Pediatrics Residency

 

During the first year of training, our pediatric residents are introduced to foundational clinical and scholarly experiences through integration into varied clinical settings with exposure to a diverse patient population.  PGY-1 residents build upon their undergraduate medical education competencies in the ability to perform thorough but focused age-appropriate histories and physical examinations in the inpatient and outpatient settings. PGY-1 residents develop patient appropriate assessments and management plans with the guidance of their upper level residents and faculty. They learn to identify level of illness severity and begin to address psychosocial and environmental influencers to care delivery. In the first year of training, residents will begin to establish their panel of continuity clinic patients at their continuity clinic site.

As they progress through the first year, PGY-1 residents are encouraged in their ability to independently seek knowledge and critique the medical literature through a structured evidence based medicine curriculum. They are coached in their ability to be “Residents as Educators” for both their teammates and their patient families. They are also introduced to Quality Improvement concepts and begin a project relevant to their career interests, with the guidance of an experienced faculty mentor.

Throughout the first year of training, residents establish a framework of understanding of pediatric practice that incorporates issues of child health advocacy, preventive health care, clinical ethics and effective cost containment into each aspect of their future experiences.

The second year of pediatric training builds upon the skill and knowledge base established in the first year and uses evidence-based medicine to enhance patient care and self-improvement. During the year, PGY-2 residents refine their clinical assessment skills. They also broaden the scope and complexity of the health care problems they address and critically analyze their performance and patient outcomes.

PGY-2 residents are exposed to in-depth experiences in a variety of subspecialty areas, including adolescent medicine and community-based pediatrics. They expand their practice experience and demonstrate greater clinical competency and efficiency in providing care to patients with a broader range of disease complexity. In the primary care setting, residents gain increasing responsibility and autonomy to begin functioning in an effective supervisor role for interns and medical students.

Residents enhance their teaching role at the bedside and expand their teaching efforts in the conference room. They learn to develop effective group teaching sessions and to efficiently utilize available teaching materials and literary resources. Via exposure to an expansive number of pediatric experiences, the PGY-2 residents begin to focus their career planning deliberations through discussions with faculty advisors and mentors and successfully develop or confirm their future practice interests. PGY-2 residents affirm their role as trusted child health advocates, preventive primary care providers and ethical and cost-effective practitioners.

PGY-3 residents continue to expand their pediatric knowledge base through additional supervisory, subspecialty, and intensive care rotations. As they prepare for the American Board of Pediatrics certifying examination, there is opportunity to spend dedicated time to study.  Residents further refine their competence in clinical diagnostic evaluations and technical procedural skills as well as in their patient stabilization, office preparedness and telephone triaging abilities. They practice pediatrics efficiently and effectively with a significant degree of independence and demonstrate level-appropriate leadership, confidence and supervisory capabilities.

PGY-3 residents assert their preceptorial and group-teaching skills as they expand their capacity to critically evaluate the medical literature and to teach other healthcare professionals and multiple level learners in a “round” format with a concurrent, patient-care service function. Residents complete a scholarly activity that will be submitted for presentation and/or publication. Third-year residents develop focused sign-out skills to facilitate continuity of care and learn how to expand these skills to apply to the community practice setting. They bring appropriate closure to their resident continuity care clinic  experience and, while establishing successful lifelong learning habits, they complete plans for their future careers in primary care practice or in additional fellowship training. PGY-3 residents participate at the community level in preventing or solving problems in child healthcare, publicly promote preventive healthcare and advocate for the causes of children. Residents provide children with ethical, cost-effective medical care.

Our program has transitioned completely to a night float or night shift schedule; there is no traditional 24-hour in-house call. Our program strictly adheres to the duty hours restrictions outlined by the ACGME, with zero duty hour violations. There is also a resident back-up schedule to provide coverage in the event that the assigned resident is unable to fulfill the assigned responsibilities.

Night Float

Night float is a two-week rotation of night shifts on the inpatient pediatric service. This is integrated into each PICU and MSU inpatient rotation.

Cross Cover

Cross cover is assigned to residents on the weekend to cover a service other than the rotation the resident is currently assigned to for the month. Residents serve a role at their level of training on an inpatient service for a weekend shift. Currently each PGY level is assigned 2-3 weekends annually. 

