The pediatric emergency medicine (PEM) fellowship at Mount Sinai, an established ACGME-accredited program, currently accepts one fellow per year from either pediatrics or emergency medicine residency training. The fellowship is designed to train physicians interested in academic PEM. We provide didactic and bedside teaching of pediatric emergency medicine to both the pediatric and emergency medicine residents. Some of our current research projects include the use of positive airway pressure for patients with asthma, the use of simulation to augment resident education, and utility of focused right lower quadrant CT scan for the diagnosis of appendicitis. The department at Mount Sinai has a volume of approximately 30,000 pediatric patients per year and is a referral center for pediatric subspecialty care. The division is fully integrated within our successful emergency medicine department, with strong ties to the department of pediatrics. Seven full time BC/BE faculty supervise the child friendly department 24 hours a day in a distinct location from the adult emergency department containing its own nursing, child life specialists and social workers. Our first fellow graduate in 2007 took a position in academic PEM at the Children's Hospital at Montefiore. This year the program was able to recruit it's graduating third year fellow to stay on as the director of pediatric simulation training.