What invasive procedure are you most excited to learn during PICU Fellowship training?

"During my residency training, I was exposed to intubation and central venous catheterization. I'm most excited about learning thoracostomy tube placements because I know this procedure is a vital skill for any Pediatric Intensivist, and I haven't had hands-on experience with it yet. I fully trust my hands-on skills working with pediatric patients at any age, and now it will be just learning the ins and outs of the procedure."

You should be well aware of the invasive procedures you will be learning over the next three years. Your interviewers want to hear what invasive procedure is most exciting to you and learn a bit about what you want to accomplish during your time training with their program.

Come to your interview prepared to openly discuss one or two invasive procedures that excite you the most. There is no right or wrong answer to a question like this, so your interviewers will be listening for your passion and drive in your answer.

How would you stay on top of trends and changes in the field of Pediatric Intensive Care during your time as a fellow with our program?

"During residency training, I've taken advantage of joining the AAP, and I subscribe to the Pediatrics journal. Their CME virtual courses have proved to be very beneficial over the last two years as well. As a PICU Fellow, I would like to join PedsCCM. Are there any other resources that you would suggest looking into?"

Your interviewers want to know that you will fully immerse yourself in your field as a PICU Fellow with their program. This includes staying up to date on new trends and understanding the challenges the industry faces, both now and in the future.

Talk about a couple of the resources you currently use to stay on top of trends in general pediatric care. You might also ask the interviewers if they have any recommendations. This can start a conversation that will be helpful to you! Before your interview, look into the journals and publications that are specifically geared toward Pediatric Intensive Care Medicine.

Are you considering or interviewing with any other PICU Fellowship programs?

"I have formally applied to many of the reputable PICU Fellowship programs across the country because I want to give myself the best chance of matching into a program with a reputable academic and research center. No matter the number of interviews I complete, I hold your program in the highest regard because of the combined clinical, academic, and research success that your past trainees are now having in practice."

It is no secret that hopeful PICU Fellows are encouraged to apply to many programs to better their odds of matching. It always puts a little bit of fire under the interviewers and programs you are interviewing with if they are aware that you are actively pursuing many opportunities, especially if you are one of their top candidates.

Talk openly about the applications you've submitted, but emphasize your interest in this particular PICU Fellowship program. Give the specific reasons you want to complete your training with this program and explain how the program will benefit you in the pursuit of your dream career as a physician.

Talk about the most interesting case you were exposed to during your Pediatrics Residency training. What made it so interesting to you?

"The most intriguing case I was exposed to during my residency training was an infant who had been experiencing 15 days of daily fevers of 102 degrees. The child was three months old and was losing some weight during the sickness. The patient had been adopted just one month prior from overseas, which further complicated the case. This was a true learning opportunity. I had the opportunity to work with my attending on a physical exam, order numerous lab tests, and have an ID physician consult with the patient. With a rare diagnosis of typhoid fever, I had the opportunity to follow the treatment of the patient for 13 more days on the inpatient unit."

Your interviewers want candidates who have a passion for medicine. This conversational-based question is intended to get to know the types of cases you find most interesting.

Before your interview, think of what you consider the most intriguing and thought-provoking case of your residency training. These cases should pertain to the specialty you want to pursue. Take a few minutes to set the stage for the case, name a couple of points that intrigued you, and explain why. If you know the outcome of the case, discuss that briefly as well.

A recent patient survey comes back, and you find out that you did not meet a patient's expectations as their physician. What are the next steps you would take to improve?

"I was faced with this situation as a Pediatrics Resident, and I didn't let it get me down. I saw it as an opportunity to improve. The family that submitted the feedback anonymously said that my approach was not personal. I took the time to analyze the feedback and remember which patient encounter it came from. It was a turning point in my approach to patients and families, and I appreciated the feedback. I would take the same approach to patient surveys at your institution."

Patient satisfaction surveys are commonplace in any healthcare institution and are put in place to ensure that the best possible care is provided to every patient of the institution. During your time in PICU Fellowship training, the families of your patients will fill out satisfaction surveys about your performance, and your team of interviewers poses this question to understand how you will take constructive feedback and learn from it.

If you were to ask any physician if they have ever received critical feedback on a patient survey, the answer would be a resounding yes. The goal in answering this question is to demonstrate to your interviewers that you can take feedback, analyze it, and use it as motivation to improve the care you provide. Keep in mind that most patient feedback is anonymous, and you may not be able to pinpoint the exact interaction that resulted in the feedback from the patient. If you have any experience with patient feedback surveys during your time in Pediatrics Residency, don't hesitate to talk about that experience.

As a new trainee in our PICU Fellowship program, how will you respond when asked to do a procedure or task that you are unfamiliar with and uncomfortable handling?

"I am confident in my medical knowledge and the skills I developed during my Pediatrics Residency training, but I also know I will be expected to master procedures like venous catheterization, endotracheal intubation, and thoracostomy tube placement. When faced with a new situation and am not 100% confident in my skills, I wouldn't hesitate to ask a senior fellow or faculty member for guidance. My goal is to leave the fellowship with all of the skills necessary to be a confident and competent physician, and I look forward to these learning opportunities with your program."

