Curriculum by Residency Training Year
|2020 - 2021 Academic Year
Cleveland Clinic Children's Residency Program
|Pediatric In-Patient Wards||4||2||3|
|Inpatient Senior Night Shift||N/A||0.5||0.5|
|Normal Newborn Nursery||1||0||0|
|Community Pediatrics and Child Advocacy||1||1||0|
|General Pediatrics/Behavioral Development||1||0||0|
|Pediatric Emergency Medicine/Acute Care Illness||1||1||1|
|Elective/Subspecialty Rotations/Individual Curriculum||2||3.5||5.5|
Starting the 2019-2020 academic year, the Cleveland Clinic Children’s Pediatric Residency Program adapted immersion scheduling. Instead of the traditional 4-week modules, residents have a 4+2 schedule, meaning every 4-week block of inpatient/elective time is followed by a 2-week ambulatory block. This ensures that no resident is on wards for more than 4 weeks in a row. Exceptions may be made depending on individual resident schedules and requirements, but overall this structure will be maintained throughout residency.
Below is a sample of immersion scheduling. The colored blocks represent inpatient or core elective rotations, and white blocks represent ambulatory blocks. Continuity clinic will occur three half-days a week during the ambulatory blocks.
This schedule allows for longitudinal elective experiences. Instead of a traditional elective lasting one 4-week block, the elective may be taken over three ambulatory blocks. Furthermore, a second continuity clinic may be pursued during PGY2 and PGY3 years during the ambulatory blocks. In addition, this schedule allows for a robust, expanded primary care experience.
As of the 2020-2021 academic year, we've transitioned to an intern night float schedule. Interns no longer have 24 hour shifts. Intern night float consists of one week of nights while on inpatient months. Interns arrive at 5 p.m. and sign out the next morning at 6 a.m. They will then switch to 3 weeks of day shift (6 a.m. to 5 p.m.) for the remainder of their rotation.
Our continuity clinics are held at four primary care offices within Cleveland Clinic Children’s large primary care network. These sites were selected for resident clinics due to faculty dedication to education, patient diversity, and their close proximity to metropolitan Cleveland. Each resident attends their continuity clinic for three half days per week during their ambulatory blocks. They will work with the same group of preceptors at the same site throughout their training. As a result, our residents develop a robust and meaningful longitudinal experience serving as the primary pediatrician for their own patient panel. Prior to each clinic, residents can expect a mini educational conference focused on a blend of primary care and community pediatrics with staff members who are very familiar with and active within their communities. Our engaged continuity clinic faculty are also invaluable resources for residents interested in developing quality improvement or clinical research projects in primary care.
Individualized Curriculum (Individualized Learning Plans/ILPs)
Residents design their own individualized curriculum rotations 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 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 their mentor. Some unique experiences could include a combination of multiple subspecialties. Examples from previous years include cardiac imaging, bone marrow transplant service, surgical neonatal ICU, public health, and many others.
APB Elective Subspecialty Rotations
Residents will be required to fulfill a minimum of four core subspecialty rotations within their three years.
- Child Abuse
- Infectious Disease
Additional pediatric electives offered:
- Ambulatory General Pediatrics
- Behavioral Developmental
- Child Psychiatry
- Emergency Medicine
- Palliative Medicine
- Pediatric Rehabilitation
- Sleep Medicine
- Sports Medicine
The descriptions below are accurate for the 2020-2021 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 admissions under the supervision of pediatric hospitalists. This team may also have patients from additional sub-specialties (neurology, genetics, etc.) that do not have an admitting team but work closely with the staff from those departments.
Red Team: The red team is comprised of the general pediatric patients. This team consists of two interns and one senior.
Purple Team: The purple team is comprised of overflow patients from the red team, nephrology service patients and general pediatrics consult service patients. This team consists of a one senior resident and one intern.
Green Team: The Green Team is comprised of our hematology/oncology and endocrinology in-patient teams. This team consists of one senior and two interns.
Orange Team: The Orange team cares for our gastroenterology and pulmonology inpatient teams, including intestinal transplant patients. 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 by the one senior and two interns. We utilize a night float system for both seniors and 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 or Fairview 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 at the main campus. You will be exposed to a variety of critically ill medical and surgical pediatric patients including those with: congenital heart disease, acute respiratory distress, toxic ingestions, encephalitis, and transplant recipients. You will work directly with our PICU staff, fellows and nurse practitioners that are all in-house 24/7, managing critically ill patients and gaining experience performing a variety of procedures.
Normal Newborn Nursery
This experience takes place at two of our Cleveland Clinic community hospitals, Hillcrest Hospital and Fairview 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 our Neonatology and Hospitalist staff.
The adolescent medicine rotation is a required 4-week outpatient module designed to highlight the unique needs of this transitional age group. Clinic time is spent at the main campus, Lakewood Clinic, and various other community outreach centers. There is extensive exposure to the care of LGBT youth, 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 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 designated sessions on child abuse. Residents are responsible for health care education sessions at local elementary schools. The rotation is now a longitudinal experience during PGY2 year.
Behavioral and Developmental Pediatrics
This rotation combines outpatient general pediatrics with an introduction to behavioral pediatrics. The outpatient general pediatric experiences take 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. Residents also attend scheduled clinical and didactic sessions with our pediatric psychology and psychiatry 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.
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. Half of the clinical time is spent working directly with pediatric anesthesiologists performing intubations in the operating room. Participation in other procedures, such as venipuncture and IV placement may also be included. The other half of the time is spent in a variety of outpatient pediatric surgical clinics, during which time there may be an opportunity to assist in the operating room..
Emergency Medicine and Acute Care/Illness
Each year, the resident's experience in managing acute illness and emergency medicine will vary as each resident spends time in different settings. PGY-1 interns will work for one month in an ambulatory acute care clinic or in the pediatric emergency departments. PGY-2 and PGY-3 residents will spend two months in the Pediatric Emergency Departments located at Hillcrest Hospital and Fairview Hospital. Residents have increasing responsibility providing pediatric emergency care under the supervision of our Cleveland Clinic Pediatric Emergency Medicine staff.
Residents have the opportunity to rotate in our free-standing Cleveland Clinic Children’s Hospital for Rehabilitation. This facility is home to Cleveland Clinic Children's Center for Autism, the Judith M. Power Pediatric Dialysis Unit and Community-Based Services for Children with Special Needs. The rotation will include inpatient service time along with outpatient exposure with our inpatient rehabilitation patients and chronic pain patients, along with outpatient work with the same patient population. There is also opportunity for additional experiences with children with special nutritional needs and feeding disorders, as well as time with our pediatric physiatry clinics.
Residents have 3 weeks of vacation (15 work days) each year that may be taken as either three 1-week blocks, or a 1-week block with a 2-week block. Residents receive additional time away for holidays including a special holiday schedule for Christmas and New Year’s.