Jeopardy Call

The jeopardy call resident is available as back-up for inpatient rotations (MSU/PICU/NICU/nursery) in the event of illness. Currently, PGY-2 residents cover 2-3 half blocks PGY-3 residents cover 1-2 half blocks.

Attendance at scheduled conferences is monitored, with a goal of 70% attendance to account for clinical obligations and time off. The entire conference series addresses the first three aims of the program, with a primary emphasis on successful passage of the American Board of Pediatrics exam following completion of the training program. During the CoVID-19 pandemic, conferences are held via videoconference to allow for the safety and wellness of our residents and staff.  Our conferences are recorded and can be viewed at any time.

Department of Pediatrics Grand Rounds

Grand rounds are held weekly with some exceptions during the academic year.  Speakers include Baylor Scott & White pediatric medical staff, guest lecturers and residents . Several of the guest speakers are known nationally or internationally in their area of expertise. General and subspecialty clinical issues, health policy and pediatric research are some examples of the types of topics presented.

Critical Thinking Conference (CTC)

This conference is conducted weekly and is moderated by the program director(s). Topics include: Clinical Pathology Conference (CPC), Risk Management Conference (RMC), intern presentations and leadership updates. CPCs are presented by PGY-3 residents and consist of case discussion, differential diagnosis, work-up in diagnosis and final diagnosis.  All residents are required to complete six RMCs, including risk management/ethics lectures/modules over the course of their residency. These lectures are given by individuals from the hospital’s legal office and cover issues such as jousting, confidentiality, sexual harassment, HIPAA and informed consent. Intern presentations consist of interesting cases from the inpatient/outpatient services. Leadership updates focus on providing information regarding ongoing changes in health care delivery in the outpatient and inpatient settings.

Core Curriculum (Half-day Conference)

Residents have weekly half day conference led by various faculty and staff members. They cover a broad range of board-relevant topics that encompass both general and subspecialty clinical areas. Additional topics such as excellence in telemedicine, billing/coding, child advocacy, residents as teachers, evidence based medicine, quality improvement, procedural skills, food insecurities, and social determinants of health supplement the core medical knowledge series.

Journal Club

A discussion based, multidisciplinary journal club series based on a nationally recognized curriculum is facilitated by PGY-3's who are mentored by faculty in their areas of clinical expertise. Residents  read an article of current literature to facilitate discussion and focus on mastering evidence based medicine concepts through guided practice.

Simulation Training

Simulation is shifting the paradigm of medical education from didactic lectures to a hands-on approach. Simulation also supports the practice of safer medicine.

In pediatrics, the residents perform mock codes both in the simulation center and at the bedside every block under the supervision of one of the PICU/MSU physicians. The attending physicians also work one-on-one with residents throughout the course of their residency to become more comfortable with specific procedures, including bag-valve mask technique, neonatal and pediatric intubations, central line placement, IV placement, and other resuscitation skills.

Wellness

Our residency wellness events vary from balint-type group discussions to social gatherings as well as annual program wide and class specific retreats. 

Quality improvement- Residents participate in ONE quality improvement project that impacts their learning or patient care environment to facilitate the delivery of safer, more effective patient care or high impact learning. They also have the option to engage in a multitude of ongoing projects within the institution.  All QI projects are done with the guidance of a faculty mentor.

AND

Residents will choose one or more additional option from below:

• Hypothesis driven Research project
• Poster & Case Report write-up to be submitted for publication
• QI project (additional)- with particular attention to publishing and/or presenting at conference

For each of the above projects, residents work closely with a research mentor

Residents will have the opportunity to present their scholarly activity at Resident Research Day. Residents are strongly encouraged to present at local, regional and national conferences. These presentations can be funded by our GME department.

Innovation from system-wide to patient’s bedside

We believe research is an integral part of innovation. That's why we host an Annual Pediatric Scholarly Activity Forum where our residents showcase their original research and quality improvement initiatives.

Care that extends beyond the hospital walls

Here, being a pediatrician is more than a job, it is a calling. Our residents regularly volunteer at a free area clinic our former residency program director established to care for underserved children's medical needs, teach local students about online safety, attend the Texas Pediatric Society advocacy day at the Texas state capitol, volunteer at local pediatric camps, write news articles highlighting pediatric health and safety, and give news interviews on the local broadcast channel.