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Ambulatory Experience
This experience must constitute at least 50 percent of the overall
pediatric training program. During the ambulatory rotation, the
resident will learn to manage the growth and development of the
healthy child and treat a wide variety of acute and chronic pediatric
illnesses. This experience will also involve interaction with social
services, nutrition, nursing, and other members of the pediatric
team. The resident will conduct a comprehensive history and physical
examination in a variety of settings and clinical situations and
become familiar with medications that are common to outpatient practice.
The resident will also participate in specialty clinics such as
pulmonology, genetics, dermatology, and nephrology.
Emergency Pediatrics
During the emergency rotation, the resident
will become familiar with emergency management of the acutely ill
child. This will involve identification of illness or injury, stabilization
and treatment of the patient, and transfer of that patient, if necessary,
to the pediatric floor, pediatric intensive care unit, or other
service. The resident will develop skills in identifying and managing
pediatric trauma and pediatric resuscitation.
Inpatient Experience
The resident on the inpatient service
will learn to evaluate and care for children with disorders requiring
inpatient therapy. The resident will recognize the physical findings
and know the pathophysiology of diseases in children including,
but not limited to, the disorders of fluids, electrolytes, and metabolism.
The resident will learn to coordinate care with other medical and
ancillary services and to transition care to the outpatient setting
when appropriate.
Neonatal Intensive Care Nursery (NICN)
Experience
The resident will attend deliveries with
the neonatologist, nurse practitioner, and transport team to learn
resuscitation and stabilization skills and will learn to perform
basic history and physical examinations on infants admitted to the
NICN. The resident will follow the infant through NICN and intermediate
care nursery to discharge if it occurs during the rotation. Procedures
will be taught as the opportunities arise. The resident will also
gain experience working with the neonatologist to direct stabilization
and transport of sick newborns from outlying hospitals.
Behavioral/Developmental Experience
This experience will constitute a minimum
of one block rotation. The resident will learn normal and abnormal
child behavior and development. The resident will also develop the
skills necessary to interview parents and children to develop management
strategies for children with developmental disabilities and special
needs. The resident will become familiar with psychosocial and developmental
screening techniques and their interpretation.
Intensive Care Experience
The pediatric resident will obtain a firm
knowledge in the care and assessment of the critically ill child
from infancy through adolescence. The resident will learn to recognize,
stabilize, and manage the care of the acutely ill child, including
infection, neurologic, cardiac, pulmonary, and/or traumatic multi-system
failure. The resident will learn to apply principles and pathophysiology
to the critically ill child and will learn a full range of techniques
and procedures including airway management and invasive hemodynamic
monitoring skills. The resident will understand the multi-disciplinary
approach to the care of the critically ill child and the roles played
by each service in the overall management of the child's illness
and support of the family's needs.
Normal/Term Newborn Experience
This experience will constitute at least
one month of the residency experience. During this rotation, the
resident will learn all aspects of the newborn exam and will be
able to distinguish well from sick infants. The resident will also
be able to identify high-risk infants and plan for appropriate intervention.
Common anomalies, birth defects, and syndromes will also be recognized
and appropriate referrals made for follow-up care.
Adolescent Medicine Experience
This experience will constitute at least
one month of the residency experience. During this rotation, the
resident will become familiar with evaluating and managing common
issues, concerns, and problems of adolescents; understanding adolescent
growth and development; learning to obtain a thorough history from
adolescents and their parent(s); and performing an appropriate physical
examination. The resident will increase awareness of public health
issues for adolescents and recognize the importance of family, school,
and social influence on the development and health of adolescents.
Required Subspecialties
Hematology/Oncology
The resident will learn to recognize and
understand normal age-specific hematologic findings and learn historic
physical and laboratory findings leading to a hematologic or oncologic
abnormality. The resident will learn various strategies of treatment
and their associated risks/limitations, as well as how to treat
toxicities associated with therapy. The resident will learn to recognize
hematologic/oncologic emergencies and implement appropriate therapeutic
actions, become aware of common side effects of chemotherapeutic
agents, and become familiar with supportive care issues.
Cardiology
During this subspecialty experience, the
resident will develop an understanding of the classification of
heart disease (both congenital and acquired) in infants, children,
and adolescents, including innocent murmurs, arrhythmias, syncope,
chest pain, and complex congenital heart disease. The resident will
develop skills in the physical examination and diagnosis of patients
with suspected heart disease, as well as the appropriate management,
referral, and ongoing follow-up in both the inpatient and outpatient
setting.
Infectious Diseases
The resident will develop skills needed
to perform infectious disease history, physical examination, laboratory
interpretation, differential diagnosis, diagnostic plan, and treatment
recommendations. The resident will acquire a working knowledge of
anti-infectives to include antibiotics, antifungals, antivirals,
and antiparasitic agents. The resident will also learn the basic
principles in the clinical microbiology, serology, and virology
laboratory.
Gastroenterology
The resident will learn symptoms, diagnosis,
and therapy of specific diseases of the upper and lower GI tract.
The resident will also learn diagnosis and therapy of specific liver
diseases, including infectious hepatitis, biliary atresia, paucity
of the interlobular bile ducts, metabolic liver disease, and toxin-induced
liver injury.
Allergy/Immunology
Office-based practice of allergy immunology
will be stressed. Doctor and patient consultations will also be
reviewed with the assigned resident.
Endocrinology
This experience provides a comprehensive
program involving the treatment of children with metabolic disease,
diabetes mellitus, growth abnormalities, endocrine disorders, and
metabolic bone disease. Doctor and patient consultations will also
be reviewed with the assigned resident.
Neurology
The resident will develop a structured
neurologic approach to physical examination and diagnosis. The inpatient
neurologic evaluation of critical illness and neonatal neurology
will also be stressed. The resident will develop knowledge of seizure
classification, diagnosis, and treatment. In addition, residents
will develop an understanding of the neurological basis of developmental
and congenital disorders, headache, and other outpatient neurological
issues.
Program Selectives
During the second year, residents are
assigned a one-month rotation in community pediatrics and a one-month
rotation in private practice. Both will enable the resident to work
within the community, learn and understand important local public
health issues, and gain knowledge of how to manage patients within
a private practice.
Electives
In addition to the core curriculum and
required subspecialties, electives are available in orthopedics/sports
medicine, ophthalmology, ENT, pediatric surgery, special care newborn,
dermatology, pediatric radiology, anesthesia, adolescent gynecology,
and child psychiatry.
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