Overview

The Division currently consists of five faculty members, including four full-time child abuse pediatricians, Drs. Nancy Kellogg, James Lukefahr, Natalie Kissoon, and Lora Spiller, and a pediatric nurse practitioner, Ms. Kathleen Buckley, as well as a certified Sexual Assault Nurse Examiner, Ms. Annette Santos, a Division Administrator, Ms. Sandra Quiroz, and a Project Coordinator, Ms. Francis Johnson. This fellowship is a well-balanced experience in physical abuse, sexual abuse and neglect in both outpatient and inpatient settings.

Program Description

Established in 2006, this fellowship was one of the first to become accredited by the ACGME. The program provides an extensive and diverse clinical experience in outpatient and inpatient settings. Patients are referred through unique multi- and interdisciplinary collaborations:

  1. Center for Miracles (CFM): outpatient facility and office space for faculty, fellows, staff and social workers. A collaboration between UT Health San Antonio and Children’s Hospital of San Antonio (CHofSA).
  2. Inpatient consultations provided at three hospitals, University Hospital (UH), ChofSA and Methodist Children’s Hospital (MCH); ongoing collaborative work with other area hospitals that provide care for children and two facilities that house detained juveniles and human trafficking victims.
  3. Forensic nurse examiner program at CHofSA: fellows work with extensively trained forensic nurses who assess suspected victims of abuse and severe neglect in the emergency department. CFM provides follow up care and consultations for these patients.
  4. Case consultations/record review: as a center of excellence receiving state funding, CFM provides medical expertise for CPS workers in more than 50 counties through a unique web-based referral system.
  5. Serious Abuse and Neglect case staffings are held twice per week at the CPS regional office to assess safety plans and ensure adequate medical assessment and follow up care.

Recognizing that fellow interests are variable and educational experiences should evolve, our program strives to provide the flexibility and freedom for fellows to explore their interests, allowing them to participate in community, multidisciplinary and advocacy activities.

All fellow graduates passed the CAP board exam the first time and all obtained employment in their position of choice following fellowship.

Program Aims

Aim 1: to build and improve intra- and interdisciplinary collaborations to optimize detection, investigation, assessment, management and prevention of child maltreatment, and to provide a variety of team-building experiences and strategies that will enable fellows to be effective in their post-fellowship careers. These collaborations will also preserve the patient referral base which is a strength of the fellowship program.

Aim 2: to optimize opportunities to educate medical and non-medical professionals in clinical settings, classrooms, communities, and courtrooms, which may further strengthen intra- and interdisciplinary collaboration.

Aim 3: to identify gaps in fellow clinical experiences and explore ways to provide access to experiences and patient populations not currently accessible to ensure a more comprehensive fellowship experience.

Aim 4: to explore strategies for preserving wellness through early detection and effective interventions for work-related stressors

Aim 5: to explore strategies for enhancing fellow applicant pool

Selected References

  • Kellogg ND, Menard SW, Santos A. Genital anatomy in pregnant adolescents: ‘normal’ does not mean ‘nothing happened’. Pediatrics 2004 Jan;113(1 Pt):67-69.
  • Kellogg ND. Oral and dental aspects of child abuse and neglect. Pediatrics 2005 Dec;116(6):1565-1568.
  • Kellogg ND, Lukefahr JL. Criminally prosecuted cases of child starvation. Pediatrics 2005 Dec;116(6):1309-1316.
  • Kellogg ND. Evaluation of Suspected Child Physical Abuse Pediatrics 2007 Jun;119(6):1232-1241
  • Kellogg N, Anderst J. Evidence-based or evidence-biased? (letter to the editor) Journal of Forensic and Legal Medicine. 2008; 15(7) 471-472.
  • Anderst J. Assessment of factors resulting in abuse evaluations in young children with minor head trauma. Child Abuse and Neglect 2008;32(3) 405-413.
  • Anderst J. Chylothorax and child abuse. Pediatric Critical Care Medicine 2007 Jun;8(4):1-3.