Child Advocacy and Protection
Child Abuse Pediatrics Fellowship

Children's Hospital of WisconsinThe Medical College of Wisconsin and Affiliated Hospitals (MCWAH) sponsors a three-year fellowship in Child Abuse Pediatrics (CAP), which is accredited by the ACGME. Fellows will be an integral part of the Child Advocacy and Protection Services program, which provides hospital-based and outpatient services for suspected victims of child abuse and neglect. Fellows will develop skills and expertise in evaluating all types of child maltreatment, providing legal testimony, and advocating for children through their work as members of the multidisciplinary team, didactics, rotations with other specialties, attendance at conferences, and experiences with community agencies.

The primary teaching site for the CAP fellowship is Children’s Hospital of Wisconsin (CHW), a freestanding academic children’s hospital affiliated with the Medical College of Wisconsin (MCW). A 306-bed hospital with a Level I Trauma Center, CHW serves children throughout Wisconsin and northern Illinois.

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  Program Highlights

Milwaukee Child Advocacy CenterWell-staffed, multidisciplinary, statewide program
The Child Advocacy medical team is composed of four board-certified child abuse pediatricians, two general pediatricians, six advanced practice providers, as well as social workers, forensic interviewers, child life specialists and support staff. The program does not rely on learners for service obligations, allowing fellows to focus on learning.

Diverse range of clinical experiences
The child abuse team evaluates more than 6,500 cases of child maltreatment annually, making it one of the largest Child Abuse Pediatrics programs in the country. Fellows rotate with a diverse range of subspecialty services, including Burn Surgery, Forensic Pathology, Toxicology, and Mental Health among others. In addition to a wide variety of inpatient consult experiences, outpatient clinical experience includes time at the Milwaukee Child Advocacy Center (MCAC) and multiple community sites.

The MCAC serves Milwaukee as well as the surrounding areas to provide onsite services including forensic interviews, mental health therapy, medical evaluations, and victim services. It is one of seven CHW Child Advocacy Centers in Wisconsin, many of which fellows will rotate through for experience in more rural settings. Fellows also will complete forensic interview training during their fellowship. In addition to evaluating children suspected of being maltreated, fellows gain multiple skills in evaluation of children in foster care through the MCAC’s busy foster care medical home program called Care4Kids.

Established board review program
Child Advocacy and Protection faculty have developed written board review material based on the American Board of Pediatrics Content Specifications for the Subspecialty Board Exam. These materials are updated regularly and reviewed with fellows during weekly board review sessions. MCWAH Child Abuse Pediatrics fellows consistently score at least one standard deviation above the mean on in-service examinations and the Board pass rate for the program is 100%.

Unique community and systems perspective
The Milwaukee CAC is housed within Milwaukee’s Family Peace Center, the largest and most comprehensive family justice center in the nation. Multiple youth-service community and investigative agencies are co-located within the center. Multidisciplinary team agencies, including CHW, have signed a Memorandum of Understanding recognizing a joint protocol for the initial investigation and service provision of child maltreatment investigations in Milwaukee County. These collaborative efforts allow our fellows unique opportunities for systems-based learning and community advocacy.

Milwaukee's Family Peace Center

Support for scholarly activities
Members of the medical team are actively engaged in teaching and research in addition to their clinical duties. A research coordinator provides support to the Child Advocacy and Protection division, and the Medical College of Wisconsin Quantitative Health Sciences department provides support for research development, study design, and statistics. Subsidized tuition is available for fellows who wish to obtain a Master’s Degree in Public Health, Bioethics, or Clinical and Translational Science through the Medical College of Wisconsin during their fellowship. In addition to dedicated research blocks, the program offers protected time and funding for attendance at local and national conferences.

Emphasis on work-life balance
Given the nature of Child Abuse Pediatrics, the program recognizes the importance of work-life balance. This culture is supported by Child Advocacy and CHW leadership and is reflected in program policies and within the structure of the fellowship and health system.

Located on the shores of Lake Michigan, Milwaukee is a great place to live. The Milwaukee metropolitan area offers a wide variety of communities from urban to rural. You will find excellent schools, professional, college and amateur sports, a vibrant restaurant scene, one of the most extensive park systems in the country, and numerous opportunities for enjoying theatre, music and art.

