goals.

In addition, fellows are expected to initiate and implement a quality improvement project as a means of learning the CQI process. They are also offered the opportunity to attend 1-2 meetings of the Departmental CQI Committee as a guest reviewer to familiarize themselves with root cause analysis. Contributions to the pediatric ABA keyword database encourage our fellows to prepare for the new ABA pediatric anesthesiology subspecialty examination. Fellows are encouraged and mentored in the art of writing compelling PBLDs for submission and presentation to the SPA and/or ASA meetings. Finally, each fellow will plan and present a journal club session in pediatric anesthesia during the course of their training and give at least one presentation to the OR staff, or at grand rounds to another institution with a faculty member as a part of the VisiPAP program (Visiting Pediatric Anesthesia Professors).

Tilikum Bridge during the day

The goals of the fellowship program are to:

1. Equip the fellow with the knowledge, skills, and abilities to function independently and competently as a Consultant Pediatric Anesthesiologist.

2. Provide a broad clinical experience that allows fellows to develop proficiency in the care of neonates, infants, children, and adolescents in all surgical subspecialties.

3. Foster a thorough understanding of the anatomical, physiological, developmental and behavioral characteristics of patients in different age groups.

4. Teach fellows the technical skills related to airway management, invasive monitoring, regional anesthesia, and the use of ultrasound for point-of-care applications.

5. Provide opportunities for fellows to learn principles of crisis resource management via high-fidelity simulation and our innovative OHSU Pacific NW Regional Bootcamp with Seattle Children’s and Vancouver BC Children’s Hospitals (which was placed on hold during COVID).

6. Expose fellows to intravenous sedation techniques for a variety of office-based settings and diagnostic radiology.

7. Provide experience in acute and chronic pediatric pain management, including cognitive behavioral therapy.

8. Provide experience in the management of critically ill neonates, infants, children, and adolescents.

9. Fellows should achieve certification in Pediatric and Neonatal Advanced Life Support.

10. Encourage the fellow to develop as an educator by providing opportunities to teach principles of airway management and pediatric anesthesia to residents and students.

11. Teach the basic principles of clinical research, the protection of human subjects, and evidence-based medicine via didactic sessions and involvement in a suitable research project or review article.

In addition to appropriate PGY-year salary and benefits as outlined in the OHSU and AFSCME House Officers Union contract, fellows also get:

  1. 20 days of vacation, 5 days CME
  2. 4 half days a year for “Health Maintenance” for your medical/dental/vision appointments etc. to promote wellness
  3. 2 days a month for academic activities (can be increased based on academic projects planned)
  4. CME allowance ($2500)
  5. SPA membership ($100)
  6. Support to attend the spring SPA meeting (conference fees, hotel, per diem, $2000)
  7. Oral board examination fees if taken during fellowship ($1600)
  8. Funds to attend the CHOP boot camp if we don't end up hosting one. (course fee, flight, hotel $1000)
  9. Fully paid Mission Trip expenses to provide anesthesia in a low-income country (assuming COVID abates sufficiently for OHSU Risk Management to allow foreign travel), plus ABA approval to count the trip as regular training time.
  10.  Numerous discounts on services, stores, tickets and sporting events on the OHSU benefits webpage.

Our program offers a comprehensive clinical experience with a strong emphasis on education in a collegial atmosphere. Faculty members are committed to maximizing the educational opportunities available for trainees, and encourage fellows to balance the demands of their training with their personal life by experiencing the outstanding recreational pursuits available in the beautiful Pacific Northwest. Portland is a vibrant, 'clean-green' bike-friendly city that boasts excellent restaurants, cultural attractions, and an easygoing outdoor lifestyle in true Pacific Northwest tradition. It is an hour or less to the spectacular Oregon Coast, Mount Hood, the Columbia Gorge, and Oregon wine country.

We are confident that we offer an excellent experience that previous graduates from our program (several of whom are on our faculty) can attest to. We are also happy to share contact details of past fellow graduates at other institutions or in community practice. We welcome your interest in our program, and hope you will consider submitting your application.

Kirk Lalwani, MD, FRCA, MCR, FASA
Program Director
Professor of Anesthesiology and Pediatrics 

Jamie Rubin, MD
Assistant Program Director
Assistant Professor of Anesthesiology      

To apply, please register with ERAS and submit the following documents.

  • CV
  • Personal statement.
  • At least 3 letters of recommendation (including one from your residency program director)
  • Dean's Letter
  • Transcripts
  • USMLE and/or COMLEX scores
  • ABA certificate as evidence of passing the anesthesiology Basic Examination (This must be sent directly to the Program by email: APOM Fellowships)

Please submit completed application packets to ERAS

Questions may be addressed to: APOM Fellowships

The beginning of fall at OHSU

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