Pediatrics Residency Curriculum

Boot Camp
2 weeks inpatient, 2 weeks outpatient

Inpatient Pediatrics Including Night Team
3 blocks

Neonatal Intensive Care Unit
2 blocks

Pediatric Emergency Room
1 block

Developmental Behavioral Pediatrics
1 block

Mixed Subspecialty
 1 block

Nursery
1 block

Culture/Society/Health (CSH - Community Advocacy)
1 block

Elective
1 block

Call
Ambulatory/elective rotations – several evening urgent care clinics per month
Emergency medicine – should have 15-17 X 9 hour shifts

Some Highlights from Selected Months

Boot Camp

During July or August, each first year resident participates in an intensive, introductory 2 weeks in both the inpatient and outpatient areas. On the inpatient unit, the resident learns about the inpatient team, how family-centered rounds work, how to navigate the electronic medical record as well as the requirements for safe, effective handovers. At 140 High Street, the resident learns key elements of the primary care experience with the help of the support staff, the senior residents and the general pediatrics faculty.

Developmental / Behavioral Pediatrics

The Developmental-Behavioral Pediatrics rotation provides the resident exposure to both typical and atypical child development in a variety of settings including office, hospital, school, and playgroup. Residents work directly with faculty in the diagnosis and management of disorders such as ADHD and autism. In addition, they become acquainted with related subspecialty fields including developmental psychology, neuropsychology, and rehabilitative therapies.

Nursery

This rotation focuses on normal newborn care.  Residents see patients in the normal newborn nursery and in the Continuing Care Nursery, which functions at an intermediate level between the NICU and routine care.

Mixed Subspecialty Experience

The rotations formerly known as Amb2 and MSK are now merged into two blocks of “mixed subspecialty” during intern year. The goal is to expose residents to the many facets of the pediatric ambulatory subspecialty world in the Springfield Area. This includes time at 140 High Street (Continuity Clinic, On Demand (Urgent Care) Clinic, Lead Clinic), 50 Wason (Cardiology, Endocrinology, Gastroenterology, Genetics, Neurology, Pulmonology, Rheumatology, etc) Shriner’s Hospital (just 6 blocks away) , Allergy and Immunology, New England Orthopedics, and Sports Medicine. The resident should get a chance to visit all of these places at least once during your two MSS blocks.

3 blocks (includes 1 block of nights)

Pediatric Intensive Care Unit
1 block

Neonatal Intensive Care Unit
1 block

Pediatric Emergency Room
1 block

Adolescent Medicine
1 block

On Demand (Urgent Care)
1 block

Culture/Society/Health (Community Advocacy)
1 block

Elective w/ Call
2 blocks

Elective w/out Call
1 block

• Inpatient Pediatrics: Gridmaster or manager + 2x2 week night rotations
• Q5-6: Call for ambulatory and elective rotations
  Includes some jeopardy call,  sick call, beeper call from home for ambulatory phone coverage, evening urgent care ("Mommy" call known as BPG call)
• NICU: includes 1 week of nights
• PICU: every 4th night

Some Highlights from Selected Months

Adolescent Medicine

In this block, residents enjoy the opportunity to delve into the many issues surrounding the care of adolescents. Exposure to eating disorders, STIs, Job Corps, school-based clinics, adolescent lock-up and much more.

Culture/Society/Health

Culture, Society and Health block provides residents a variety of community-based agency and advocacy experiences which encourage broad thinking about social determinants of health.  The block helps familiarize residents with both available resources and ways to be involved in their communities.   Residents prepare a literature review of a topic that arises during their experiences which they present at the end of the block.  Projects are encouraged as well.

On Demand (Urgent Care)

Urgent care provides a one block longitudinal experience in the outpatient urgent care setting. Residents also learn about triage in a busy inner city practice. Time is also protected for your research project and continuity clinic.