Reimbursement for fellowship interviews
Applicants who are interested in further exploring fellowship training through the MCWAH Child Abuse Pediatrics Fellowship will be reimbursed for lodging and other travel expenses.

  Application Process

Our three-year fellowship program is ACGME accredited and begins on July 7 each year.

Applications are accepted through ERAS and matches are conducted through the NRMP Specialties Matching Service.

International Medical Graduates should refer to the Medical College of Wisconsin Affiliated Hospitals (MCWAH) Visa Information page for additional information.

If you have any questions regarding this process, please email Angela Rabbitt, DO, Program Director.

Reimbursement for fellowship interviews
Applicants who are interested in further exploring fellowship training through the MCWAH Child Abuse Pediatrics Fellowship will be reimbursed for lodging and other travel expenses.

  Conferences and Teaching Opportunities

Required Conferences

Medical Peer Review
The Child Advocacy and Protection Services (CAPS) medical providers meet each week to discuss inpatient and outpatient cases.

National Peer Review
Child Advocacy Centers across the country meet via this monthly web-based conference to discuss difficult cases.

Documentation Peer Review
Each month the documentation of a member of the CAPS medical team is chosen randomly and brought to the group for feedback and discussion. Fellow documentation is reviewed twice a year.

Research Meeting
The CAPS medical team discusses active research and quality improvement projects in the program at this bimonthly meeting. The team also discusses research needs within the field and potential projects.

Subspecialty Board Exam Prep
This is a weekly, fellow-led meeting and will include one CAPS faculty member on a rotating basis. In preparation for taking the subspecialty certification exam, the fellow and faculty member will review the American Board of Pediatrics (ABP) Content Outline for Child Abuse Pediatrics (PDF) using study materials developed by the CAPS team.

Each month a member of the CAPS team chooses one or two journal articles and leads a discussion about the content, limitations, and validity of the article. Fellows present two times during each academic year.

Joint Fellowship Curriculum
The Joint Fellowship Curriculum (JFC) committee consists of Directors of the Medical College of Wisconsin Affiliated Hospitals (MCWAH) pediatric subspecialty fellowship programs. This committee has developed a core curriculum designed to address the academic requirements mandated by the American Council for Graduate Medical Education (ACGME) and the career and personal development goals of the fellows.

WI CAN (Wisconsin Child Abuse Network) Sexual Abuse Peer Review
The CAPS team meets quarterly with representatives from the Child Advocacy Centers and local Sexual Assault Nurse Examiners to discuss pediatric cases.

Suspected Child Abuse and Neglect (SCAN) Committee
Members of the SCAN committee include representatives from the CAPS program as well as the legal department, medical records, patient advocacy, emergency department, and hospitalist medical teams. The goal of this committee is to address systems issues within Children’s Hospital of Wisconsin related to child maltreatment.

Subspecialty Conferences
Fellows will receive financial support and protected time for participation in local, regional, and national conferences. Attendance at a minimum of one of these conferences during fellowship is required.

Recommended Conferences (when applicable to subspecialty)

WI CAN (Wisconsin Child Abuse Network) Educational Series
Monthly statewide, web-based lectures on various topics related to child maltreatment. Fellows are expected to provide presentations at this meeting when appropriate. Attendance at every meeting is encouraged.

Pediatric Grand Rounds are held most Fridays in the CHW Auditorium from 8:30-9:30 am. Go to the Pediatric Grand Rounds schedule for upcoming topics.

Professor Rounds occur each Thursday from 12:00 pm-1 pm in the CHW Auditorium.

Schwartz Center Rounds (supported by The Schwartz Center for Compassionate Healthcare) is a multidisciplinary forum where caregivers discuss emotional and social issues that arise in caring for patients. Upcoming dates and topics are posted on Children's Connect.

The MCW Office of Continuing and Professional Education offers a comprehensive list of upcoming CME activities.

