PL - Year 1

The major goal of the first year of training is to develop and refine clinical skills, including pediatric problem solving and differential diagnosis, by assuming responsibility and caring for both well patients and those with a wide variety of pediatric illnesses. A close working relationship with a team of supervisory residents and attending faculty provides a supportive environment in which the PL-1 resident gains confidence in clinical assessment and decision-making. The rotations are structured and taught to ensure optimal educational benefits.

Each PL-1 will spend 4 four-week rotations on the inpatient services at Connecticut Children's, caring for hospitalized patients from all socioeconomic backgrounds. Each intern will do one week of night shift during each inpatient rotation. The PL-1 resident has primary responsibility for five to eight patients, with supervision by senior housestaff and attending faculty. PL-1 residents are also responsible for presenting during the weekly inpatient conferences.

A block rotation in the Level I Trauma Center Pediatric Emergency Medicine Department introduces the PL-1 resident to the principles and skills needed in this area. Residents will care for a full spectrum of children with emergent needs, including injuries due to trauma, toxic ingestions, and acute illness. A formal curriculum in emergency care is taught by pediatric emergency medicine trained faculty who staff the unit 24 hours per day.

First-year residents are assigned to two rotations in ambulatory pediatrics, which includes 4 weeks of vacation. These are the first of seven blocks that occur in the same practice setting throughout the three years, and where most residents also participate in their weekly continuity sessions. The initial rotation, usually assigned in the first half of the year, introduces the residents to their practice. The subsequent rotations involve a full range of practice activities, including: newborn follow-ups, well-child exams, scheduled follow-ups, and acute care visits. In addition, PL-1 residents will have a longitudinal community activity integrated into their ambulatory assignments. This experience spans across all three years, and each year is the equivalent of 1 block rotation.

The block rotation in Developmental-Behavioral pediatrics is provided in the first year. The needs of the newborn are also addressed in two rotations of the first year, with one block of well baby care and the other rotation in neonatal intensive care. The PL-1 typically cares for 5-10 sick neonates while in the NICU. In addition, PL-1 residents have 3 discretionary rotations in the first year that can be oriented towards a particular career goal.

Call Schedule/Vacation: During the PL-1 year, the only call responsibilities are to the inpatient units. PL-1 residents can also cross-cover the inpatient units while on ambulatory, discretionary, newborn nursery, and development blocks. PL-1 residents have four weeks of vacation scheduled during the ambulatory rotations. National holidays are covered as weekend days, so only those ‘on call’ are on duty. Each resident is scheduled to have a holiday break of four days at either Christmas or New Year's, but alternative holiday time away can be arranged. Residents generally have at least three of four days off on Thanksgiving weekend.

PL - Year 2

The PL-2 year focuses on skill and knowledge enhancement as well as career development. Greater emphasis is also placed on independent decision-making as residents assume the role of supervisor. More in-depth knowledge of both general and subspecialty pediatrics is acquired for the role of supervisor and teacher. Residents are also introduced to group teaching during the PL-2 year by giving a formal case-based, evidence-based presentation on a topic of their choice to an audience of residents and faculty.

The PL-2 residents are assigned to two rotations in the ambulatory pediatric practice where they continue their community longitudinal experience. They have their first opportunity to supervise on the inpatient service with close faculty support. Inpatient night team during the PL-2 year consists of two, 2-week blocks. There is a second, higher acuity emergency medicine experience and two PICU rotations. The block rotation in adolescent medicine occurs in the second year, as well as four discretionary block rotations, one of which is call-free. Call responsibilities when not on inpatient/PICU/ED blocks include weekend cross-cover for the inpatient units, sick call coverage, and after-hours telephone coverage for the outpatient practice. Calls during adolescent medicine and elective experiences are minimized to ensure adequate exposure. PL-2 residents receive four weeks of vacation, taken during ambulatory rotations. Holiday coverage is as described for PL-1 residents. Senior residents also have the opportunity to participate in internal moonlighting (additional call for additional pay). This allows for backup coverage staffing.

PL - Year 3

During the PL-3 year, residents assume the greatest amount of responsibility for teaching and supervision of residents and medical students in all areas of patient care. The greatest level of leadership and knowledge is required in this role, though senior residents still benefit from the guidance of their faculty supervisors whenever needed.

The PL-3 resident serves as the senior supervisor for 3 inpatient rotations at Connecticut Children's, including 2 two-week blocks of nights. This inpatient experience includes a Teaching resident role, which also provides the opportunity for independently admitting and managing patients. In addition, a choice is given for a fourth inpatient rotation or a third PICU rotation. During the PL-3 ED block, the resident continues to have primary patient care responsibilities, with greater independence in caring for patients of higher acuity. Each PL-3 resident also has three additional blocks dedicated to the ambulatory practice experience, but with an added level of complexity to allow for necessary growth and sophistication in completing this curriculum.

There are five additional block discretionary rotations for a total of twelve discretionary rotations over the course of three years. They may choose to have additional advanced acute care rotations based on career interests. A fourth block of ambulatory medicine at the same or different site may be added if the resident chooses to have one of his/her discretionary blocks to be an ambulatory block. One of the rotations in the PL-3 year is also taken call free, without any night or weekend call. Call responsibilities when not on Inpatient/PICU/ED blocks include weekend cross-cover for the inpatient units, sick call coverage, transport calls, and after-hours telephone coverage for the outpatient practice. There are four weeks of vacation, and holiday coverage is the same as described for the PL-1 year. Senior residents also have the opportunity to participate in internal moonlighting (additional call for additional pay). This allows for backup coverage staffing.

PL - 4 Chief Resident

Three chief residents are selected for their outstanding abilities in patient care, teaching and leadership. They receive faculty appointments. They work closely with residents, faculty, the program directors and the department chairman to facilitate the clinical and educational programs of the department. They provide on-site leadership at Connecticut Children's, at the NICU at UConn Health, at two urban academic primary care health centers, and in the community. They also provide consultative guidance throughout the program. They are given faculty appointments commensurate with their level.

The efforts of the chief residents are divided between supervision, service, and scholarly activities. They supervise scheduling, conduct housestaff meetings, participate on the Clinical Competence Committee and Resident Advisory Committee, and may participate in faculty meetings as well. They provide additional teaching support to residents and students, facilitate teaching conferences and evidence-based medicine conferences. They maintain a continuity clinic, supervise outpatient activities, and may attend on the inpatient service. They are involved in community service and resident social activities. They participate in hospital quality initiatives and may pursue scholarly endeavors preparing them for future careers. The chief residents play a major role in the program, and are provided a management and supervision retreat prior to, and during, the academic year to facilitate their planning and organizational skills. They are available on a rotating basis from home for acute problems, and they have four weeks of vacation. Each chief resident is provided support to attend an academic meeting during the year and they receive the same professional support as all other residents.