Pediatrics

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Pediatrics Residency Curriculum

A comprehensive curriculum for the Pediatrics Residency includes community pediatrics, subspecialty care, critical care and ambulatory care as well as opportunities to pursue medical research and experiences in global health and community health.  With graduated responsibility each year, the program incorporates all core competencies and the main components of clinical care: inpatient, ambulatory, primary, specialty and critical care. In each of the three program years, residents complete 13, four-week rotations, choose two or three electives, and can preference rotation blocks to develop an individualized curriculum to fit their needs.

The majority of rotations are based at Riley Hospital for Children at IU Health on the IU School of Medicine—Indianapolis campus. Other rotations occur at IU Health Methodist Hospital and Eskenazi Health, the county hospital—both located downtown Indianapolis, near the IU School of Medicine campus—and at IU Health North Hospital in suburban Carmel.

Continuity Clinic

Residents are assigned a continuity clinic to develop skills of longitudinal care. As the name of the clinic implies, residents have the same assignment throughout their residency in order to maintain a personal panel of patients and families. The continuity experience is offered in a variety of environments that includes hospital and community-based clinics and private practices. Residents may preference their continuity clinic based on career goals and special interests, such as largely underserved urban neighborhood clinics, subspecialty clinics or clinics with a large Spanish-speaking population. Residents attend their clinic one half-day per week and maintain the same faculty mentor(s) throughout the three years. Skills in efficient primary care management are emphasized with attention to health systems issues.

Call Schedule

The pediatrics residency program strikes a good balance in support for time off and rest, while preparing residents to manage admissions, deliveries and events that are unique to nights and call. The overall call schedule is comparable to most large academic centers; call is an important time to learn, develop independent decision-making and participate in deliveries and procedures. Resident teams on call work together, and 24/7 in-house faculty support for teaching and assistance.

Most inpatient rotations for interns are q5 short calls, assisting with admissions in the late afternoon/evening. This ends at 9pm so interns can have time at home and not miss out on daily rounds and conferences. Intern electives have weeks without call and a few back-up / jeopardy calls. Interns are exposed to some night call experiences as well. PGY1s have a total of four weeks of night float, divided into two blocks. Interns also have some night calls while covering rotations like Hem-Onc, NICU and normal newborn. Interns average 60-65 hours per week on the busier services, and IU School of Medicine fully complies with ACGME Duty Hours.

Residents have many weeks on electives that are call-free, with a few jeopardy calls. Emergency Medicine and urgent care rotations involve shifts. For the half of the year on wards and ICU, call is approximately q5 with a few q4 night rotations in the PICU. PGY3 seniors have more electives and fewer calls. Residents average 60-65 hours per week on the busier services, and IU School of Medicine fully complies with ACGME Duty Hours.

Sample Rotation Schedule

Each program year contains 13 4-week block rotations. Electives are outpatient-oriented and residents in special pathways/tracks can focus on research, global health or primary care with their electives.

PGY – 1

PGY – 2

PGY – 3

General Wards 1General WardsGeneral Wards
General Wards 2Specialty Selective (e.g. Hem/Onc)General Suburban Hospitalist
General Wards 3Specialty selective (e.g. ID)Specialty selective (e.g. Endo)
PulmonarySpecialty selective (e.g. Cards)Specialty selective (e.g. Renal)
Heme OncPICUPICU
Specialty selective (e.g. GI)EDED
EDNICUNICU
NICUNICU/Night FloatRheumatology
Normal NewbornUrgent CareDevelopmental Behavioral Peds
Ambulatory/Urgent careAdolescent MedNormal Newborn (w/QI block)
Community/advocacy-ICommunity/advocacy-IIElective
ElectiveElectiveElective
ElectiveElectiveElective

Rotations

Ambulatory care is a key component of the Pediatrics Residency curriculum. Approximately half of the three-year residency experience is in an ambulatory setting, such as the continuity clinic, urgent visit centers, emergency department, specialty clinics, behavioral pediatrics, adolescent medicine and community pediatrics rotations. All residents receive training in the management of developmental and behavioral problems of children. First year residents spend one outpatient month becoming familiar with developmental milestones and assessment and learn about community resources for both typically developed and developmentally delayed children. In years two and three, residents complete a behavioral pediatrics rotation, involving clinics for children with school problems, developmental disabilities and behavior disorders, and residents gain experience in school health and community pediatrics, learning about the role of physician as advocate for children’s health.

Proficiency in critical care is a distinguishing feature of pediatrics. The Pediatrics Residency at IU School of Medicine provides a graduated experience each year as residents train in state-of-the-art neonatal and pediatric intensive care units and emergency departments. Residents learn about anesthesia and other critical-care procedures from neonatologists and other pediatric specialists. At Riley Hospital alone, there are 36 pediatric intensive care beds and 12 cardiovascular intensive care beds. Residents develop skills to diagnose, stabilize and initiate treatment of children with critical illness. Graduates of the program can recognize and manage any pediatric emergency.

Residents have one block rotation in the Neonatal Intensive Care Unit each year at either Riley Hospital, Methodist Hospital or Eskenzai Hospital, which provides a broad range of level II and level III NICU experiences. Second-year residents receive additional training working in obstetrics newborn delivery. In these settings, residents become confident in their abilities to provide resuscitation, stabilization, transport and treatment of seriously ill newborns. The large volume of patients provides exposure to all types of newborn disease, including complex cardiac and surgical conditions.

Riley Hospital for Children serves as the major source of subspecialty pediatric care in Indiana, making it an exceptional venue for resident teaching. A full range of pediatric subspecialty services is provided by nationally recognized board-certified subspecialists who are eager to train the next generation of pediatricians. Residents also benefit from working with pediatric pharmacists, social workers, physical therapists and others who have specialized in pediatric fields. Teaching includes well-supervised direct patient care, bedside rounds and didactic presentations.

While each clinical service varies slightly, residents typically participate in a mixture of inpatient and consultation services as part of scheduled subspecialty rotations. Ambulatory care is integrated within some of the services as well. Pediatric specialty services include adolescent health, cardiology, endocrinology/ diabetes/ metabolism, gastroenterology/ hepatology/ nutrition, hematology/ oncology, infectious disease, nephrology, pulmonology, rheumatology and developmental pediatrics. During specialty rotations, pediatric residents are often exposed to other medical specialties such as pediatric surgery, orthopedics, ophthalmology, anesthesiology, radiology and psychiatry.

The Section of General and Community Pediatrics is the largest section in the Department of Pediatrics at IU School of Medicine and educates residents in all aspects of outpatient primary care, including well-child care, chronic disease management and the treatment of common behavioral disorders and acute illness. In addition, residents typically complete two general pediatrics inpatient experiences per year at Riley Hospital for Children and nearby Methodist Hospital or Eskenazi Hospital. Some of the common illnesses and conditions diagnosed and treated during the general pediatrics ward rotations include fever, apnea, asthma, pyelonephritis, pneumonia, failure to thrive, seizures, gastroenteritis and dehydration. Time spent in large newborn nurseries help residents become proficient in the management of problems of the newborn.

Educational Conferences

Educational Conferences

Daily educational conferences focus on preparing our residents for clinical practice, as well as for the American Board of Pediatrics board examination. Annual retreats off campus allow for extra workshops on topics ranging from teaching and communication to leadership and practice/financial management.
Community Pediatrics Training Initiative

Community Pediatrics Training Initiative

All pediatric residents participate in one or two months dedicated to expanding their knowledge of community resources, participating in service learning experiences, and developing the skills to become leaders in child advocacy.