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Rotations

Residents rotate through a variety of services during their residency. Here is the typical breakdown of rotations by year for a categorical pediatrics resident. Pediatric subspecialties are available for residents to do during elective rotation time. Most times Pediatric residents are the only resident on the service, meaning they get one to one teaching from the subspecialist.

Descriptions of Rotations and Call Schedule

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Outpatient General Pediatrics and Continuity Clinic

Pediatric Residents spend their outpatient rotations and continuity clinics at University Pediatric and Adolescent Center (UPAC). Residents are assigned to a weekly half-day continuity clinic and have their own panel of patients for whom they are the primary care provider. They also rotate through the Division during their month of Newborn medicine, two months of outpatient pediatrics as a PL-1, one months as a PL-2, and one month as a PL-3. Additionally in the intern year they spend time in the Center of International Health and ENHANCE through the Primary Care Skills rotation. Second-year residents spend a month in Adolescent Medicine. Residents rotating through UPAC attend conferences 3 days each week, including the Current Events faculty-led journal club, UPAC lecture series, and UPAC case conference. UPAC faculty join the entire residency program each week for resident Journal Club or Intern Conference.

Critical Care

In the PICU, resident education and fostering an academic approach to inquiry and critical care is strongly emphasized. Second-year and third-year Pediatrics residents, Emergency Medicine residents, Pediatric Emergency Medicine fellows, and Anesthesiology residents are integrally involved in patient care and multidisciplinary team management of all PICU patients. Residents consistently rank this educational environment and training as one of the strongest and formative experiences in their training. Residents provide direct, hands-on patient care for the sickest 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.

Neonatal Care

In the newborn nursery and NICU rotations, residents have extensive exposure to a variety of neonatal conditions and receive formal training in both newborn management and resuscitation of critically ill infants. NICU residents have an opportunity to closely interact with neonatal nurse practitioners and physician assistants thereby broadening their overview of other aspects of pediatric health care provision.

Emergency Medicine

At Upstate's Pediatric Emergency Department, residents are the front line with more than 25,000 pediatric patients annually. Here residents are supervised by a board specially trained in Pediatric Emergency Medicine faculty while caring for the critically ill or injured children aged newborn to 18 years. As the region's only dedicated pediatric emergency department and Level-One Trauma Center, residents are exposed to rapid diagnosis and evaluation, procedures, resuscitation and everything else that comes through the door in a fast-paced facility with state of the art technology.

Inpatient/Hospital Medicine

Our inpatients are cared for in the General Pediatric Inpatient Units in the Upstate Golisano Children’s Hospital by teams that include Pediatric Hospitalists, residents, medical students, and nurse practitioners. The care is enhanced with the assistance of dedicated pediatric case managers, social workers, pharmacists, child life specialists, and art and music therapists.

In the intern year residents have a total of four months of hospital medicine. As second-year residents they have two total months, and then two months in the third year. Additionally second-year residents have one month on the inpatient pediatric subspecialty service and one month on the inpatient hematology/oncology service.

The Division of Pediatric Hospital Medicine provides comprehensive care for children from newborns to young adults up to age 20 requiring inpatient medical care. The division provides care for a variety of disorders, acute and chronic, with general and subspecialty needs. Common conditions on the inpatient service include: acute and chronic respiratory illnesses, gastrointestinal disorders, infectious diseases, rheumatologic and cardiac conditions, and neurologic concerns. The faculty provides direct care and coordination of care for medically complex patients while they are inpatients. The hospitalists provide medical care alongside the Child Psychiatry Consultation and Liaison service for children and adolescents with psychiatric and behavioral health problems. The division also provides consultative care for patients on surgical and medical subspecialty services.

Developmental Pediatrics

Training in developmental pediatrics includes our 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 cerebral palsy and genetic disorders.

Hematology/Oncology

The Division of Hematology/Oncology cares for infants, children and adolescents with the full spectrum of hematologic and malignant disorders. The clinical activity of the section is based in the Waters Center for Children's Cancer and Blood Disorders (CCCBD). The Waters Center at Upstate Golisano Children's Hospital is the sole pediatric cancer speciality center in Central New York and serves a 21-county area in New York and Northern Pennsylvania. Each year, the center treats more than 700 local children diagnosed with leukemia, tumors, sickle cell anemia and other life threatening diseases.

The division also provides the primary source of patients for the 13-bed in-patient Pediatric Hematology/Oncology unit on 11G with its supporting staff. The division cares for approximately 50 newly diagnosed children with cancer annually and more than 70 children are actively on chemotherapy programs. The division also provides care to children with a wide variety of hematologic disorders on an ongoing basis as well as providing consultative services for regional primary care providers who need assistance caring for children with potential hematologic or oncologic diagnoses.

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.

Career-Focused Rotations

We have three distinct pathways intended to provide residents with the skills and knowledge they will use in their careers

  • Advocacy:  Residents can explore opportunities to engage in community pediatrics and participate in advocacy at local, regional, and national levels.
  • Global Health: Residents on this pathway have exposure to caring for global patients locally and abroad, and gain insight into the particular needs of this population.
  • Research: Residents seeking to develop skills in this area have access to a broad range of resources, and can pursue anything ranging from lab-based projects to clinical research and quality improvement.

The keystone of the career pathways is the Primary Care Skills rotation.  It is a career pathway rotation all interns complete. It is designed for interns to gain new knowledge and skills in the areas of advocacy, global health, and research. It combines in-person and virtual learning experiences. Interns choose their desired pathway near the end of the academic year.

International Health

The Pediatric International Health Clinic is a refugee clinic that serves refugees from all over the world. These patients present with a unique spectrum of diseases and conditions that are not otherwise encountered on a routine basis in a typical North American urban setting. Residents rotate through this clinic during the intern year. Residents also have the opportunity to participate in a global health elective during a call-free month in their PL-3 year with further opportunities for elective engagement throughout training depending on individual interests. Our program has a relationship with the Obama Children's Hospital in Kisumu, Kenya. On this rotation, residents serve in a primarily educational role to the students and residents at their hospital.

Child Abuse Referral and Evaluation (CARE) Program

Since 1989, the CARE Program has been providing comprehensive evaluation and treatment to children suspected of being abused or maltreated. The CARE team consists of specially trained and experienced physicians, nurse practitioners, nurses and social workers who work together to assess the social and medical evidence of abuse. The CARE team works closely with community agencies concerned with the welfare of children, including law enforcement, child protective services, Vera House and the McMahon/Ryan Child Advocacy Center. The CARE Program offers a three year child abuse fellowship training program.

Call Schedule

The program runs on a night shift schedule on weekdays. The day shift is 6:30 AM to 5 PM (and night shift is 5 PM to 6:30 AM), Monday through Friday. On weekends, residents at all training levels have 24-hour calls. Night shift is usually scheduled in no more than two-week increments. In the intern and second years, residents do a total of five weeks of night shift. In the third year, residents do a total of six weeks of nights. When interns are on inpatient, they may be scheduled for a week of long call, which involves staying until 8 PM to help the admitting resident with admissions. When they are scheduled for long call, they will have a call-free weekend. Only senior level residents take backup calls (e.g., cover when someone is ill or unable to work). The call schedule is typically released on a month-to-month basis.

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