As you enter PICU Fellowship training, you know that you will be tackling many new procedures and tasks that you haven't been directly exposed to before. Your interviewers want to hear that you would take a collaborative and learning approach and that you aren't afraid to ask for help.

This is not the time to say that you would jump in with both feet and potentially risk the safety and wellbeing of a patient. Your interviewers are not looking for someone who jumps when someone says jump but someone willing to jump with confidence and competence. Provide an answer that illustrates this difference. Talk about your willingness to ask for help and learn in the process.

As a PICU Fellow, how will you explain complex procedures and diagnoses to the families of your patients using verbal instructions?

"I read once that most newspapers are written at a 5th-grade level so most people can understand the message. I think that today we are inundated with verbal and written messages, so what we choose to say should be prime real estate. Because of that, I strive to speak in a way that the patient or family can understand without filler or fluff words. In any pediatrics setting, the education we provide can be to parents who are fearful, sad, and overcome with feelings they may have never had before. This education has to come with a great deal of compassion. My approach to the patient's family will always be to let them know the information as soon as possible and explain what is happening in ways that they understand. I think that education materials are very important for parents to understand a new diagnosis for their child. I would always allow them to ask questions and clear up any misconceptions they have."

Your team of interviewers wants a full team of PICU Fellows who can be world-class educators. They need it to be able to successfully manage the stressed families of patients in the PICU. A question like this allows your interviewers to see how you would handle educating a patient and their family on a complex diagnosis or procedure using only dialogue.

Healthcare is increasingly complex, so it makes sense that the instructions can be as well. This question provides a chance to showcase your ability to take a complicated idea and explain it without losing integrity and dumbing it down. Explain to your interviewers your step-by-step approach to ensure that the complicated subject is understood by your audience.

Tell us about a time you had to work with new technology during your Pediatrics Residency training. What did you do to ensure proficiency as quickly as possible?

"First and foremost, I want you to know that I understand that today's pediatric critical care staff need to embrace technology to provide the best patient care possible. I've always been enamored by the great technological advancements in healthcare. More recently during the pandemic, one area that physicians need to embrace is telehealth, and I was fortunate to be exposed to this during almost all of my rotations. Learning technologies like Zoom and other video conferencing apps was a new concept to me. Before beginning their use, I watched training videos and practiced having virtual consults with my classmates to ensure that there wouldn't be any technical glitches when I worked with patients. I am fully confident in my ability to use video for telehealth consults with patients."

Technology in the medical field has been evolving and will continue to evolve year after year. While you may be academically gifted, your interviewers need to know that you can pick up and master any new technologies in pediatric intensive care during your time with them. During your PICU Fellowship training, you will likely work with many pieces of equipment you haven't had the opportunity to in the past.

Think of a time you had to learn new technology and choose an example that proves your ability to study, learn, and master its use in short order. Then, discuss with your interviewing team the fact that you know you will be learning a new EMR and other medical equipment during your fellowship training and are willing and ready to be a great learner of any new technologies thrown your way during your time with them.

Talk about a time you showed initiative by taking the lead in a situation during your Pediatrics Residency training. Why did you take action as the leader, and what was the outcome?

"Growing up and into my college years, I was a natural leader to my peers. This is evident from my years participating in team sports and being a captain of my teams. During my residency training, I was excited to be voted as chief resident during my final year. While recently rotating in our inpatient peds ward, I took charge of a critical patient situation on a night shift and guided our nursing staff to stabilize a patient. It was gratifying to be the physician in charge of directing care and feel comfortable and confident doing so. I will carry what I learned from this experience into your PICU Fellowship program."

Your interviewers want to see that you are confident enough to take the initiative when the opportunity arises. Most medical training programs don't provide formal leadership training, so your interviewers want to know that you are a natural leader. As you advance to the final year of your PICU Fellowship, you will lead teams of junior fellows and care teams consisting of nursing and other support staff and your interviewers will want to hear that you can lead others successfully.

Carefully describe a situation from your residency training where you saw a chance to lead and took advantage of it. Talk about the success of the moment and your biggest takeaway from the experience. Highlight your ability to communicate effectively and lead others.

How would you describe your personality in three words?

"I would say the three words that describe me best are genuine, determined, and loyal. What you see is what you get. I'm confident and comfortable in my skin, and my patients appreciate that. I'm also very driven to succeed as a Pediatrician and to provide the best care possible. My loyalty to my patients means going the extra mile for them and helping them find answers and treatments that are customized for them."

Your interviewers pose this question for two reasons. First, they want to get a feel for how you will fit in with their PICU Fellowship program. They also want to hear how you view yourself. Notice they do not ask how others would describe you, but how YOU would describe yourself.

Since you only have three words, make sure the words that you use will make a lasting impact on your interviewers. Some possible words to use include adaptable, brave, compassionate, respectful, helpful, positive, thoughtful, and versatile. Avoid giving the same answer other candidates give. Explain your reasons for choosing these words.

How timely would you say your charting and dictations were during residency training?

