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Fellowship positions in Pediatric Critical Care
(from January 1, 2008 to current, most recent first) Positions prior to 2008 have been deleted...
If you'd like a fellowship position listed here, either send notice to the PICU list or email it to PedsCCM directly. If a position you've posted has been filled, please notify us by e-mail to remove the listing. Pediatric Critical Care Medicine Fellowship Directors now have a separate email list. Read more here The NRMP and Pediatric Critical Care Medicine Fellowship Directors have a match program for Pediatric Critical Care Fellowships beginning July, 2001. Read Dr. Brilli's full announcement and the NRMP Press Release 5/25/2000: Updated information on the match is here
Submitted directly to PedsCCM February 1, 2010 Arkansas Children’s Hospital/ University of Arkansas for Medical Sciences, has an exciting opportunity for a one year clinical fellowship in Pediatric Cardiac Intensive Care Medicine for the academic year 2009-10 that may be of interest to you. The Arkansas Children's Hospital Heart Center includes a 17 bed CVICU staffed by pediatric intensivists and cardiologists 24/7. The Cardiac Intensive Care Unit admits approximately 800 patients per year. The pediatric and congenital cardiovascular surgery team, led by Dr Robert DB Jaquiss performs approximately 750 congenital heart surgeries yearly, with approximately 300 being cardiopulmonary bypass cases. The program has a very strong neonatal cardiac surgery, heart transplant, ventricular assist device and mechanical support focus. Arkansas Children's Hospital maintains a very busy ECMO program, with one of the Nation’s only mobile ECMO programs, and a formal training in ECMO support of cardiac patients is readily available. The fellows will also have the opportunity of working closely with dedicated pediatric cardiac anesthesiologists during their training. The hospital also houses the Donald W. Reynolds Pediatric Intensive care unit, a state-of-the-art 26-bed facility which receives approximately 1300 admissions yearly, with the entire spectrum of diseases seen in any large sized PICU. The program presents a very conducive environment for clinical training in various aspects of care of critically ill children with congenital heart disease. In general, this position will entail approximately 85% clinical time and 15% time for clinical research. There are numerous research opportunities and the fellow is encouraged to carry out meaningful clinical research during the course of the fellowship. The clinical training and responsibilities will be flexible and tailored to the specific needs of the individual candidate, depending on prior fellowship experience (i.e. Critical Care or Cardiology) and personal interests. We are primarily seeking individuals who are board certified/board eligible in either Pediatric Cardiology or Pediatric Critical Care Medicine. This training is available for a period of 9-12 months to individuals. Clinical fellows will be appointed to the Dept of Pediatrics, UAMS at the Instructor level in a non-tenure track position with faculty benefits including health and liability insurance. Applicants accepted for this clinical fellowship will be required to obtain an Arkansas medical license prior to starting training. The University of Arkansas Medical Sciences is an Equal Opportunity Employer and Arkansas Children's Hospital does sponsors J-1 waivers for qualified candidates. Little Rock, the capital of Arkansas is a warm and friendly cosmopolitan community with affordable housing, is well connected to other parts of the country and offers an abundance of recreational activities. For additional information please contact:
W. Robert Morrow, MD or
Parthak Prodhan, MD
Submitted to the PICU list January 21, 2010 Unexpectedly the Division of Pediatric Critical Care Medicine at Cincinnati Children's Hospital Medical Center will have a fellowship opening July 1, 2010 at the first or second year level. Our program provides robust clinical education in a new 35+ bed PICU and a 16+ bed CICU. The clinical experience here is robust and spans the breadth of pediatric critical care medicine involving solid organ and bone marrow transplantation, airway reconstruction, ECMO, cardiothoracic surgery, transport, trauma, and neurosurgery as well as many other subspecialty services. We also provide a fantastic environment for scholarly activity. Our research facilities are state of the art within the Cincinnati Children‚s Research Foundation with a multitude of pediatric research divisions available to support the interests of clinical fellows. Our division has 10 faculty members and is currently expanding. Seven of our faculty members receive NIH funding providing a unique opportunity to be mentored within the division and to work in our joint critical care laboratory if research interests are compatible. A fourth research year is funded for those interested. In addition, multiple funded clinical trials are being conducted simultaneously in the ICU providing rich exposure to large and small clinical studies. We also offer a Master's Degree programs in Clinical Science Research, Education, and Public Health through the University of Cincinnati and a Quality Scholars in Transforming Health Care program aimed at quality improvement and safety research. Currently we have 11 fellows in our program and will continue to accept a cohort of 4/year. For additional information please contact:
Lesley Doughty, MD
Submitted to PedsCCM directly January 7, 2010 Pediatric Injury Research Training Program
The Harborview Injury Prevention and Research Center and the University of Washington are offering post-doctoral training in Pediatric Injury Research, with positions available summer, 2010. This training program is funded through a National Institute of Child Health and Human Development T-32 grant.