Teaching Opportunities

Residents / Medical Students
Pediatric Residents participate in a required one-week rotation with Child Advocacy during their second year. Medical Students have the option for a one-month rotation during their final year. Rotators participate in patient care at both our hospital-based and outpatient locations. Fellows will have ample time to develop teaching skills during these encounters. Fellows will also have the opportunity to provide lectures to students and residents as part of their regular didactic series.

Community Education
The CAPS program is actively involved in community education at the local and regional level through the development of conferences related to child maltreatment. CAPS also provides lectures and training workshops to community partners, including law students, social services, community physicians, law enforcement, etc. In addition to the education that occurs during communication with these agencies during routine patient care, fellows will have the opportunity to participate in the development of these lectures and workshops as their training progresses.

Education of other fellows
Fellows will gain experience educating other subspecialty fellows as they participate in CAPS involvement with the Joint Fellowship Curriculum, which directs workshops on the topics of Legislative Advocacy and Expert Witness Testimony.

  Curriculum

Child Abuse Pediatrics requires a broad range of knowledge spanning multiple disciplines. The curriculum for the Child Abuse Pediatrics fellowship program includes a wide variety of patient care experiences, research opportunities and educational activities.

female doctor with boyThe fellow will spend twelve months on the Outpatient Clinic-Consult Service rotation. This includes two days each week at the Milwaukee Child Advocacy Center (MCAC), and two days covering the Child Advocacy consult service with one of our attendings. The fellow will spend one half day per week throughout fellowship at the MCAC. The fellow will also take first call for the hospital-based consulting service every 3-4 days throughout fellowship. This will provide substantial exposure to management of all forms of child maltreatment.

Required educational experiences will include rotations with Mental Health, Trauma/Burn Services, Radiology, Neurosurgery, Forensic Pathology, Orthopedics, Emergency Medicine, Hematology, Adolescent Medicine, Toxicology, and Community Advocacy.

Fourteen months are devoted to completion of a scholarly project. The fellow will also have one elective block to use towards either research or additional clinical experiences.

Additional non-clinical and educational activities consist of regular conferences and didactics (see Conferences & Teaching Opportunities). Of note is the Fellow Board Review. This is a weekly, fellow-led meeting and will include one CAPS faculty member on a rotating basis. In preparation for taking the subspecialty certification exam, the fellow and faculty member will review the American Board of Pediatrics (ABP) Content Outline for Child Abuse Pediatrics using study materials developed by the Child Advocacy team.

The fellow will also complete a Forensic Interviewing Course, a Medical Photography workshop, and media training to develop skills for effective communication and documentation of injuries. CAP fellows will electively participate in lectures during the Workshop on Child Abuse and the Law through Marquette University Law School when this course is available as well as a mock hearing with the law students at the completion of this course.

  Faculty & Staff
  Living in Milwaukee
  Child Abuse Pediatrics Fellowship Masters Programs in Bioethics, Clinical and Translational Science, and Public Health

female studentPediatric Child Abuse fellows wishing to obtain a Master’s Degree in Public Health, Bioethics, or Clinical and Translational Sciences during their fellowship may receive a subsidized tuition through the Department of Pediatrics at the Medical College of Wisconsin. A description of each program is listed below.

Master of Arts in Bioethics

The traditional Master of Arts in Bioethics program provides advanced training for professionals, academics, and other interested individuals in health care, law, the humanities, and public policy who wish to become prepared for teaching, research, policy development, and clinical consultation work related to bioethics. The program provides students an opportunity for on-campus study and research of current and emerging issues through a combination of didactic, clinical, and research activities. The core curriculum of the program provides a solid foundation in the language and literature of bioethics and develops related critical thinking skills. Students may create an area of emphasis through the selection of appropriate elective courses and the thesis topic. The program allows for full-time or part-time study in order to accommodate the needs of working professionals, as well as medical students, residents, and fellows involved in Medical College of Wisconsin programs.

Master of Science in Clinical and Translational Science

The Master of Science in Clinical and Translational Science is a multifaceted program is designed to provide the education and practical training that are important to planning and conducting clinical and translational research projects in an academic or commercial environment. The program and its curriculum are designed to offer appropriate training to individuals who have established skills and credentials as basic scientists, bioengineers, clinicians, and health care providers (nurses, nutritionists, psychologists, pharmacists, dentists, veterinarians, etc.).

