Curriculum by Residency Training Year
Continuity Clinic occurs at least one half day per week over the 3 years of training. Residents have 3 weeks of vacation each year that are taken in a one week and a two week block. Residents receive additional time away for holidays including a special holiday schedule for Christmas and New Years.
In accordance with new changes from the ACGME, all of our PGY2 residents will design their own six (6)-block individualized curriculum to be spread over their elective time during their last two years of training. The curriculum design is incredibly flexible and is overseen by a mentor selected by the resident and residency advisor. We strongly recommend that the curriculum include a second longitudinal experience. This could be a second community continuity clinic, or it could be a continuity experience with a subspecialty patient population, such as in a dialysis unit or inflammatory bowel disease clinic. Additional rotations could include established electives, or they could be experiences designed by the resident and the mentor. Some unique experiences could include a combination of multiple sub specialties.
Elective Subspecialty Rotations
Resident will be required to fulfill a minimum of four core subspecialty rotations within their three years.
- Infectious Disease
Additional pediatric electives offered:
- Ambulatory General Pediatrics
- Behavioral Developmental
- Child Psychiatry
- Emergency Medicine
- Pediatric Rehabilitation
- Sports Medicine
The descriptions below are accurate for the 2013-2014 academic year.
Pediatric Inpatient wards
Our inpatient census is divided into 5 teams: Red, Purple, Green, Orange and Blue. Our Red and Purple teams care for our General pediatric admission under the supervision of Pediatric Hospitalists. This team may also have patients from additional sub-specialties (Neurology, Nephrology, Genetics, etc) that do not have an admitting team, but work closely with the staff from those departments. This team(s) has one senior and two-three interns.
Green Team: The green team is comprised of our Hematology Oncology and Endocrinology inpatients. This team is one senior and one to two interns.
Orange Team: The Orange team cares for our Pulmonology and Gastroenterology inpatients, including intestinal transplants. This team is made up of one senior and one intern.
Blue Team: This is our inpatient Cardiology and Heart Failure/Transplant team and is managed by one senior resident.
Overnight Team: The inpatient units are managed overnight by a senior and two interns.
During your PGY-1 year you will work directly with a Cleveland Clinic Children’s neonatologist in the community based Level III NICU at Cleveland Clinic Hillcrest Hospital. You will have 1:1 teaching experiences in this setting, which will make you well prepared for your PGY-2 NICU experience at Cleveland’s Metro Health Medical Center in their Level III, 49 bed unit. Teams consist of neonatologists, NICU fellows, residents and interns, as well as neonatal nurse practitioners. The experience includes management of deliveries, neonatal resuscitation, acute and chronic neonatal issues, and performance of invasive procedures.
As PGY-2 and PGY-3, you will rotate through our 25-bed intensive care unit. You will be exposed to a variety of critically ill medical and surgical pediatric patients including: congenital heart disease, acute respiratory distress, toxic ingestions, encephalitis, and transplant recipients. You will work directly with our PICU staff that are in-house 24/7, managing critically ill patients and gaining experience performing a variety of procedures.
Normal Newborn Nursery
This experience takes place at our Cleveland Clinic affiliate, Hillcrest Hospital where over 4,000 deliveries occur annually. As an intern, you will work in the nursery with a pediatric hospitalist and become competent in the newborn exam, common newborn issues, and in delivery room resuscitation skills. Your experience in delivery room resuscitation skills is under the supervision of neonatology and hospitalist staff.
The adolescent medicine rotation is a 4-week, required outpatient module designed to highlight the unique needs of this transitional age group. Clinic time is spent at the main campus, Euclid Free Clinic, and various other community outreach centers. There is extensive exposure to the care of patients with complex eating disorders, the medically underserved, menstrual irregularities, sexually transmitted diseases, and substance abuse.
Community Pediatrics and Child Health Advocacy
The community medicine rotation is a 4-week, required outpatient rotation that introduces residents to the collaboration needed between pediatricians and community-based organizations to optimize the care we give to our patients. The rotation also gives residents exposure to public health policy and child health advocacy. A variety of experiences is available and includes visits with multiple community-based organizations such as Women, Infants and Children (W.I.C.) and the American Sickle Cell Anemia Association. They work in general pediatrics clinics providing care to the medically underserved and multidisciplinary clinics which address public health issues such as obesity and lead exposures. Residents learn about evidence based medicine as well as provided designated session on child abuse. Residents are responsible for health care education session in local shelter for women as well as in one of the local schools.
General Pediatrics/Behavioral Development
This month combines out-patient general pediatrics with an introduction to behavioral pediatrics. The outpatient general pediatric experiences takes place in one of our many ambulatory pediatric practices, either on the main campus or in one of our numerous community based pediatric practices in our Cleveland Clinic Regional Medical Practice. During this month, residents are assigned to the practice site where they have their weekly continuity clinic, providing an excellent opportunity for you to form patient relationships and build their practice.
Throughout the module you will also attend scheduled clinical and didactic sessions with our pediatric psychology staff, aimed toward providing experience in managing the common behavioral and development problems most frequently encountered in general pediatric practice. These educational sessions include topics such as: ADHD, behavioral interventions, learning assessments and Psychological/Psychiatric evaluations. The goal is for the resident to gain expertise in the assessment and management of common pediatric behavior issues, and then apply this knowledge in the care of the patients encountered in their continuity clinic practice.
This required, 4-week elective rotation done as a PGY-2 gives the resident an opportunity to develop procedural skills, specifically endotracheal intubation, along with exposure to the pediatric surgical subspecialties. This rotation benefits all pediatricians regardless of ultimate career path. Clinical time is spent working directly with pediatric anesthesiologists performing intubations in the operating room. Participation in other procedures, such as venous access, may also be included. Two additional weeks are spent in a variety of outpatient pediatric surgical clinics, which may include; ENT, Orthopedics or Ophthalmology, during which time there may be opportunity to assist in the operating room. The resident on this rotation also serves as the primary backup to assist when needed on the inpatient service.
Emergency Medicine and Acute Care/Illness
Each year your experience in managing acute illness and emergency medicine will vary as you spend time in different settings. PGY-1 interns will work in an ambulatory acute care/illness clinic. They may also spend an additional two weeks in the Pediatric Emergency Department at Hillcrest Hospital. PGY-2 and PGY-3 residents work in emergency departments at Cleveland Clinic Children's Emergency Departments located at Hillcrest and Fairview Hospitals. You will have increasing responsibility providing pediatric emergency care under the supervision of our Cleveland Clinic Pediatric Emergency Medicine staff.