1. Diagnosis and treatment of acute illnesses and injuries in infants, children and adolescents.
2. Diagnosis, acute management and coordination of care for children with chronic illnesses and disabilities.
3. Diagnosis, acute management and coordination of care for children with behavioral and neurodevelopmental disorders, sexual and child abuse/neglect.
4. Diagnosis and acute management of toxicological emergencies.
5. Understand how to stabilize and transport seriously ill and injured newborns, children and adolescents before transfer to tertiary care centers.
6. Demonstrate high quality communication skills as they relate to patients, staff and peers.
7. Know the appropriate indications for referral to and develop relationships with other health professional and community agencies.
8. Possess skills for interpreting medical literature and in continuing professional growth as a PEM specialist.
9. Provide high quality, cost effective patient management.
10. Demonstrate knowledge of ethical principles as they relate to the emergent care of children and families.
11. Demonstrate knowledge of disaster preparedness strategies as they relate to the Pediatric Emergency Medicine department.
12. Provide effective child health advocacy.
13. Perform, prepare for publication in a peer reviewed journal and publish as first author Pediatric Emergency Medicine research.
14. Understand the administrative responsibilities of a Pediatric Emergency Medicine physician.
15. Demonstrate knowledge of the emergency medical system as it relates to the Pediatric Emergency Medicine department.
16. Demonstrate knowledge of adult and obstetrical emergencies.
17. Possess skills for teaching patients, staff and peers about Pediatric Emergency Medicine.

First Year Goals

1. Understand and implement appropriate emergency department (ED) management of common pediatric emergencies and urgencies including, but not limited to: respiratory distress, seizures, SVT, allergic reactions, toxic ingestions, HTN, hypoglycemia, DKA, meningitis, post tonsillectomy bleeding, appendicitis, PID, intussusceptions, volvulus, febrile infant, fever and neutropenia, and testicular torsion.
2. Discuss the etiology and natural history of common pediatric emergencies and urgencies.
3. Learn and perform common pediatric procedures including, but not limited to: LP, laceration repair, reduction of commonly dislocated joints, esophageal bougienage, hernia reduction, 10 line placement, endotracheal intubation, splinting, and cardioversion.
4. Discuss potential complications of common pediatric procedures.
5. Understand alternatives for, and implement, effective pain management.
6. Communicate effectively with patients, families, nursing staff, EMS personnel, ancillary service personnel, referring physicians and consultants.
7. Document so as to promote seamless patient care appropriate billing and a medico legally sound record.
8. Use attending physicians as a resource for references, information, experience and style.
9. Focus reading on diagnosis and initial management of pediatric problems presenting to the ED.
10. Participate in educational opportunities at rotation site.
11. Participate in ongoing research protocols.
12. Discuss all patients with attending staff physicians. Make one available to see patients in critical care room along with staff physician and take active role in resuscitation.

Second and Third Year Goals

1. Understand and discuss controversies in the ED management of common pediatric emergencies and urgencies.
2. Understand and implement the ED management of life threatening pediatric emergencies including, but not limited to: respiratory failure, shock, status epilepticus, increased intracranial pressure, altered consciousness, cardiac dysrhythmias, cardiac arrest and electrolyte disturbances.
3. Perform resuscitative procedures including but not limited to: rapid sequence induction, endotracheal intubation, pericardiocentesis and defibrillation.
4. Understand and implement effective procedural sedation.
5. Manage ED patient flow at staff level.
6. Manage ED as the physician in charge on overnights with onsite ED staff back-up.
7. Precept house staff in their care of ED patients.
8. Communicate effectively with patients, families, nursing staff, EMS personnel, ancillary service personnel, referring physicians and consultants.
9. Document so as to promote seamless patient care; appropriate billing and
   a medico legally sound record.
10. Focus reading on controversies and advances in PEM.
11. Participate in ongoing research protocols
12. Participate in educational opportunities at rotation site.
13. Use attending physicians as a resource for references, information, experience and style. Review all critical patients with attending staff physician and when performing difficult procedures. Senior fellows will be doing shifts as staff physicians and work as the lead physician with on-site back up of a staff physician.