Pediatric residents provide primary care to a diverse range of pediatric patients in the Outpatient Department. Under the direct supervision of attending physicians, ambulatory residents master the well-child-care visit and manage children presenting for sick visits. Learning objectives essential to this rotation include improving time-management, providing effective advice, recognizing patterns of disease presentation, knowing when to admit a patient, and understanding developmental nuances. Apart from their ambulatory rotation, all residents are also responsible for their own weekly continuity patient panel in the Outpatient Department.
General Pediatric Inpatient Service
During their inpatient rotation, residents learn how to care for children with a wide variety of acute medical and surgical illnesses. A supervising generalist conducts daily attending rounds, and residents work closely with attending sub-specialists and pediatric surgical teams, resulting in a varied and challenging inpatient rotation.
Pediatric residents play a major role in the management of healthy newborns. Under the supervision of an attending physician, residents gain hands-on experience by attending both vaginal and c-section deliveries. Residents learn to manage infants of diabetic mothers and infants with hyperbilirubinemia, electrolyte abnormalities, anemia and platelet disorders, birth trauma, and other neonatal conditions. A large emphasis is put on resident participation in the promotion of breastfeeding.
Neonatal Intensive Care Unit
Our Level III nursery has thirty-one NICU beds, including a transitional care unit, under the supervision of board-certified Neonatologists. The NICU admits 750-800 babies per year, from 23 weeks to 40+ weeks gestation. Residents participate actively in the care of premature infants and full-term infants requiring intensive care for pathology such as hypoglycemia, suspected sepsis, jaundice, congenital heart disease, and congenital anomalies requiring surgical repair. Residents perform procedures and learn delivery room resuscitation and neonatal pathophysiology as part of this rigorous neonatology training experience.
Pediatric Intensive Care Unit
Our five-bed PICU provides sophisticated management of patients with a wide spectrum of pediatric conditions, including respiratory distress, severe electrolyte disorders, neurologic and cardiac emergencies, and intensive post-operative care. Under the direct supervision of board-certified pediatric intensivists, pediatric residents gain valuable hands-on experience in the management of the critically ill child. Residents also participate in a four week PICU rotation at New York Presbyterian-Weill Cornell Medical Center.
Pediatric Emergency Department
Our newly renovated ten-bed pediatric emergency unit, supervised by board-certified pediatric emergency medicine attending physicians, provides one of our program's most valuable learning experiences. Pediatric residents become competent in dealing with a broad range of acute major and minor pediatric medical and surgical emergencies including trauma, poisoning, lacerations, burns, fractures, child abuse, gynecologic problems, and psychiatric and social emergencies. Residents become proficient in a multitude of procedures including lumbar punctures, urine catheterizations, fracture reduction, and splinting. The Pediatric ED has a fully accredited Pediatric Emergency Medicine Fellowship, and graduates of our residency program often continue on to this fellowship.
Through participation in outpatient adolescent clinics and inpatient consultations, pediatric residents on their adolescent rotation learn to delve into adolescent pathophysiology, social-emotional challenges, and community contexts, thereby developing an integrated approach to adolescent care. The rotation is directly supervised by a board certified, fellowship-trained subspecialist in Adolescent Medicine.
Pediatric residents participate in all aspects of the thriving NYPBMH pediatric cardiology service, including outpatient clinics and inpatient consults throughout all pediatric units. Supervised by a board-certified Pediatric Cardiologist, residents see cardiac pathology ranging from complex congenital heart disease to neonatal and perinatal cardiac complications, infectious and rheumatological carditis, lifestyle-related cardiac pathology, and arrhythmias. Approximately 2,400 echo-doppler studies and 3,500 EKG tracings are performed annually.
The rotation in Child Development is designed so that residents learn the developmental milestones, appreciate the range of normal behavior, and begin to differentiate typical and atypical development. They also gain an awareness of the impact that family characteristics and poverty have on development. The diagnosis and management of common developmental problems such as language delay, autism, ADHD and learning disabilities are the central focus of the rotation. Residents learn to take a developmental history, perform developmental assessments, utilize screening tools, make appropriate referrals and work in a multi-disciplinary team. There is a strong emphasis on improving interviewing and observational skills. Residents also recognize how our colleagues contribute to developmental practice by observing sessions in the Hearing and Speech Center and visiting an early intervention school in the community.
Our community-based rotation is designed to provide resident physicians with an understanding of cultural, economic, and familial risk factors affecting the health of our pediatric patients. Residents are exposed to community resources that serve the pediatric population, including the court system and child protective agencies.
During their endocrinology rotation, residents play an active role in the diagnosis and management of endocrine disorders including thyroid disease, growth and pubertal disorders, adrenal and pituitary dysfunction, diabetes mellitus, and obesity and weight management. Residents accompany a board-certified pediatric endocrinologist on inpatient pediatric consults throughout the hospital and in outpatient specialty clinics.
Board-certified pediatric gastroenterologists supervise residents in outpatient GI clinics and on inpatient consults. Feeding disorders, malabsorptive disorders, inflammatory bowel disease, GI bleeds and nutritional disorders are commonly seen conditions. Residents are exposed to clinical procedures such as endoscopies, liver biopsies, pH monitoring and wireless capsule endoscopies.
Residents on their hematology rotation spend time on the inpatient units and in the outpatient infusion center and clinics. They learn to manage patients with a wide variety of blood disorders including thalassemia major, sickle cell anemia, neutropenia, and bleeding disorders. They also evaluate patients with acute hematological emergencies. Residents are taught to perform lumbar punctures and bone marrow aspiration/biopsy and learn how to interpret peripheral smears and bone marrow biopsies.
Pediatric Infectious Disease
During their ID rotation, residents actively participate in outpatient infectious disease clinics (including HIV clinics) and inpatient consults on all neonatal and pediatric units. Under the direct supervision of an infectious disease specialist, residents learn to diagnose and manage children presenting with a broad range of infections. Residents also are expected to research and critique the current ID literature and become familiar with common laboratory tests and infection control procedures.
Residents assist board-certified pediatric neurologists in outpatient office hours and inpatient consultation during their pediatric neurology rotation. They are exposed to a wide variety of neurological pathology and learn to apply diagnostic tests such as MRI, EEG and video EEG. The pediatric resident is expected to prepare a short lecture on a topic in pediatric neurology and conduct in-depth research on an interesting clinical question that presents itself during the rotation. Learning objectives include understanding the diagnosis and management of common pediatric neurology disorders, recognizing neurological emergencies, and achieving competency in the neurological examination of children.
The Division of Pediatric Pulmonology specializes in an integrated and team-based approach to the care of pediatric patients with acute and chronic respiratory disorders. During their pulmonology rotation, residents learn normal pulmonary physiology and develop their ability to diagnose and manage respiratory disease. They are taught to provide effective counseling and comprehensive health education to chronically ill patients and their families.