Curriculum by Residency Training Year
|2018 - 2019 Academic Year
Cleveland Clinic Children's Residency Program
|Pediatric In-Patient Wards||4-5||2||3|
|Inpatient Senior Night Shift/Vacation||N/A||1||1|
|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||3||5||6|
Starting the 2019-2020 academic year, the Cleveland Clinic Children’s Pediatric Residency Program will adapt immersion scheduling. Instead of the traditional 4-week modules, residents will have a 4+2 schedule, meaning every 4-week block of inpatient/elective time will be followed by a 2-week ambulatory block. This will ensure that no resident will be 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 will also allow 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.
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 day 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 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.
Residents will 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 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 subspecialties.
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 2018-2019 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, 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 three interns.
Red Team: The red team is comprised of the general pediatric patients. This team consists of three interns and one senior.
Purple Team: The purple team is comprised of overflow patients from the red team. This team consists of a pediatric hospitalist and a senior resident.
Green Team: The green team is comprised of our Hematology Oncology and Pulmonary inpatients. This team is one senior and two interns.
Orange Team: The Orange team cares for our Gastroenterology and Pulmonology inpatients, including intestinal transplants. This team is made up of one senior and two interns.
Blue Team: This is our inpatient Cardiology, Heart Failure/Transplant and Nephrology team and is managed by one senior resident.
Overnight Team: The inpatient units are managed by the overnight senior and two on-call 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 affiliates, 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 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 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 sessions at the local schools. The rotation is now a longitudinal experience during PGY2 year.
This month 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. 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, during which time there may be an opportunity to assist in the operating room.
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 for one month in an ambulatory acute care/illness clinic. PGY-2 and PGY-3 residents will spend two months in the Pediatric Emergency Departments located at Hillcrest Hospital and Fairview Hospitals. You will 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 also home to our 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 with our inpatient rehabilitation patients and chronic pain patients, along with outpatient work with the same patient population. There is also an opportunity for additional experiences with children with nutritional needs and feeding disorders and 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 Years.