Our Residency Curriculum

The broad-based curriculum enables residents to become competent in all areas of general pediatrics. Some of the highlights of the curriculum include:

• Primary care – The training in primary care takes place at the University Pediatric and Adolescent Center (UPAC). The residents participate in a continuity clinic experience one half day per week. In addition, there are six separate month-long block rotations at UPAC during the three years of residency. This combination of experience provides residents with a greater continuity for health maintenance, chronic diseases and acute illnesses. In the second year, residents combine their UPAC experience with longitudinal training in the outpatient clinics of various subspecialties. An additional rotation in Adolescent Medicine rounds out their education in general pediatrics. Community practices are also available as sites for resident education, and nicely complement their training in the inner city, hospital-based UPAC.

• Critical Care – The PICU and Stepdown units are the setting for the training in Pediatric Critical Care Medicine. Residents provide direct, hands-on patient care for the sickest of pediatric patients in Central New York. Patients have a wide-range of acute conditions. Residents also provide concurrent care for patients admitted primarily for surgical conditions. The training in Neonatal Intensive Care takes advantage of the two NICUs in Syracuse. Residents have exposure to the field through two distinct NICU experiences, first at St. Joseph’s Hospital Health Center and subsequently during rotations are at the tertiary care NICU at Crouse Hospital.

• Emergency Medicine – Residents are the front line for children aged newborn to 18 years who present with both medical and surgical emergencies to the area’s only Pediatric Emergency Department. More than 20,000 annual visits are seen, and supervised by a board certified Pediatric Emergency Medicine faculty.

• Developmental Pediatrics –This rotation takes advantage of some of the outstanding community resources in child development, as well as those at the Center for Neurodevelopmental Pediatrics. The Center is home to services for children with developmental and behavioral problems, as well as those with complex medical conditions, such as spina bifida, cerebral palsy, and genetic disorders.

• Inpatient - Education on the general inpatient service has changed in the past few years with the establishment of an academic pediatric hospitalist service. Dedicated hospitalists provide oversight and direct care for the inpatients at University and Crouse Hospital. They also provide consultative care to medical and surgical patients. A great deal of the education of residents and medical students is provided by these inpatient specialists. In addition, a separate attending, the Teaching Attending, provides hands-on and didactic teaching to complement the learning on the wards.

• Subspecialties – The curriculum continues to provide comprehensive training in the pediatric subspecialties. Clinical instruction is available in virtually all the major pediatric medical and surgical subspecialties. Residents have elective time that allows them to create additional experiences in focused areas of the subspecialties. In the third year, residents are able to have a "call free" elective month.

• COAT – The Community Oriented Advocacy Training program, established in 1995, is one of the first such advocacy training programs nationally. The COAT curriculum educates residents on a wide range of topics in Child Advocacy including a section utilizing case based format to cover the curriculum on systems based care.

• Teaching Skills for Housestaff – This monthly seminar series is designed to meet the needs of residents as teachers. The series addresses topics such as: delivering effective lectures, teaching at the bedside, providing feedback, evaluating students and serving as a role model.

• International Health - The Pediatric International Health Clinic is a refugee clinic that serves primarily African Refugees from Sudan, Somalia and recently Liberia. These patients present with a unique spectrum of tropical diseases that are not otherwise encountered on a routine basis in a typical North American urban setting. 

• Evidence Based Medicine – The housestaff present and participate in a series of workshops designed to analyze recent literature and demonstrate possible effects on practice. These workshops are held twice each month and utilize a curriculum in evidence based medicine.

• Research - Many of our residents participate in active research with faculty. The underlined authors of the manuscripts in the sections below are our residents or students.

• Docs for Tots – This program is offered to students in the first and second year of medical school who are interested in a career in pediatrics. It provides an introduction to pediatrics through case presentations, informal lectures and community outreach and is offered in addition to the regular student curriculum.

Curriculum Overview

First Year - PL-1
The focus for the intern year (PL-1) is to learn the diagnosis, management, and follow- up of acutely and chronically ill infants and children. An important aspect of this year is to learn what is normal for each age and to be able to identify when a child falls outside this range. There are four months of inpatient pediatrics. Three months are on general inpatient services where residents care for patients on medical and surgical services, ranging from common primary care problems to complex subspecialty concerns. Patients range from newborn to adolescent. Although the ward attending is primarily responsible for the residents' education, the inpatient service offers an opportunity to work closely with community pediatricians, subspecialists and our surgical faculty. The fourth inpatient month is on Hematology/Oncology service. Here, residents work closely with an attending on a team that includes a PL-3, specialized nurses and pharmacists.

Four months are dedicated to general ambulatory pediatrics; three at our UHCC Pediatric and Adolescent Center where residents care for acute and chronic problems and address issues in preventive health and heath maintenance. One month of child development provides supervised experiences in a variety of community settings to learn variations in behavior and development and to learn about the diagnosis and management of children with developmental disabilities.

Of the two-month neonatal experience, the first concentrates on the evaluation and care of the full term newborn in the nursery and outpatient setting. The second month allows experience in neonatal intensive care. Residents receive one-on-one attending supervision as they learn the care of the sick or premature infant, neonatal resuscitation, and delivery room stabilization in a NICU that stresses family-centered care .

Two months are spent in our pediatric emergency department learning acute care management. Through clinical, didactic, and patient simulation technology, residents become credentialed to perform all of the Residency Review Committee (RRC) required skills.

Second Year - PL-2
The second year of post graduate training expands the content of medical care and provides the opportunity to supervise PL-1s and medical students on the inpatient service. This is in part accomplished by providing a one month experience supervising a general pediatric inpatient ward.

A two month block is based in the pediatric outpatient department and includes experiences in the subspecialty clinics. Combining ambulatory pediatrics with outpatient subspecialties is a major part of the curriculum for generalist training. The longitudinal experience allows residents to select two subspecialty clinics where knowledge is reinforced with repeated encounters. Continuity with both subspecialty patients and those in the general clinic is achieved with this extended rotation. In addition, residents participate in a one month, in-depth experience in adolescent medicine. Two months of subspecialty elective time gives residents a more concentrated look at selected specialties.

The second year is balanced with greater exposure to acute care medicine. Residents spend one month in the state-of-the-art tertiary care NICU and two months in our Pediatric Intensive Care Unit integrating pathophysiology with recognition of physiologic deterioration and critical problem solving. There are also two months with enhanced responsibility in the pediatric emergency department.

Third Year - PL-3
Our PL-3 year capitalizes on the residents' sharpened skills and places them in a more supervisory role. PL-3s serve as Assistant Chief Resident and lead the teams on the general inpatient floor, the PICU, the outpatient department, and the Hematology and Oncology service. Further enhancement of acute care skills take place in the PICU, NICU, and emergency dept.

This year is balanced with the opportunity to tailor the curriculum to the residents' career goals. Five elective months are available for a wide range of activities, from greater exposure to the subspecialties, to community practice experiences, to clinical and basic science research opportunities. Research electives are available to all interested residents and encouraged for those pursuing academic careers. A call-free elective allows residents to seek areas of study at other institutions.

A unique and rewarding option for PL-3s is to participate in a 12-month continuity experience providing primary care for Native Americans at the Onondaga Nation Health Clinic.