The goal of this training program is to prepare investigators to specialize in pediatric injury research and to be productive academic scientists and scholars in this field. We define injury research broadly to include both intentional and unintentional injury mechanisms, and research on the risk factors and causes of injuries and prevention strategies, the acute and chronic care of injured patients, and the outcomes from trauma, including interventions to return the injured individual to their full potential and avoid future injury.
The Program includes coursework, seminars and an intensively mentored research experience. We will provide our trainees with methodological knowledge and practical skills for conducting high quality interdisciplinary research in an environment that infuses them with the excitement of research, and nurtures their early career development. We believe that our graduates will become research leaders prepared to conduct interdisciplinary research using the highest ethical standards and capitalizing on state of the art research methods.
The Training Program is two years long, with the option of a third year for exceptionally productive trainees. A Master of Public Health or Master of Science degree is available as part of the Training Program.
Post-doctoral level scholars are welcome from all health professions, and specialties within those professions including pediatrics, surgery, urology, rehabilitation medicine, emergency medicine, anesthesia/critical care, psychiatry, psychology, epidemiology, health services, public health, social work, nursing and health economics.
Interested individuals should contact Frederick Rivara, MD, MPH at fpr@uw.edu or (206) 744-9449 to obtain application materials. Applications must be received by March 1, 2010.
Submitted to PedsCCM directly December 15, 2009 The Pediatric Critical Care Fellowship Program at the University of Iowa is actively seeking fellowship applicants for a July, 1, 2010 start date. The PICU at the University of Iowa Children’s Hospital has recently expanded to a 20-bed multidisciplinary combined medical/surgical ICU with an active congenital cardiovascular program. The fellowship program currently has 5 fellows across the 3 years, and the PICU is staffed by 5 full time critical care attending physicians, with a 6th faculty member currently being recruited. Comprehensive pediatric critical care training is delivered in an academic environment with 15-16 months of clinical rotations, interspersed with basic science or translational research opportunities and an integrated didactic educational curriculum. In addition to clinical rotations in the PICU, fellows rotate on the anesthesia service, the cardiovascular surgery service, and learn echocardiography and bronchoscopy. The PICU fellow has primary responsibility for management of all patients in the ICU including management of the post-op congenital heart patients. Fellows are exposed to all aspects of pediatric critical care management/illness including trauma, ECMO, bone marrow transplantation, solid organ transplantation and varied renal replacement therapies. All Pediatric Surgical services are represented with particularly active Pediatric Otolaryngology and Neurosurgery services that admit patients frequently to the PICU. The research opportunities include working with one of 3 NIH funded faculty members in the Division of Pediatric Critical Care, or with any faculty member on the University of Iowa campus, including both clinical and basic science departments. The research interests within the Division and Department are broad-based with numerous opportunities for collaboration. Master’s programs in Public Health, Medical Education, or Clinical Investigation can also be pursued during fellowship. Interested applicants should call or email Jessica Moreland, M.D., Fellowship Director in Pediatric Critical Care. (319)-356-1615 or jessica-moreland@uiowa.edu Submitted to the PICULIST November 19, 2009 St. Christopher's Hospital for Children/ Drexel Univ College of Medicine has an newly accredited fellowship program in Pediatric Critical Care Medicine. St. Chris has a 33 bed pediatric critical care service, including a cardiac care unit and a burn unit and admits over 1500 patients/year. We have an active CT surgery program and ECMO service, in addition to being a Level One Trauma Center. We have 8 attendings who are passionate about teaching and mentoring fellows in a variety of areas of research. The section Faculty have multiple presentations at SCCM this year, including some award winning abstracts. We are looking for one fellow starting July 2010. The program is robust and well balanced mix of clinical learning and mentored scholarly training. Please contact Sarah Hoehn, Program Director , or me if you are anyone you know is interested in finding out more details. ( sarah1220@comcast.net or venkat.shankar@drexelmed.edu )