"Although I've been occasionally remiss in keeping all sign-offs and dictations current, I feel it is important to be diligent in keeping current. It is not lost on me that reimbursement by third-party payers can be affected by incomplete charts. Just as important is the need for accuracy, and the specifics of a procedure or rounds can be spotty if too much time has passed. For these reasons, I agree that keeping current is important and would always strive to be timely in my charting as a Pediatric Intensive Care Fellow with your program."

Getting behind on charting after a long and busy day happens in any practice, and this is especially true for residents and fellows in training. Your interviewers ask a question regarding the timelines of your charting and dictation to hear how you prioritize these tasks during a busy and that you can do what is necessary for a patient's record, even on the busiest of days as a PICU Fellow.

Speak openly and honestly about how you prioritized your patient charting during your Pediatrics Residency training, and push your answer further by highlighting any direct feedback you received. If you experienced a time where your charting/dictation wasn't timely, it is okay to bring that situation up as long as you can express what you learned from it moving forward into PICU Fellowship.

We are always looking for our fellows to participate in, and even lead, PMET teams at our facility. Are you willing to participate during PICU Fellowship training?

"I would jump at the chance to participate on your code teams. I am well-versed in cardiac arrest situations and love the quick thinking and fast-paced environment of saving a young patient's life. As you can see, my residency training is in New York City at a very busy metropolitan hospital. Code teams were a marvel to watch in action the few times they came to units I was rotating on."

In any large inpatient pediatrics hospital, pediatric medical emergency teams (PMET) are put in place to assist patients in cardiac or respiratory arrest. PICU Fellows that are fortunate enough to be invited to participate in these traditional code teams during their training gain invaluable experience that they can bring to their future practice. It is a highly desirable skill and experience by many employers. Your interviewer ideally wants to hear that you would jump at an opportunity to participate on their PMET team.

Let your interviewers know that you are familiar with the code teams in a hospital setting. Be sure to elaborate on the fact that Pediatric Intensivists typically participate in teams that include a physician, a fellow, a PICU Nurse, and a PICU Respiratory Therapist.

At our institution, you will be working side by side with Advanced Practice Providers as a PICU Fellow. Would you have any issues in doing so?

"During residency training, I got to work very closely with APP staff in both the outpatient and inpatient settings, and they were all amazing to work with. They greatly improved patient access, which is a benefit to all. They are also very knowledgeable in procedures and can provide a second set of eyes in many situations. In the state where I trained for residency, they did not have a full scope of authority, and physicians needed to sign off on any prescriptions they wrote. Can you talk about your state's scope of practice for APP staff?"

Over the years, there has been some hesitation for physicians to work alongside APPs in their practice, but the reality is that most pediatric intensive care units have made the financial decision to employ and use more APPs, and your interviewers need to know that you are comfortable training in this situation and that you will be a team player with Nurse Practitioners and Physician Assistants.

Keep your answer short and sweet. Tell the interviewers that you wouldn't have any issues working closely with APP staff while training during PICU Fellowship. To further solidify your response to this question, highlight some of the positive aspects that Nurse Practitioners and Physician Assistants can bring to a practice.

Are you able to handle the physical requirements of the work of a Pediatric Critical Care Fellow?

"Yes, I can handle the long 12-hour shifts during PICU coverage during my fellowship training. I'm a very active person and found that working similar shifts during residency training came easily to me. As a father to two children, I am also very comfortable working carefully with pediatric patients of any age."

Being a successful PICU Fellow has a unique blend of competing physical requirements. This can include being on your feet for typical 12-hour shifts with little time to sit because of the need to round on patients and the need to have gentle hands with the young patients that you will be working with on a daily basis. Your interviewers need to know that you will be able to handle all of the physical demands if they are going to seriously consider you to match into their program.

Speak honestly and to the point about your ability to handle the long hours on your feet and the quick action of the PICU environment. If you can, talk about the long hours that you covered during your residency training and how you successfully managed them. Then, talk about your ability to work carefully with PICU patients and how you will prioritize being a gentle and caring physician if you were to match into this program. It can also be beneficial to discuss your self-care methods because being in physical shape can greatly benefit PICU Fellows on the job.

Talk about the most stressful situation you had to handle during residency training. What did you learn from that situation that you can bring to your PICU Fellowship training?

"I'd have to say that the most stressful week of my residency training was a combination of both work and personal stress. I was on a busy rotation during the second year that had me working a 60-hour inpatient week. One week, my family at home was down and out with the stomach flu. In this situation, I learned to keep my mind focused on work while at work and then shift to home life when I went home. I pride myself on not taking my work stress home with me and vice versa because I believe this is a critical skill in preventing physician burnout on the job."

Staff in the pediatric ICU setting can find themselves in very stressful working situations from time to time for a variety of reasons. Given the highly specialized nature of pediatric intensive care and the patient situations they deal with, the stress can be both physical and psychological. Your interviewer wants to get a feel for how you will handle these situations as a fellow with their program.

Think of a specific time you had to manage a stressful situation during your residency training. Describe how you handled it, talk about what tools or resources you used, and explain the outcome of the situation. If possible, talk about specific coping techniques you used to help you through that particular situation to prove your ability to handle the mental and physical challenges of your PICU Fellowship.

Tell us about a time you had to communicate bad news to the family of a patient during your residency training. How did you effectively communicate that news?

