Curriculum

Mayo Clinic's two-year Pediatric Rehabilitation Medicine Fellowship is designed to prepare you for a career in pediatric rehabilitation medicine. Graduates of this program are able to function independently as clinicians, medical or program directors, teachers, or laboratory investigators in university medical schools, medical centers or private practice.

Clinical training

The Pediatric Rehabilitation Medicine Fellowship at Mayo Clinic's campus in Rochester, Minnesota, features 24 months of required and elective rotations as well as dedicated research time. It is geared toward the individual who has completed an adult physical medicine and rehabilitation (PM&R) residency, but wishes to specialize in the care of children and adolescents. Most trainees who have completed adult residencies in PM&R have limited pediatric experience.

Because we feel it is extremely valuable to have a broad knowledge base related to care of children with disabilities, we offer a wide variety of rotations in other pediatric specialties. For example, learning directly from a pediatric orthopedic surgeon about surgical indications for hip dysplasia in a child with cerebral palsy and then actually seeing the operation performed enables you to provide excellent care and advice to future similar patients. Handling and assisting with the care of a 2-pound preemie in a neonatal intensive care unit (NICU) provides the context for the years to come in the Cerebral Palsy Clinic.

Through established partnerships, your training may include rotations to Shriner's Hospitals for Children — Twin Cities and the University of Florida in order to experience different styles of practice and patient populations. It also includes a continuity clinic throughout the two years.

Pediatric rehabilitation medicine is one of the over 40 pediatric specialties at Mayo Clinic. With excellent and respectful relationships with our colleagues in other specialties, we participate in numerous multispecialty clinics such as cerebral palsy, spina bifida, brain injury, neuromuscular, Angelman syndrome, Friedreich's ataxia, aerodigestive, NICU follow-up and others.

Just like the Mayo Clinic adult practice, we see a combination of local and regional "bread and butter" diagnoses as well as a wide variety of unusual presentations and interesting patients from around the world.

Rotation schedule

Rotation Length
Inpatient pediatrics PM&R 6 months
Outpatient pediatrics PM&R 6 months
Dedicated research 3 months
Pediatric subspecialty rotations* 7 months
Electives 2 months

*Neurology, rheumatology, orthopedic surgery, genetics, developmental pediatrics, NICU, PICU, general pediatrics, radiology, sports

Rotation descriptions

General outpatient pediatric rehabilitation clinics

During your outpatient pediatric rehabilitation rotations, you evaluate and manage a wide variety of patient diagnoses in youth ages birth to 21, such as:

  • Cerebral palsy
  • Spina bifida
  • Muscular dystrophies
  • Hereditary peripheral neuropathies and peripheral nerve injuries
  • Musculoskeletal disorders and sports injuries
  • Inflammatory joint disease and other rheumatologic disorders
  • Chronic pain
  • Limb deficiency and amputation
  • Plagiocephaly and torticollis
  • Developmental delays due to hereditary and acquired disease
  • Acquired brain injury
  • Spinal cord dysfunction due to injury, MS, tumor and other causes
  • Cancer

You also:

  • Evaluate, prescribe and follow up on age-appropriate assistive devices and technology, such as orthotics, prosthetics, seating systems, adaptive equipment, gait aids, augmentative communication and environmental accessibility aids in order to improve independent function
  • Understand, integrate and perform pediatric rehabilitation procedures such as Botox and phenol injections, baclofen pump refills and programming
  • Advocate for care needs within the systems of care including educational, vocational, transition and home care systems

General inpatient rehabilitation service

During your pediatric inpatient rehabilitation rotations, you serve as the primary physician for children and adolescents admitted to the rehabilitation unit. In addition, you provide consultation and follow-up services for children in the pediatric acute care hospital and assist in decision-making regarding next steps of care.

The Mayo Clinic Eugenio Litta Children's Hospital is a "hospital within a hospital" and adjacent to the rehabilitation unit. Consultation services for rehabilitation inpatients are readily available from any of the pediatric services as are pediatric Rapid Response and code teams.

Primary diagnoses on the rehabilitation unit include:

  • Brain injury
  • Spinal cord dysfunction
  • Multitrauma (Mayo Clinic Hospital, Saint Marys Campus, is a Level 1 Pediatric Trauma Center)
  • Stroke
  • Cerebral palsy
  • Tumors and cancer

You learn to:

  • Identify and manage common medical conditions associated with childhood onset disorders
  • Lead the rehabilitation team conferences
  • Plan and coordinate transitions

Procedures during your inpatient months include electromyography (EMG) and selective dorsal rhizotomy monitoring and injections.

