Introduction: Pediatric intensive care in India has expanded significantly with the growth of the Indian Academy of Pediatrics–Intensive Care Chapter (IAP ICC) fellowship programs. This study aimed to characterize the temporal growth, practice settings, research activity, and challenges faced by IAP ICC–trained pediatric intensivists nationwide. Methods: We conducted a cross-sectional electronic survey of all active IAP ICC fellows practicing in pediatric intensive care units (PICUs) across India between March and July 2025. The survey captured fellowship details (type/year), PICU characteristics, resource availability, research involvement, and perceived challenges. Descriptive statistics were used for analysis. Results: Since its launch in 2002 at 5 centers, the IAP ICC fellowship program has expanded to 65 centers by 2025. Of 676 eligible fellows, 661 (97.8%) responded; 79.4% held the Indian Diploma in Pediatric Critical Care Medicine. Most practice in the South (51.1%), followed by the North (21.3%), West (19.2%), East (6.4%), and Central (2%) India. The majority work in general PICUs (86.9%) and Level 3 centers (70.5%). PICU sizes include 1–10 beds (49.8%), 11–20 beds (39%), 21–30 beds (8.6%), and >40 beds (2.7%). Access to advanced therapies has improved but remains variable: continuous renal replacement therapy (74.2%), plasma exchange (67.9%), and high-frequency oscillatory ventilation (64.1%). Research engagement is limited, with only 16.3% of fellows actively involved and minimal multicenter or externally funded studies. Workforce shortages (36.6%), particularly in nursing and junior medical staff, and resource constraints remain major challenges. Conclusions: The IAP ICC fellowship network has substantially strengthened pediatric intensive care in India. However, persistent workforce gaps, uneven access to advanced therapies, and limited research capacity highlight the need for targeted national strategies in workforce development, research support, and standardized training to improve care for critically ill children.
Bansal et al. (2026) studied this question.