"During my community health rotation in the second year of residency, we found a concerning lump in a young patient's neck. After some quick lab work, we found that the lump was cancerous. My attending allowed me to have a conversation with the patient and her mother, and she coached me through the right approach. I broke the ice by letting them know that I had bad news and that the lump was found to be cancerous. I paused to allow them to think and react, but they didn't. I then asked what they were thinking, and the mother broke down into tears. I let her know that there were a lot of unknowns at the current moment and that we would refer her daughter to our pediatric oncology team for an initial consult the following day. I reassured the mother that she would be able to meet with a financial counselor in our oncology department and not to worry about that aspect of her daughter's care."

As you likely found out during your Pediatrics Residency training, the most difficult part of the job of a Pediatrician is often communicating a bad diagnosis to the family of a young patient. In the pediatric ICU setting, you will have to deliver horrifying and life-altering news to the families of your patients. Your interviewers want to see that you handled these situations by showing empathy and composure.

Before your interview, think back to a time when you had to have a difficult conversation during your residency training. Talk openly about what made the communication difficult and how you prepared and delivered the communication. Talk about your ability to understand their perspective and that you are open and available for questions from the family.

How did you learn to prioritize your work during residency training when multiple patients demanded your attention at once?

"Throughout my Pediatrics Residency training, I've learned that communication is the key to success in any overwhelming clinical situation. In my rotation in a full pediatric ICU during the peak of the pandemic, it was vital to ensure that the entire team of physicians and nursing staff were on the same page. I focus on making sure my duties are organized and timely and that I handle one patient at a time before moving my focus onto the next."

Practicing as a Pediatric Intensivist in any busy PICU setting can be overwhelming for new fellows. While you likely got your feet wet in the intensive care unit during your Pediatrics Residency training, your venture into fellowship training will put you in charge of handling a large patient load at one time. Your interviewers ask this question to determine how you will manage situations like this as a trainee in their PICU Fellowship program.

To successfully answer this question, talk about a particular situation during residency training where you had to prioritize multiple patients at once and describe how you handled the situation. Highlight your ability to prioritize, stay organized, and communicate with the entire care team.

If you noticed a physician or member of the care team not taking proper safety precautions in our PICU, how would you handle that situation?

"In the healthcare field, safety depends on consistent, simple, and easy actions. If I ever see members of the care team not taking precautions seriously, I talk with them immediately and positively, reminding them of the importance of safe work habits. If I noticed a physician skip handwashing, for example, I would talk to them in private and explain the importance of hand hygiene in keeping all patients and staff safe. If it came to continued blatant disregard, I would take the issue to the program director as quickly as possible. Pediatric patients are so susceptible to common viruses and infections that we as adults wouldn't bat an eye at yet could prove to be fatal for them. Extra diligence in the routine safety precautions is something I would take seriously every day as a trainee in your PICU Fellowship program."

Safety is of the utmost importance when providing direct patient care in the Pediatric ICU setting. When it comes to patient safety, all direct patient care staff are at the frontline of providing a safe environment for both the children they are caring for and the families that accompany them. Your interviewer expects to hear that you will be an advocate for safety at all times if you were to join their PICU in the next class of fellows.

Whether you notice a colleague not washing their hands before and after seeing a patient or about to administer an improper dose of a medicine, tell the interviewer that you wouldn't hesitate to intervene immediately. Explain that you understand why an increased focus on safety is so important in this role as a PICU Fellow due to the patient base that you will be providing care for.

Tell us about a time you had a conflict with a family member of a patient during your residency training. How was it resolved in a healthy manner?

"During my outpatient clinic rotation in residency training, I encountered a parent who was adamantly against vaccinating their two-month-old for the standard series of vaccinations. I cautiously educated the parent on the benefits of vaccination, but she became very frustrated and rude. I agreed that it was her choice and continued my exam with the infant. In the end, I thanked her for listening and let them know that I was looking forward to seeing them again at the one-year wellness appointment."

Pediatricians need to be able to handle the stressed and angry family members of patients respectfully and healthily. Your interviewers need to know that you can handle family member conflicts with ease in the PICU setting, and your answer to this question will indicate how well you handle conflict.

Briefly describe a simple scenario, focusing on your response to the challenge rather than the details of the conflict. Emphasize your communication skills. Describe what you learned from the situation that will help you in the critical care setting.

What motivated you to pursue Pediatric Critical Care Fellowship training?

"From the first day of medical school, I knew that my passion was in pediatrics. My PICU rotation during residency training cemented my career goal to become a Pediatric Intensivist. I was very fortunate to have worked with some great faculty during my program training there, and they saw that I could handle the long hours and the intensity of the care needed for children in critical care. I developed a passion for working with this patient base and look forward to learning and growing so much more with your program."

Coming out of Pediatric Residency, most physicians focus their career on an outpatient clinical setting to see patients and start making the paycheck they've worked so hard for. Your decision to pursue a PICU Fellowship training program hopefully means that you have planned a career path. Your interviewers want to hear your career goals following your training and how their program will help you achieve those goals.