General pediatric hospital

During this two-week rotation, you become familiar with general acute pediatric conditions warranting hospitalization, as well as pediatric fluid, nutrition and medication management.

NICU

Two weeks in the NICU allow you to better understand what infants and their families experience at the beginning of life. You become familiar with the risk factors for future disability and manage basic preemie care with ample support.

PICU

The two-week Pediatric Intensive Care Unit (PICU) rotation is intended to familiarize you with the identification and management of life-threatening emergencies, respiratory support options, postoperative care and airway management. You develop a deeper understanding of disorders of consciousness, end of life and palliative care, transplants, and initial trauma care.

Pediatric neurology

During your one-month pediatric neurology rotation, you evaluate, work up and treat a wide variety of pediatric neurologic presentations and diagnoses such as genetic syndromes, epilepsy, acquired central nervous system and peripheral neuromuscular dysfunction, movement disorders, developmental delays and regression, and headaches.

Pediatric rheumatology

During your two-week pediatric rheumatology rotation, you are likely to see:

  • Juvenile rheumatoid arthritis (JRA)
  • Systemic lupus erythematosus (SLE)
  • Henoch-Schonlein purpura (HSP)
  • Kawasaki disease (KD)
  • Seronegative spondyloarthropathies
  • Juvenile dermatomyositis (JDMS)
  • Noninflammatory causes of joint pain like "growing pains"

Pediatric orthopedic surgery

You rotate with the pediatric orthopedists for one month. This includes OR observation as well as clinical evaluation of a wide variety of bone and soft tissue abnormalities, including fractures, scoliosis, hip dysplasia and genetic bone syndromes. You learn about optimal timing and conditions for various procedures.

Genetics

During your genetics rotation, you refine your history-taking skills and learn to look for signs of common genetic disorders that are referred to rehabilitation clinics.

Developmental pediatrics

This rotation allows the opportunity for you to acquire a deeper understanding of the evaluation and treatment planning for children with developmental delays and autism, in particular.

Community advocacy

You tour numerous facilities in and around Rochester that provide support to youth with disabilities, so that you can assist in connecting your patients and families with appropriate groups and activities.

Call frequency

Night call is taken from home. During call, you have an attending rehabilitative medicine specialist available for consultation as needed. Mayo Clinic follows the recommendations of the Accreditation Council for Graduate Medical Education (ACGME).

Moonlighting

You may moonlight with program director approval. Moonlighting must not interfere with the required learning and must not violate the work-hour rules of the Accreditation Council for Graduate Medical Education (ACGME) or visa regulations.

Research training

The goal during this fellowship is to support your area of academic interest. The time dedicated to research during this program is utilized to prepare you to become an independent investigator upon completion of your training. At Mayo Clinic, there are many opportunities to pursue basic science, translational, clinical or educational research. Your personal interests are matched with the research interests of a dedicated mentor.

You are encouraged to take research courses within Mayo Clinic Graduate School of Biomedical Sciences. These courses aid in the development of a scholarly approach to patient care.

Didactic training

Mayo Clinic's Pediatric Rehabilitation Medicine Fellowship gives you dedicated time to participate in didactic training, including:

  • PM&R education conferences, journal club and an annual research seminar
  • Dedicated pediatric rehabilitation medicine lecture series and journal club
  • Pediatric morning report, noon conferences and grand rounds
  • Lectures and grand rounds in pediatric orthopedics, pediatric neurology, pediatric radiology and others

During your final year, you present research at the annual PM&R research seminar. In addition, you may attend one national subspecialty-related meeting for education purposes and any other national meeting for which you have an abstract accepted for presentation.

Teaching opportunities

Opportunities are available for teaching rotating residents, medical students, therapists and therapy students.

Evaluation

To ensure that you acquire adequate knowledge and develop the appropriate technical skills to meet program expectations, your individual performance is monitored carefully during the Pediatric Rehabilitation Medicine Fellowship. You are formally evaluated by your supervising faculty members on a regular basis and meet with your program director to review these evaluations. In addition, you regularly evaluate the faculty to confirm that your educational needs are being met.

Sept. 06, 2017