The HCA Houston Healthcare Kingwood – University of Houston EMS Fellowship is a one-year, ACGME-accredited program based at one of the nation's most progressive EMS systems.
Applications for 2027-2028 are open now through October 1st.
Emergency Medical Services is the practice of medicine beyond the hospital walls — in homes, on highways, at mass gatherings, and in the air. We train emergency physicians to lead EMS systems, direct prehospital care, and advance the science of out-of-hospital medicine.
You'll work directly with one of the country's most forward-thinking EMS agencies and a faculty known nationally for prehospital education.
Montgomery County Hospital District (MCHD) is a county-based third-service system answering over 100,000 calls for service a year, known for progressive, evidence-based protocols and the widely followed MCHD Paramedic Podcast.
Rotate across ground EMS (MCHD), a fire-based ALS first-response service (The Woodlands Fire Department), and air medical / critical-care transport (HCA AirLife).
24/7 access to a medical director field response vehicle. Respond to emergency scenes as on-line medical control and provide direct education and guidance to EMTs and paramedics.
Review and propose protocol changes, medication additions, and provide education that will shape the service and local EMS environment for years to come.
From the Program Director
Welcome, and thank you for your interest in the HCA Houston Healthcare / University of Houston Kingwood EMS Fellowship. Our philosophy is that the EMS medical director is, at heart, a teacher, a mentor, and a clinician who leads best by providing the education EMS clinicians need to perform at the highest clinical level. Here, you will experience comprehensive medical direction across the entire continuum of care; from the first keystroke of a 9-1-1 call, to fire department first response, to scene management, to hospital handoff.
In Montgomery County, one of the nation's fastest-growing regions, you will step into the role of Assistant Medical Director within a nationally recognized county-based third-service EMS system. You will have 24/7 access to a response vehicle and we encourage field response, to provide real-time medical direction alongside the paramedics and EMTs you train. You will learn on the scene, in the dispatch center, and through active participation in case reviews, gaining a view of the entire system of care that few physicians ever see. And through active participation in quality assurance and protocol revision, you will have the opportunity to make a significant and lasting impact across the county.
You will grow as an educator and as a leader, sharpen your skills in the administrative and clinical work that defines the role, and take part in the research, teaching, and event and disaster medicine that give this program its regional and national footprint. If that is the kind of training you are looking for, we invite you to explore all that this program has to offer.
Casey Patrick, MDProgram Director · EMS Medical Director, MCHD
MCHD EMS provides all 9-1-1 response for one of the nation's fastest-growing counties, covering 1,100 square miles and answering nearly 100,000 calls for service each year. We also provide medical direction for all 14 of Montgomery County's first-responder organizations and for the 9-1-1 dispatch center, allowing the fellow to gain a true system-of-care perspective — from the first call-taker's keystroke to hospital discharge. This ground-based EMS experience is further augmented by longitudinal involvement with HCA AirLife.
MCHD is deeply embedded in the county's mass-gathering, disaster-response, and event-medicine framework. Fellows have the opportunity to participate in Ironman Texas, The Woodlands Marathon, and regular MCI and disaster-response training exercises at both the local and regional levels.
The fellowship rests on our belief that an EMS medical director is, above all, a teacher and mentor. Fellows have consistent field, classroom, and administrative exposure to EMTs and paramedics, developing their skills as bedside educators. A successful medical director balances advocacy for prehospital clinicians with the willingness to provide honest, constructive feedback.
MCHD EMS maintains a strong regional and national footprint in education and research, with multiple recent AAEM and NAEMSP abstracts and educational presentations, along with a track record of consistent peer-reviewed publications. The fellow plays a significant role in our annual cadaver lab training and on the MCHD Paramedic Podcast.
The Woodlands Fire Department (TWFD) is a robust, fire-based ALS first-response service and a key partner in the region's emergency care system.
The fellow contributes to TWFD's quality assurance efforts and plays an active role in the ongoing training and clinical development of the department's paramedics.
During the orientation month, the fellow spends several shifts riding on fire apparatus and responding to calls alongside TWFD crews, building a firsthand understanding of the capabilities, workflow, and challenges of fire-based first response.
HCA AirLife provides aeromedical critical care transport to the greater Houston area, delivering advanced care to critically ill and injured patients across the region. Over the course of the fellowship year, fellows integrate longitudinally with the AirLife program, gaining exposure to the clinical, operational, and safety considerations unique to the aeromedical environment.
Fellows participate actively in the program's quality assurance process, reviewing transport cases and contributing to ongoing performance improvement.
For those interested, there is the opportunity to serve clinically as a member of the flight crew, providing hands-on critical care during helicopter transport. Flying is available to fellows who want it — it is not required.
Dr. Patrick completed residency training in Emergency Medicine at Indiana University in 2007 and is board-certified in Emergency Medical Services. He has served as the medical director for Montgomery County Hospital District EMS since 2016, and developed and continues to produce the MCHD Paramedic Podcast.
Dr. DePasquale worked as a full-time paramedic for several years before receiving his MD. He completed residency training in Emergency Medicine at Indiana University in 2023 and fellowship training in EMS at IU in 2024. He is currently the Associate Medical Director at MCHD.
Dr. Dickson completed his Emergency Medicine residency at Indiana University. Following a career in academic emergency medicine and EMS leadership, he now serves as an advisor to the University of Houston EMS Program at MCHD. He has authored numerous publications and has presented nationally and internationally on EMS.
Dr. Joshua Tsau was born and raised in San Francisco, but has been in Texas since high school. He now wears boots on shift and finally considers himself a Texan. He did undergrad at Texas A&M, where he met his wife; medical school at UT Houston; EM Residency at the University of Central Florida–Orlando; and EMS Fellowship in San Antonio. Dr. Tsau finally made his way back to Houston to work at Texas Medical Center and Clear Lake. He has two little boys; his hobbies include jiu jitsu, cooking, and gardening. Interests within EM include all things meta: systems, logistics, operations, policies, procedures, efficiency.
Applications close October 1, 2026
Email your CV, cover letter, and two letters of recommendation to the program coordinator. Applications are accepted now through October 1, 2026, and the EMS fellowship match takes place on November 18, 2026. One fellow is selected each year.
The fellowship is open to physicians who have completed residency training. Applicants should be board-eligible or board-certified in their specialty.
Your current CV, a cover letter describing your interest in EMS and your career goals, and two letters of recommendation.
Send all three to program coordinator Kareema King-Johnson, MBA at Kareema.King-johnson@HCAHealthcare.com with the subject line EMS Fellowship Application. PDF is preferred. Applications are accepted through October 1, 2026.
Selected applicants are invited to interview with program leadership.
The EMS fellowship match takes place on November 18, 2026. Once matched, GME onboarding and credentialing follow ahead of the July 2027 start.
Fellows receive a competitive salary and benefits at the appropriate PGY level. For full details on GME salary, benefits, and stipends, see the HCA Houston Healthcare Kingwood GME site.