Venkat Shankar, MD, MBA Submitted to PedsCCM directly October 26, 2009
Birmingham Children's Hospital NHS Foundation Trust, University of Birmingham, Birmingham, UK
Submitted to the PICU list August 26, 2009 The Pediatric Critical Care Fellowship Program at C.S. Mott Children's Hospital at the University of Michigan is actively seeking applicants for the program beginning in July, 2010 http://www.med.umich.edu/pediatrics/division/critical/index.htm. C.S. Mott Children's Hospital provides a comprehensive range of pediatric medical and surgical disciplines as it is a major quaternary, referral childrens hospital serving the state of Michigan, northwest Ohio, and northeast Indiana. Clinical training occurs in two intensive care settings: a 22 bed PICU with ~1200 annual admissions and a 15 bed Pediatric CardioThoracic Unit (PCTU) with ~750 annual open heart surgeries. Fellows will train in a multidisciplinary, family-centered PICU with a strong focus on quality initiatives and patient safety for which it was named the Clinical Program of the Year for the entire University Health System. The Division of Critical Care Medicine is staffed by 9 full time, board-certified pediatric critical care physicians with a variety of expertise in critical care research. In 2012, the C. S. Mott Children's Hospital will move into a new, 1.1 million square foot structure that will include a 12-story inpatient care tower which will increase the total bed capacity of the PICU and PCTU to 30 beds each. Opportunities for pursuing scholarly activity exist over a broad range of biologic themes and research strategies which include but are not limited to: basic science investigation within the Pediatric Critical Care Medicine Laboratory located within the University's Immunology Program http://www.med.umich.edu/immprog/faculty/index.htm and housed in the state-of-the-art Biomedical Sciences Research Building with opportunities for fellows to be supported on a T32 training grant; clinical research training supported by our CTSA-sponsored, Michigan Institute for Clinical and Health Research (MICHR) http://www.michr.umich.edu/index.html of which the Program Director is Associate Director; education training provided through the Medical Education Scholars Program http://www.med.umich.edu/meded/programs/mesp.htm; and health service research supported by a T32 training grant within the Child Health Evaluation And Research (CHEAR) Unit https://www.med.umich.edu/ott/mott/research/chear.html. In addition our program is extremely well networked among all organizations relevant to pediatric critical care investigation. We are a standing member of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network, VPS, NACHRI PICU focus group, and CTSA-Child Health Oversight Committee. Within existing networks, our group actively participates in on-going, NIH-sponsored studies such as the RESTORE Study, Catheter-Associated Blood Stream Infection Collaborative, and our center serves as the lead scientific site for the Therapeutic Hypothermia After Pediatric Cardiac Arrest (THAPCA) Trial within the PECARN and CPCCRN Networks. In total, 24 IRB-approved active clinical studies are on-going, 9 of which are supported by NIH funding and PCCM faculty research is supported by a UO1, 3 RO1s, a K23, a K12 and additional support from NACHRI and additional foundations. The University of Michigan is located in Ann Arbor which combines the congenial atmosphere and ease of living of a small city with the wide range of cultural opportunities typically found in a much larger community. Intercalation of the University of Michigan campus and the city of Ann Arbor provides easy access to these activities and to an abundance of affordable and conveniently located housing. As a place to live, Ann Arbor regularly places within the top 10 communities in the country in national magazine ratings. Over 140 parks in the city and surrounding areas offer countless possibilities for outdoor activities, from boating on the Huron River to biking, rollerblading and hiking, and in the winter cross-country skiing, skating and other outdoor activities. Inland lakes and an abundance of streams and rivers offer canoeing and fishing opportunities. The combination of cultural, outdoor and sporting activities, excellent restaurants and a lively community make Ann Arbor a unique place for fellowship training. Interested applicants are encouraged to apply through the ERAS application system and to contact the Program Director with additional queries.