Come to your interview prepared to talk about your career goals as a physician and why this program is the best option for your pursuit of those goals. No matter what your motivations and goals are, speak with passion about your future.

Tell us about a difficult patient experience during your Pediatric Residency training. How did you handle the situation professionally and respectfully?

"During the second year of my rotation in the pediatric ED setting, I had a patient who appeared to be the victim of abuse. The patient had a broken arm and bruising consistent with abuse. This situation was difficult for me because it was the first time I had ever been exposed firsthand to a potential abuse case. While it raised some strong emotions inside of me, I kept my composure and watched my attending and support staff walk through the proper steps of a suspected abuse case. Looking back, I feel fortunate to have had this exposure to know how to handle similar situations moving forward."

During your Pediatric Residency training, you had the opportunity to work with patients in a wide variety of settings. This likely has included handling difficult patients. This question allows your interviewers to assess your patience, communication skills, conflict resolution skills, and stress management skills.

Talk about a simple scenario so you don't spend too much time describing details of the patient's story. Instead, spend your time describing your thoughts and actions. Your answer should demonstrate your ability to remain calm, patient, empathetic, and logical while helping the patient to the best of your abilities.

What challenges do you think the field of Pediatric Critical Care Medicine currently faces?

"The two challenges I've been following closely over the last year are staffing shortages and the need for more research in the field. This is a unique subspecialty in medicine, and burnout is common among providers and allied health staff. I believe that the right hiring and screening processes can help limit staff turnover and get employees in the positions that are right for them. As far as research is concerned, I recently read about the shift from receiving funding from industry to receiving more federal grants, and this poses a big challenge. I am highly interested in research and innovation in the field, and I would love to someday pursue grants in airway interventions and infection prevention."

This question assesses your familiarity with the field of PICU medicine and the issues currently occurring in the field. Your interviewers hope the candidates they interview are prepared to talk about the issues the field faces.

Before your PICU Fellowship interviews, research this question and be prepared to talk about a couple of issues. You may also consider offering a suggestion to fix the issues you mention. As you research, you'll quickly see that the field of Pediatric Critical Care medicine deals with issues like staffing, research translation, innovation, and access to care.

Would you have any worries or fears about joining our PICU Fellowship program?

"I have all of the confidence in the world in the clinical skills I've developed over the last three years of Pediatric Residency training. I know that I will be mastering new skills in clinical and procedural practice during PICU Fellowship training, and I'm not worried on that end. The only thing that might keep me up at night is integrating quickly with the existing team of senior fellows. I am a firm believer in cohesiveness on a team, and this is honestly a pressure that I put on myself. If I were to match into your program, I would make getting to know my colleagues a priority in my initial days."

Your interviewers ask this question for two reasons. First, they want to ensure that any common myths about becoming a Pediatric Critical Care Fellow are debunked for prospective fellows who have worries that aren't true. Second, they want to hear how you are working on the areas in which you are not confident.

Rather than focusing on a potential deficit in your ability to perform as a PICU Fellow, openly talk about any questions you may have upon joining this PICU Fellowship program. If you feel that your training and skills are lacking in any area, discuss that and have a plan for getting up to speed if you were to match into this program.

What aspects of our PICU Fellowship program interest you the most?

"In my search for a great Pediatric Critical Care Fellowship program, it's important for me to match into a program with well-rounded clinical rotations and research experience. I love that your program is based out of a children's hospital, where I will get to partner with experts not only in the PICU but also in the emergency, cardiology, and cancer care settings."

This question is asked by most PICU Fellowship programs to understand what interests you about their program. With many prospective candidates for a few PICU Fellowship openings each year, your interviewers need to know that their program is a match for you. Candidates who show passion and interest often get ranked near the top of the list.

Think about two or three features of this particular program that interest you and how the program can help you achieve your personal goals. Before your interview, thoroughly research the program. More often than not, you can find a lot of great information on the program's website. This can include the mission and values of the program and institution, the curriculum, and where alumni go after their time with the program.

What was the biggest challenge you faced in your residency training program?

"My biggest challenge of residency training was handling the stress and managing a delicate work-life balance during my first year. In medical school, I was taught that stress management skills were important, but I never knew how true those words were until I needed them. I admit that I had some breakdowns during my first year, and some great senior residents and attending physicians gave me encouraging advice. Throughout the remainder of my training, I learned some great tactics to manage busy clinical loads and have a happy home life."

There are many challenges when coming into a program as a new Pediatric Critical Care Fellow, from learning new faces to taking on a more focused group of patients for the first time. Your interviewers are aware that you likely faced a few challenges as a Pediatrics Resident and want to know that you can face challenges head-on, embrace them, and learn from them.

Pick a challenge that is commonly faced by residents rather than focusing on a potential deficit in your ability to perform as a PICU Fellow. You can also pick something unique to you that is not the result of your actions (e.g., a family member passing away). Then, explain how you took steps to manage this challenge and prepare for similar challenges in the future.

Would you have any concerns about relocating to join our PICU Fellowship program or living in this city for the next three years?

"Being from the west coast, coming to Philadelphia for three years would be a dream for me. I am a big history buff, so getting to explore Independence Hall and other landmarks would be exciting. I'd also look forward to catching a Phillies game during the warm summer nights and feasting on all of the great east coast food options here."

