Pediatric Residency Programs
Clinical Experience
PL-1 Function
PL-1 house officers act as primary physicians for our patients. PL-1 residents spend a full day in the General Pediatrics practice except when on the ward and NICU rotations when they spend a half day in the practice. When rotating through the PICU, clinic is cancelled for that month. In addition, Pl-1 residents spend a one month block of time rotating exclusively in the outpatient practice and one month in adolescent medicine. On the wards and in the PICU, PL-1 residents are responsible for taking histories, performing physical examinations, and carrying out diagnostic and therapeutic procedures. All orders on all patients must be written or countersigned by a member of the floor housestaff, ensuring that the residents know what is being done with their patients. The PL-1 resident is supervised by a PL-2 or PL-3 resident, the chief resident, and the attending physician directly responsible for each patient's care. There are separate, dedicated teaching attendings for the ward teams. There are third and fourth-year medical students on the patient care teams as well. The interns are responsible for supervising and teaching the 3rd year medical students.
In the neonatal intensive care unit, the PL-1 resident has direct responsibility for the care of a cadre of patients under the supervision of the senior residents, neonatology fellows and full-time neonatologists; with increasing experience, the PL-1 resident will manage seriously ill newborns in the intensive care unit. While on call the PL-1 resident helps the senior resident in the management of critically ill newborns and accompanies the resident to the delivery room. In addition, a separate rotation in the well baby nurseries is supervised by an attending pediatrician, who oversees the care of the newborns and goes with the PL-1 resident to the delivery room. In the emergency room, the PL-1 resident interviews, examines and treats children under the supervision of senior residents and attendings.
Interns rotate to two outside institutions for experiences that augment the education they receive at the Mount Sinai campus, Elmhurst Hospital Center, a city hospital in Queens, and Englewood Hospital Center, a community hospital in New Jersey.
PL-2 and PL-3 Functions
The supervisory and teaching roles of the second and third-year pediatric residents increase with experience. Residents spend a full day in the General Pediatrics practice during the PL-2 and 3 years, except when on the ward and ICU rotations. There are four weeks of NICU, PICU and Ambulatory block time in each year. One rotation period in the second year is devoted to developmental pediatrics.
On the wards, the senior residents with the PL-1 residents initiate and carry out treatment of all patients. In addition, the senior residents play a major role in the teaching and supervision of the third and fourth-year medical students. These activities are performed in concert with the chief residents and the pediatric attending physician. The NICU and PICU experiences include supervisory responsibilities and direct patient care. The elective program is designed to give residents the opportunity to explore fields of interest as well as to provide competency in sub-specialties that are of particular importance in pediatric practice. There are 4-5 months of elective time during the PL-2 year; PL-3 residents have six months of elective time.
Call Schedule
PL-1 residents are on call an average of every 4th night during their Sinai ward and NICU rotations. PL-1 residents assigned to Elmhurst Hospital wards are on call every third or fourth night. PL-1 residents assigned to the well baby nursery may cover 2 calls in the NICU on weekends during the 4-week rotation. There is no overnight call in the ER for PL-1 residents. There is no overnight call for PL-1 residents during their primary care, englewood and adolescent rotations. PL-2 and PL-3 residents are on call 4 to 7 times during each 4-week rotation while on the wards, NICU, and most electives. At Englewood residents take 3 weekend calls a month. In the ED residents are assigned 12 hour shifts. In a typical 4-week rotation residents cover 4 to 5 overnight shifts with an attending. There is no inpatient call during the ambulatory blocks. One call free month is allotted to each resident in the PL-3 year. In the PICU, residents will now take call about every 4th night.
Primary Care Training Program
Over the course of 3 years of training residents spend 20% of their total training time in their continuity practice. Residents spend a full day each week in their continuity practice during all months except Sinai and Elmhurst Floor and ICU rotations. In addition, residents spend a full month in the continuity practice in each year. Residents are exposed to a formal curriculum in community and primary care pediatrics as part of the core didactic series in the continuity practice as well as focused small group training sessions during the block rotations. Particular focus is given to community advocacy and school based health.
Teaching Program
The formal teaching program for the housestaff consists of a series of daily conferences covering the entire spectrum of Pediatric topics, a bi-weekly X-ray conference, a weekly formal Grand Rounds, and a monthly morbidity/mortality conference. In addition, separate daily conferences at the General Pediatrics practice cover a wide range of topics including a formal curriculum in physician-patient communication taught by a multidisciplinary team. Each of the pediatric sub-specialty services has its own rounds and conferences. Separate conference series are held for those rotating in the Emergency Department, PICU, NICU, and WBN. Each morning there is a case presentation conference ("morning report" with the chairman and program director) as well as attending rounds on the wards and nurseries. The Kravis Children's Hospital of The Mount Sinai Hospital is part of the Jack and Lucy Clark Department of Pediatrics of the Mount Sinai School of Medicine. Pediatric medical knowledge and clinical exposure are incorporated into the first two years of the medical students' education both in the basic science courses and in the Arts and Science of Medicine course. There is an eight-week clinical clerkship for the third-year students, and a four-week subinternship for the fourth-year students. Multiple electives in pediatric subspecialties are available for interested students.