Thomas P. Shanley, M.D. Submitted to the PICU list July 17, 2009 The Division of Pediatric Critical Care Medicine at New York Presbyterian Hospital- Weill Cornell Center is currently accepting applications for a first year fellow to start in either August or September of 2009 due to an unanticipated vacancy. The PICU is a 20 bed multidisciplinary unit with approximately 1200 admissions per year, serving infants and children with critical medical and surgical illness. The unit functions as the post-operative recovery area for all cardiovascular, neurosurgical and selected general surgical procedures performed on pediatric patients. General and critical care of all patients, including surgical patients, is provided by our critical care fellows under the supervision of seven full-time pediatric critical care attending physicians. A comprehensive program of pediatric critical care training is delivered in a scholarly environment over three years and encompasses 12-14 months of clinical service, a didactic educational curriculum and training and experience in clinical and/or basic science research. Clinical activities outside of the PICU include providing consultative services in a combined pediatric-adult burn ICU, two months on the anesthesiology service, one month at the New York Poison Control Center and participation in inter-hospital transport of approximately 150-200 critically ill patients during the period of training. The fellowship program is ACGME accredited with ample opportunity for clinical and basic science research. Applicants must have successfully completed an ACGME accredited pediatric residency. New York Presbyterian Hospital and Weill Cornell Medical College are part of a tri-institutional campus along with the Memorial Sloan Kettering Cancer Center and the Rockefeller Institute. This teaching hospital and medical school provides an excellent opportunity for collaboration with basic science investigators within the Department of Pediatrics as well as across departments and with our neighboring institutions. Training at the New York Presbyterian Hospital Weill Cornell campus offers the unique opportunity to live, work and enjoy Manhattan's Upper East Side and New York City. New York Presbyterian Hospital is an Equal Opportunity Employer. Interested candidates must submit (electronically or by fax) their curriculum vitae and three letters of recommendation; a personal statement is optional. Applicants should contact: Joy D. Howell, MD, Program Director, Pediatric Critical Care Fellowship Program, Associate Professor of Pediatrics, Weill Cornell Medical College, New York Presbyterian Hospital. Telephone: (212)746-3056 Fax: (212) 746-8332, e-mail: jdh2002@med.cornell.edu.
Submitted directly to PedsCCM April 8, 2009
Pediatric Cardiac Intensive Care Fellowship Submitted directly to PedsCCM February 17, 2009
Due to unexpected circumstances, a position has become available for a first-year fellow at the University of Wisconsin, Madison beginning July 2009. This fellowship seeks to train pediatric intensivists with a strong commitment to an academic career as physician-scientists. The PICU at the American Family Children’s Hospital is an 18 bed, multidisciplinary medical and surgical intensive care unit. Fellows are exposed to all aspects of pediatric illness, including trauma, ECMO, renal replacement therapies and cardiothoracic surgery cases. All pediatric medical and surgical subspecialties are represented at the AFCH. In addition, to gain additional exposure to perioperative management of congenital heart disease, fellows spend one month each year in the cardiothoracic surgery unit at the Medical College of Wisconsin in Milwaukee. The AFCH is a level one trauma center and has a busy neurosurgical surgery service, as well as a comprehensive pediatric sedation program in which the fellows also participate. The PICU and sedation center are staffed by a group of six full-time faculty with diverse research and academic interests. Two more faculty positions will be filled in the next 6-9 months. Submitted directly to PedsCCM February 13, 2009 PICU Fellow urgently needed. At Alder Hey Children’s Hospital in Liverpool, England. Vacancy for at least 6 months, can be extended by mutual agreement. We have about 1200 admissions on our 20 bedded PICU. We do approximately 500 cardiac operations of which roughly half are on bypass. The other admissions include all major specialties (medical, surgical, neonatal surgical, oncology, orthopaedics, neurology and neurosurgery). The unit retrieves between 500-600 patients per year. We run a 10 fellow rota supervised by 7 whole-time consultants. 8 of the posts are training posts. Interested candidates should contact: Dr D. Sidaras under Dsidaras@doctors.org.uk
Submitted to PedsCCM and the PICU list February 6, 2009
Are you interested in an investigative career in translational research in Pediatric Critical Care Medicine? The Pediatric Critical Care Section at Baylor College of Medicine located at Texas Childrens Hospital in Houston Texas has Post Doctoral Fellows Research Positions available. These positions are funded on an NIH T32 Training Grant "Research Training in Pediatric Critical Care Medicine" and are ideal for individuals who are committed to a translational investigative career in areas critical to the developing host in the ICU, be it basic science or more clinically oriented.