Every year, graduating Pediatrics Residents compete to match into a wide array of fellowships to further their careers. As you are likely applying to and interviewing with programs all over the country, your interviewers need to know that you are willing to relocate for their program.

If you have lived in or visited the city or adjacent cities, you should mention this fact. If you know anyone there, talk about the good things they have told you. If it is an unfamiliar city or region, discuss traits that are unique to the city that would intrigue you and explain why an applicant may be open to living in the area. Ensure that your interviewers understand that you have done your homework on the city and can see yourself thriving there.

What are some key things that you are looking for in a PICU Fellowship program?

"I am looking for three specific things in a PICU Fellowship Program. First, a well-rounded clinical rotation curriculum was important, and I love the fact that your fellows get experience in a cardiac ICU, a trauma/surgical ICU, and an oncology ICU. I think this is important for any future PICU physician. The second thing I am looking for in a program is a distinguished research commitment for fellows, and I loved hearing about the great research activities your fellows are immersed in. The last trait is the academic success of your past fellows. Publishing is important in my career, and your alumni have a great track record of their scholarly activities."

The matching algorithm for residency and fellowship programs takes an applicant-centered approach, meaning it looks to rank residents with their top choice of fellowship program as long as the program holds the candidate as a top choice. Knowing this, your interviewers want to ensure that their PICU Fellowship program fits your needs.

Your interviewers are ultimately asking why you want to enter their program. Explain how the program meets your needs and goals as a Pediatric Critical Care Fellow. Research the program before your interview and identify a few unique features of the program that are important to you when ranking the programs that you interview with.

Take some time to tell us a little about yourself and your interests outside of medicine.

"From a young age, I have enjoyed outdoor activities. I love to mountain bike, canoe, camp, and hike. Whenever I had free time during medical school and residency training, I explored nature in many different ways, and we've started to instill these values in our children. I love that this region has awesome rivers and trails for us to explore for the next three years while I would be in PICU Fellowship training with your program."

Successfully matching into a great PICU Fellowship is a competitive process. While your interviewers will dig into your clinical skills and interests during your interview, personal fit may be an important factor during their match process. With this question, your interviewers are looking to get to know who you are as a person to gauge how you will fit with the current fellows and faculty in the program.

When asked a question about yourself and your interests, be open and honest with your interviewers. Show that your interests outside of practice include healthy lifestyle choices and genuine passion for what you do. Discuss any hobbies or interests that you have that make you a truly unique person.

What would the perfect day of PICU Fellowship training look like for you?

"My perfect day as a PICU Fellow starts with greeting my 5-year-old for the day and helping to get her ready for school before heading in for the day. The morning would entail clinical work focusing on a wide variety of pediatric patients, from recent transplants to hematologic disorders. I would hopefully work under a great attending physician. After a quick lunch, I would spend the afternoon working on developing translational research skills, particularly in novel treatments for pediatric burn victims. After a great Grand Rounds to end the day, my evening would be capped off with a nice dinner with my family, a bedtime story with my daughter, and one episode of a Netflix crime drama before bed."

Stress and burnout in the Pediatric Intensive Care setting have become much more prevalent in recent years. The same applies to PICU Fellows who undergo a strenuous training program for three years. Your interviewers want to hear what keeps you engaged and stress-free. Your answer will also help them gauge how you will fit with their program.

You can have some fun when answering this question and be frank about what your ideal day would look like when training as a PICU Fellow. No matter how you answer, speak with passion and match your perfect day to the offerings of the program you are interviewing with.

How do you think you will perform under pressure as a Pediatric Intensive Care Fellow?

"During my second year of residency training, I was exposed to the intensity of general inpatient ward coverage on the night shift. We worked in teams of two second years residents, and some nights during my rotations were filled with new admissions. I feel this experience honed my decision-making skills in a fast-paced, pressure-packed environment. I feel confident in my ability to handle the pressure of my first year of PICU Fellowship training with your program."

Your interviewers need to know that you have the tools and skillset to face the pressure that comes with training in their intense PICU Fellowship program. Describe the tools, resources, and mindset you use to navigate the most pressure-packed situations as a physician.

To prove your ability to handle the pressures of fellowship training, provide an example of a time you were challenged by a difficult workload or a pressure-packed situation as a Pediatrics Resident. This can be a time you managed several critical patients or had a difficult workload. Discuss how you reacted in that situation, what you learned from this experience, and if you would do things differently next time. Don't forget to talk about the resources you used.

What personality type do you find most difficult to work effectively with?

"I am most often challenged by staff who are poor communicators. As a Pediatrics Resident, I found that communication lines should always be open between residents, faculty, and the care team. If someone on my team doesn't communicate properly, I don't hesitate to respectfully approach them to explain what I need from them. If the problem persists, I take it up the proper chain of command. I would use this same approach in your PICU Fellowship program."

In your PICU Fellowship training, you will work side by side with a diverse group of fellows and faculty, each with a unique personality and work style. Your interviewers ask this question to understand your ability to work with even the most difficult personality styles.