Master of Public Health

The Master of Public Health degree program offers coursework towards a 42-credit Master of Public Health degree or 15-credit Graduate Certificate in Public Health. Students may also enroll in courses as non-degree or special students. Courses are offered in a convenient, distance-learning format; all can be completed online.

  Research

Child Abuse Pediatrics Fellowship ResearchAs required by the American Board of Pediatric (ABP), each Child Abuse Pediatrics fellow will complete a scholarly project during their fellowship. The fellow will have fourteen months during the fellowship to devote to completion of this project as well as one additional elective block if needed. To assist with formulating and completing this project, the fellow will choose a research mentor and a Scholarship Oversight Committee within the first six months of fellowship. More information about the requirements for a scholarly project and the function of the Scholarship Oversight Committee, see Principles Regarding the Assessment of Scholarly Activity on the ABP website.

The Medical College of Wisconsin’s Quantitative Health Sciences department provides support for research development, study design, and statistics. Opportunities for networking and collaboration with other researchers are also available through the Medical College of Wisconsin’s Comprehensive Injury Center (CIC) and Children’s Hospital’s Children’s Research Institute. In addition, fellows wishing to obtain a Master’s Degree in Public Health, Bioethics, or Clinical and Translational Sciences during their fellowship may receive a subsidized tuition through the Department of Pediatrics at the Medical College of Wisconsin.

  Benefits, Conditions & Terms of Employment

Fellows are employed by the Medical College of Wisconsin Affiliated Hospitals (MCWAH).

See MCWAH Benefits, Conditions & Terms of Employment for information regarding vacations, leaves, insurance, stipends and professional liability.

Master's Program Tuition

Fellows wishing to obtain a Master’s Degree in Public Health, Bioethics, or Clinical and Translational Sciences during their fellowship may receive a subsidized tuition through the Department of Pediatrics at the Medical College of Wisconsin. Please see the Masters Programs information above for details.

  Clinical Training - Outpatient Clinical Services, Emergency Care, and Hospital-based Consult Service

Outpatient Clinical Services

At the Milwaukee Child Advocacy Center (MCAC), physicians and nurse practitioners perform medical evaluations for child physical abuse, sexual abuse, emotional abuse, and neglect. At this location we also perform foster care evaluations. Mental health therapists and forensic interviewers are located on site. The assessments at the MCAC are multi-disciplinary and include observation/review of the forensic interview, conducting a medical interview with the caretaker, an effective and objective medical history with the child, and conducting the physical examination. At the conclusion of the assessment, the fellow explains his/her assessment to the multi-disciplinary team members and works as part of the team to assimilate this medical information into case planning.

Emergency Care

The fellow will take first call for questions and consults from Emergency Services at Children's Hospital of Wisconsin. In addition, when on service the Child Abuse Pediatrics fellow will review documentation from the emergency department for potential child maltreatment cases that were not admitted to the hospital in order to make recommendations and arrangements for any necessary follow-up. Emergency Services providers rely on Child Advocacy consultants as a source of information for victims of physical and sexual abuse that present to the ED. This often requires the Child Advocacy physician to perform evaluations personally in the emergency department. After hours, our faculty and the fellow are available for questions by phone and will perform personal evaluations after hours in select cases. In addition to these experiences, the fellow will rotate through the ED one month per year to provide additional exposure to emergent child maltreatment cases and review skills in general pediatrics.

Hospital-based Consult Service

The fellow will be first call for the Child Advocacy & Protection Services (CAPS) consult service at the Children’s Hospital of Wisconsin and Children’s Clinics on average every 3-4 days throughout fellowship. The fellow will also take first call for questions from Medical College of Wisconsin and community physicians. The CAPS program performs inpatient consults and chart reviews on physical and sexual abuse and neglect cases, ensuring a wide variety of exposures to all forms of maltreatment. The CAPS inpatient social worker will perform evaluations with the fellow and can provide a wealth of experience in the psychosocial and protective aspects of inpatient child abuse evaluations. The fellow will interface with all medical specialists involved in inpatient assessments. The fellow will also have face to face teaching with radiology and other subspecialty specialists as cases present.

 

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