Posted to the PICU list January 16, 2009
Unexpectedly the Division of Pediatric Critical Care Medicine at Cincinnati Children’s Hospital Medical Center will have a fellowship opening July 1, 2009 at the first or second year level. Our program provides robust clinical education in a new 35+ bed PICU which will expand to 40 beds in the next year and a 16+ bed CICU. The clinical experience here is robust and spans the breadth of pediatric critical care medicine involving solid organ and bone marrow transplantation, airway reconstruction, ECMO, cardiothoracic surgery, transport, trauma, and neurosurgery as well as many other subspecialty services. We also provide a fantastic environment for scholarly activity. Our research facilities are state of the art within the Cincinnati Children’s Research Foundation with a multitude of pediatric research divisions available to support the interests of clinical fellows. Our division has 9 faculty members and is currently expanding. Seven of our faculty receive NIH funding providing a unique opportunity to be mentored within the division and to work in our joint critical care laboratory if research interests are compatible. A fourth research year is funded for those interested. In addition, multiple funded clinical trials are being conducted simultaneously in the ICU providing rich exposure to large and small clinical studies. We also offer a Master’s Degree programs in Clinical Science, Education, and Public Health through the University of Cincinnati. Currently we have 12 fellows in our program and will continue to accept a cohort of 4/year.
Submitted to the PICU list and PedsCCM January 15, 2009
Due to unanticipated circumstances, the Division of Pediatric Critical Care Medicine at Emory University in Atlanta has a vacancy for a second or 3rd year in our Pediatric Critical Care fellowship training program.
Submitted directly to PedsCCM December 8, 2008
Due to unanticipated circumstances the Division of Pediatric Critical Care Medicine/Department of Pediatrics at Advocate Lutheran General Children's Hospital in Park Ridge, IL has openings in our Pediatric Critical Care Medicine fellowship program. Our multidisciplinary program consists of a 9 bed PICU (soon expanding to 15 beds) and a 4 bed Intermediate Care Center. We admit over 900 patients annually and have active programs in all pediatric medical and surgical subspecialties, including cardiology/cardiothoracic surgery, ECMO, renal replacement, and neurosurgery. We are a busy level 1 trauma center with an active pediatric critical care transport program.
Submitted directly to PedsCCM November 19, 2008
PICU Fellowship Position: Medical College of Wisconsin and Children's Hospital of Wisconsin Pediatric Critical Care Medicine Fellowship Submitted directly to PedsCCM November 13, 2008
PICU Fellowship Position: Los Angeles County-Harbor-UCLA/Children's Hospital of Orange County Pediatric Critical Care Medicine Fellowship
Submitted directly to PedsCCM November 10, 2008 The Department of Pediatrics at The Pennsylvania State University College of Medicine and the Pennsylvania State Hershey Children’s Hospital is currently accepting applications for a first year fellow to start in July 2009. The PICU is a 12 bed high acuity multidisciplinary pediatric intensive care unit with a contiguous 14 bed intermediate unit for less acute cases. The PICU has active programs in all aspects of pediatric medicine and surgery including cardiothoracic surgery and trauma. Penn State Hershey Children’s Hospital is a level one pediatric trauma center. The Pediatric Critical Care Service is the primary service for and manages all medical admissions to the PICU. A unique collaborative relationship with our surgical colleagues enables our team to be integrally involved in every aspect of the hour to hour management of all trauma and surgical patients in the PICU. Thus, the critical care fellows will actively participate in the multidisciplinary care of all patients admitted to the PICU. Six full-time board certified critical care attendings staff the intensive care unit at all times. The fellowship program is ACGME accredited with ample opportunity for clinical and basic science research. This teaching hospital with contiguous medical school provides an excellent opportunity for collaboration with basic science investigators within the Department of Pediatrics as well as across departments. The Department of Pediatrics and College of Medicine are committed to supporting the development of young pediatric investigators. Beautiful surroundings, affordable housing and excellent schools provide a superior environment for life outside the workplace. The Pennsylvania State University is an Equal Opportunity Employer. Interested candidates should contact:
Gary D. Ceneviva, MD
Submitted to PedsCCM October 20, 2008
The Robert Wood Johnson Clinical Scholars Program
Submitted directly to PedsCCM June 18, 2008 NEW Pediatric Cardiac Intensive Care Fellowship