Pick a quality that doesn't reflect poorly on you. Talking about demanding personalities may make you seem lazy or unable to work with demanding faculty in the program. Instead, choose a quality that impairs even the most competent and hard-working doctors from delivering high-quality care or working as part of a high functioning team.

If we asked your friends, what would they say are your strengths and weaknesses?

"If you were to ask my core group of close friends, they would tell you that my strengths are my communication and motivational skills. I have an infectious spirit and can connect with any type of personality. They would also tell you that my weakness is self-criticism. I frequently reflect on my words and actions and wonder if I should have said or done something different. I've continued to work on my self-criticism because I know it is unwarranted at times, and I've been more confident and comfortable with my work since making this effort."

Throughout your interviews for PICU Fellowship, you will talk about your strengths and weaknesses from your point of view. This question is unique because your interviewers request you answer from the perspective of your friends.

Give a strength that is unique to you and applies to the field of medicine. It is a common strategy to offer a weakness that is actually a strength (e.g., "My weakness is that I work too hard"). The interviewers will recognize this as a weak tactic. Instead, provide an example of a legitimate weakness that you have worked to improve. You should not offer more weaknesses than strengths in your answer.

Do you believe telehealth is an effective form of healthcare delivery, specifically in Pediatric Intensive Care?

"Yes, I think there is a time and place for telemedicine in the PICU setting and this comes into play when discharging and monitoring patients from home when it best suits the patient and their family. Great outcomes have been documented utilizing telehealth for patients who are discharged when they normally would have been under routine monitoring in the hospital setting. Can you elaborate on your current use of telemedicine in your PICU?"

While telehealth principles have been applied to patient care for years, it has come to the forefront recently. Your interviewers want their future PICU Fellows to have a positive outlook on telehealth and a vision of where it will go down the road.

Although telehealth has limitations, including the inability to do a physical exam and obtain vitals, it often has a positive clinical outcome and increased satisfaction for families who can be discharged earlier from inpatient units. For this reason, any future physician must embrace telehealth platforms while recognizing that they are not ideal. Your answer should provide the pros and cons of telehealth related to pediatric intensive care, along with any direct experience you have with the technology.

How do you feel about the 80-hour workweek limit for residents and fellows?

"I understand this system is in place to prevent poor performance due to exhaustion. I know there were times during my Pediatrics Residency training when toed the line, and by the end of the 6th day in a row working 12 hours shifts, I was exhausted. The next three years of training as a PICU Fellow will entail a great time requirement, and I'm ready to take on whatever time is needed to train with your program."

In the early 2000s, the ACGME created rules that limited work hours for all medical residents and fellows, including the 80-hour workweek. Your interviewers want to hear that you are aware of the work hour limits in place and if you have any concerns or opinions on this.

One or more of your interviewers may have strong opinions about this topic. For this reason, it is important to focus on the pros and cons but not take a strong stance on this topic. State that you are aware of the rules, why they are in place, and the impact they can have.

Tell me about a time you received constructive criticism from an attending physician or senior resident during your Pediatrics Residency training. How did you handle that situation?

"During my first-year rotation in the pediatric ED, I was told that I spent too much time with patients and families during consults, and it caused delays in the department. Seeing new patients in an emergency care environment was new to me, and my nurturing nature took over in most situations. After some coaching from my attending physician on how to best handle emergency consults, my patient consults went more smoothly and quickly. I didn't take the criticism personally and knew it was for the best in my professional development."

Your work will be scrutinized by the senior fellows and faculty of the program you join. Your interviewers want to know that you can take the constructive criticism you receive and turn it into a positive learning opportunity.

Choose an example that does not highlight a significant or persistent deficit in your ability to provide care. How you handled this criticism should show your devotion to providing optimal care and willingness to use the criticism to shape how you approach patient care moving forward. Stress that you are ready to accept any constructive criticism that will come your way.