 2 blocks (1 block on nights)

Pediatric Intensive Care Unit
1 block

Pediatric Emergency Room
1 block

Nursery
1 block

NICU
1/2 - 1 block

Ambulatory Chief
1 block

Elective w/ Call
4 blocks

Elective w/out Call
1 block

• Inpatient Pediatrics:  1 block leading the night team
• Q5-6:  Call for ambulatory and elective rotations, includes some jeopardy call (sick/transport call, beeper call from home ambulatory phone coverage
• Emergency Room: 9-hr shifts per month
• PICU: Every 4th night

Some Highlights from Selected Months

Night Team

During the senior night team block residents are able to independently manage patients, learning important skills of triage and admission of patients at night.  This resident also provides leadership for first year resident on the team and the PICU during a single month of nighttime ward coverage.  The night team resident manages admissions and supervises the first year resident caring for patients in the hospital at night.

Nursery

This rotation focuses on normal newborn care.  Residents see patients in the normal newborn nursery and in the Continuing Care Nursery, which functions at an intermediate level between the NICU and routine care. As the senior resident, you will coordinate the clinical and educational activities of the team, which includes medical students.

Ambulatory Chief

This block provides senior residents with the experience of teaching and evaluating medical students and first year residents in the ambulatory setting while getting the opportunity to refine their own ambulatory skills. The month also exposes the senior resident to the concepts of quality improvement and proper billing and coding procedures.

"Pre-Attending" Elective

This is a supervisory block where you act as a fellow or pre-attending in the PICU, NICU, hospital, or in clinic. This ensures that you are ready for the next step in your career. It involves attending meetings you would not usually attend as residents.

Inpatient Coverage

• Inpatient teams are composed of supervising seniors and first year residents. Or they are "manager" teams where a 2nd year resident works directly with the patients and attending.
• All inpatient teams may have medical students.
• Each weekend has a senior and intern from one day team and another intern from the other day team, or a manager, ensuring all patients are known to the housestaff on each day
• Two night teams, each composed of a senior resident and a first year resident cover for the block.
• All patients are covered by these inpatient residents.
• We only work 24 hour shifts in the PICU
• All shifts comply with the ACGME requirements for duty hours and days off.

NICU

In the NICU we have a night resident so there is no overnight call. All residents on the block take their turn as the night resident.

PICU

Only senior residents rotate through the PICU, where call is every fourth night. These PICU rotations are the only ones with 24-26 hour shifts during the three years.

Outpatient Coverage

On all outpatient rotations, except the emergency department, first year residents participate in the after-hours urgent care clinic which is held Monday-Thursday from 5:30 pm until the patients are gone, usually by 7:30 pm.

Senior residents participate in beeper call from home for parent questions from the general pediatrics clinics. Senior residents also take jeopardy (sick call). One month in the second year and two months in the third year may be designed as call-free months if requested. During call-free months residents may do away electives, if eligible, and cleared by the Program Director.

Baystate Medical Center has a very robust onsite simulation center.

Resident teams on the inpatient service participate in simulated scenarios twice on each rotation. Residents’ pagers are covered by attendings during this time so as to protect their educational experience.

• Residents in the PICU go down to the center once a week as a group and work with the pediatric “patients”.
• Our NICU has a newborn baby simulator which they have incorporated into their education program; the residents on the NICU service attend simulation once a week.
• There are special simulation sessions for ED and Manager Residents.
• We also have a new initiative for first year residents to practice difficult conversations.

All of our residents work with a faculty mentor to do a project over their three years here.

Most medical students come into residency with experience in research or community service, and we feel it is important for you to be able to continue in these areas of interest. Your project can be in the areas of clinical research, community advocacy, public health, or education. Drs. Weijen Chang and Elizabeth Peacock-Chambers supervise these projects.

The Program financially supports residents presenting at national meetings.

Presentations

Each year a large subset of our residents present abstract posters and/or platform presentations at national meetings.

The Program and the GME Office provide monetary support for each resident who presents at one national meeting per year.