The Eller Congenital Heart Center at St. Joseph’s Hospital and Medical Center in Phoenix, Arizona is offering a new clinical fellowship in pediatric cardiac intensive care for the academic year 2008-2009. Candidates interested in this one year training program should have completed an accredited fellowship in pediatric critical care medicine. Fellowship year will include rotations in cardiac catheterization, echocardiography, electrophysiology, cardiac anesthesia and dedicated time in the Pediatric Cardiothoracic Intensive Care Unit. Both laboratory and clinical research opportunities exist and the specific fellowship curriculum can be tailored for the individual candidate depending on experience and interests. Submitted directly to PedsCCM June 3, 2008
PEDIATRIC CRITICAL CARE FELLOWSHIP. Due to an unexpected opening in our fellowship program for July of 2008, one position is available for training in pediatric critical care medicine at Mattel Children's Hospital at UCLA, located in sunny Los Angeles. The fully ACGME accredited program offers the qualified applicant full exposure to all aspects of critical care medicine including sophisticated ventilation techniques, cardiothoracic surgery, ECMO, advanced seizure monitoring, and many other cutting edge treatments. Mattel Children's is home to the world's largest pediatric solid organ transplant program and is one of the top rated children's hospitals nationwide. The pediatric intensive care/cardiothoracic care units are located within UCLA Medical Center, one of the top three hospitals in the country. In addition a full research program, including bench and clinical research, is active. At the end of this month our intensive care unit will move to a brand new state of the art facility within the Ronald Reagan UCLA Medical Center with a combined pediatric/pediatric cardiothoracic intensive care unit. In addition, the cardiothoracic program has undergone a major revitalization with the addition of a new chief of pediatric cardiothoracic surgery. As well, our program is located on the UCLA campus, giving the trainee full access to all campus events.
Submitted directly to PedsCCM May 29, 2008
PEDIATRIC CARDIAC CRITICAL CARE MEDICINE FELLOWSHIP Submitted directly to PedsCCM May 5, 2008
Due to unanticipated circumstances, the Division of Pediatric Critical Care Medicine at Schneider Children's Hospital of the North Shore - Long Island Jewish Medical Center has a vacancy in our Pediatric Critical Care fellowship training program. Our multidisciplinary program currently consists of a 20 bed PICU that admits more than 1500 patients annually, and includes a very active cardiac/cardiothoracic surgical program, ECMO (> 20 patients/year), renal replacement (CVVH-DF), neurosurgical program, and a level 1 pediatric trauma center. Submitted directly to PedsCCM February 25, 2008 The Division of Pediatric Critical Care Medicine at Stanford University School of Medicine is currently accepting applicants for a first year fellow to begin in July 2008. The Division of Pediatric Critical Care Medicine offers an ACGME-accredited fellowship training program whose graduates will be eligible and well-prepared for the American Board of Pediatrics Subspecialty certification examination in Pediatric Critical Care Medicine. The fellowship seeks to recruit applicants with the requisite passion, dedication, diligence and insight to meaningfully inform the next several decades of pediatric critical care medicine. Fellows will have extensive clinical exposure through rotations in both the Pediatric Intensive Care (PICU) and Cardiovascular Intensive Care Units (CVICU). The PICU provides critical care services for very active programs in medicine, neurosurgery, general surgery, solid organ transplantation, craniofacial reconstruction, orthopedics, otolaryngology and trauma. In the CVICU, fellows care for the full spectrum of pediatric cardiac disease, including more than 500 postoperative patients per year following cardiopulmonary bypass, as well as patients requiring mechanical support including left ventricular assist devices, such as the Berlin Heart, and extracorporeal membrane oxygenation. During the early research rotations, the pediatric critical care medicine fellow will explore potential research opportunities within the remarkably rich Stanford University community of biologic and non-biologic scientists (e.g. policy, economics, medical humanities, engineering). The program is designed to foster greater responsibility and increasing leadership opportunities concomitant with increasing seniority. We are committed to the creation and maintenance of a fellowship training program that provides a collegial, supportive environment, while still ensuring that fellows are able to realize even their loftiest career aspirations. For more information regarding the fellowship program, please contact:
Cristina M. Alvira, MD
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