PICU Fellowship Interview Questions

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1. What invasive procedure are you most excited to learn during PICU Fellowship training?
2. How would you stay on top of trends and changes in the field of Pediatric Intensive Care during your time as a fellow with our program?
3. Are you considering or interviewing with any other PICU Fellowship programs?
4. Talk about the most interesting case you were exposed to during your Pediatrics Residency training. What made it so interesting to you?
5. A recent patient survey comes back, and you find out that you did not meet a patient's expectations as their physician. What are the next steps you would take to improve?
6. As a new trainee in our PICU Fellowship program, how will you respond when asked to do a procedure or task that you are unfamiliar with and uncomfortable handling?
7. As a PICU Fellow, how will you explain complex procedures and diagnoses to the families of your patients using verbal instructions?
8. Tell us about a time you had to work with new technology during your Pediatrics Residency training. What did you do to ensure proficiency as quickly as possible?
9. Talk about a time you showed initiative by taking the lead in a situation during your Pediatrics Residency training. Why did you take action as the leader, and what was the outcome?
10. How would you describe your personality in three words?
11. How timely would you say your charting and dictations were during residency training?
12. We are always looking for our fellows to participate in, and even lead, PMET teams at our facility. Are you willing to participate during PICU Fellowship training?
13. At our institution, you will be working side by side with Advanced Practice Providers as a PICU Fellow. Would you have any issues in doing so?
14. Are you able to handle the physical requirements of the work of a Pediatric Critical Care Fellow?
15. Talk about the most stressful situation you had to handle during residency training. What did you learn from that situation that you can bring to your PICU Fellowship training?
16. Tell us about a time you had to communicate bad news to the family of a patient during your residency training. How did you effectively communicate that news?
17. How did you learn to prioritize your work during residency training when multiple patients demanded your attention at once?
18. If you noticed a physician or member of the care team not taking proper safety precautions in our PICU, how would you handle that situation?
19. Tell us about a time you had a conflict with a family member of a patient during your residency training. How was it resolved in a healthy manner?
20. What motivated you to pursue Pediatric Critical Care Fellowship training?
21. Tell us about a difficult patient experience during your Pediatric Residency training. How did you handle the situation professionally and respectfully?
22. What challenges do you think the field of Pediatric Critical Care Medicine currently faces?
23. Would you have any worries or fears about joining our PICU Fellowship program?
24. What aspects of our PICU Fellowship program interest you the most?
25. What was the biggest challenge you faced in your residency training program?
26. Would you have any concerns about relocating to join our PICU Fellowship program or living in this city for the next three years?
27. What are some key things that you are looking for in a PICU Fellowship program?
28. Take some time to tell us a little about yourself and your interests outside of medicine.
29. What would the perfect day of PICU Fellowship training look like for you?
30. How do you think you will perform under pressure as a Pediatric Intensive Care Fellow?
31. What personality type do you find most difficult to work effectively with?
32. If we asked your friends, what would they say are your strengths and weaknesses?
33. Do you believe telehealth is an effective form of healthcare delivery, specifically in Pediatric Intensive Care?
34. How do you feel about the 80-hour workweek limit for residents and fellows?
35. Tell me about a time you received constructive criticism from an attending physician or senior resident during your Pediatrics Residency training. How did you handle that situation?

PICU Fellowship Interview Questions

1. What invasive procedure are you most excited to learn during PICU Fellowship training?

2. How would you stay on top of trends and changes in the field of Pediatric Intensive Care during your time as a fellow with our program?

3. Are you considering or interviewing with any other PICU Fellowship programs?

4. Talk about the most interesting case you were exposed to during your Pediatrics Residency training. What made it so interesting to you?

5. A recent patient survey comes back, and you find out that you did not meet a patient's expectations as their physician. What are the next steps you would take to improve?

6. As a new trainee in our PICU Fellowship program, how will you respond when asked to do a procedure or task that you are unfamiliar with and uncomfortable handling?

7. As a PICU Fellow, how will you explain complex procedures and diagnoses to the families of your patients using verbal instructions?

8. Tell us about a time you had to work with new technology during your Pediatrics Residency training. What did you do to ensure proficiency as quickly as possible?

9. Talk about a time you showed initiative by taking the lead in a situation during your Pediatrics Residency training. Why did you take action as the leader, and what was the outcome?

10. How would you describe your personality in three words?

11. How timely would you say your charting and dictations were during residency training?

12. We are always looking for our fellows to participate in, and even lead, PMET teams at our facility. Are you willing to participate during PICU Fellowship training?

13. At our institution, you will be working side by side with Advanced Practice Providers as a PICU Fellow. Would you have any issues in doing so?

14. Are you able to handle the physical requirements of the work of a Pediatric Critical Care Fellow?

15. Talk about the most stressful situation you had to handle during residency training. What did you learn from that situation that you can bring to your PICU Fellowship training?

16. Tell us about a time you had to communicate bad news to the family of a patient during your residency training. How did you effectively communicate that news?

17. How did you learn to prioritize your work during residency training when multiple patients demanded your attention at once?

18. If you noticed a physician or member of the care team not taking proper safety precautions in our PICU, how would you handle that situation?

19. Tell us about a time you had a conflict with a family member of a patient during your residency training. How was it resolved in a healthy manner?

20. What motivated you to pursue Pediatric Critical Care Fellowship training?

21. Tell us about a difficult patient experience during your Pediatric Residency training. How did you handle the situation professionally and respectfully?

22. What challenges do you think the field of Pediatric Critical Care Medicine currently faces?

23. Would you have any worries or fears about joining our PICU Fellowship program?

24. What aspects of our PICU Fellowship program interest you the most?

25. What was the biggest challenge you faced in your residency training program?

26. Would you have any concerns about relocating to join our PICU Fellowship program or living in this city for the next three years?

27. What are some key things that you are looking for in a PICU Fellowship program?

28. Take some time to tell us a little about yourself and your interests outside of medicine.

29. What would the perfect day of PICU Fellowship training look like for you?

30. How do you think you will perform under pressure as a Pediatric Intensive Care Fellow?

31. What personality type do you find most difficult to work effectively with?

32. If we asked your friends, what would they say are your strengths and weaknesses?

33. Do you believe telehealth is an effective form of healthcare delivery, specifically in Pediatric Intensive Care?

34. How do you feel about the 80-hour workweek limit for residents and fellows?

35. Tell me about a time you received constructive criticism from an attending physician or senior resident during your Pediatrics Residency training. How did you handle that situation?