Rotations

Tertiary Care Inpatient Pediatrics

  • A PHM fellow rotates through a minimum of 6 blocks (24 weeks) in tertiary care inpatient pediatrics, co-management, procedural sedation and pain management, and palliative care rotations at this primary site during the 2 years of fellowship.
  • Connecticut Children's is a 187 bed freestanding, tertiary care children's hospital which serves as the primary training site for the Department of Pediatrics at the University Of Connecticut School Of Medicine, supported by a full range of pediatric medical, mental/behavioral health, and pediatric surgical subspecialty services, a pediatric emergency department, trauma center, level 4 NICU, PICU with ECMO capabilities, dedicated operating room space, a Center for Excellence Center for Procedural Sedation, and a full regional ground transport team.
  • Additionally, a full complement of pediatric ancillary services including pediatric-specific physical and occupational therapists, speech and language pathologists, pharmacists, registered dieticians, respiratory therapists, child life therapists, registered nurses, and licensed clinical social workers participate in a multidisciplinary care team approach for pediatric inpatients.
  •  At Connecticut Children’s, the fellow is exposed to the full spectrum of acuity, from straightforward common conditions, to highly complex, children with medical complexity and technology dependence. High level respiratory support is provided on the inpatient units, affording a robust clinical experience.
  • Care on the inpatient medical units is provided by teams comprised of 1 PHM fellow, a senior resident, 1-2 interns, and 1-2 medical students, as well as in dedicated teams of 1-2 pediatric medicine advanced practice providers with faculty support.
  • Eighteen board-certified, University of Connecticut faculty PHM attendings supervise care to the degree appropriate for the trainees developmental level, including during on-site evening shift coverage, and off-site home overnight call with 24/7 PICU attending on-site presence.

    Community Inpatient Pediatrics

    • PHM fellows will spend 1 block (4 weeks) of their first year rotating at the Connecticut Children’s pediatric inpatient unit at St. Mary’s Hospital in Waterbury, CT, and underserved and urban area.
    • The inpatient pediatric unit at St. Mary's Hospital is an 11-bed inpatient unit operated by University of Connecticut faculty and Connecticut Children's bedside staff, housed within the adult hospital system of St. Mary's Hospital.
    • As a community pediatric unit, inpatient care is provided in a multidisciplinary educational and clinical team including faculty board-certified pediatric hospitalists, pediatric advanced practice providers, pediatric registered nurses, and 3rd-year medical students on their inpatient pediatric clerkship.
    • With access to pediatric surgeons, telehealth pediatric psychiatry, and telephone support from the full complement of Connecticut Children's pediatric specialties, patients are admitted to this unit for a wide array of common pediatric conditions, including hyperbilirubinemia, failure to thrive, status asthmaticus, pneumonia, respiratory failure, skin and soft tissue infections, sepsis, neonatal fever, dehydration, seizures, disordered eating.
    • Given the presence of 3rd year medical students as part of the care team, the PHM fellow will have additional opportunities to provide bedside clinical teaching, informal and formal didactic teaching, and potential mentorship for the junior medical students.

      Newborn Medicine and Advanced Community Inpatient Pediatrics:

      • Fellows will spend 4 weeks during their second year rotating at Danbury Hospital for inpatient community pediatrics and newborn care.
      • The inpatient pediatric unit at Danbury Hospital is an 8-bed inpatient unit operated by University of Connecticut and Connecticut Children's PHM faculty, housed within the adult hospital system of Nuvance Health.
      • Additionally, PHM faculty also staff a busy normal newborn nursery service. As a community pediatric unit, both inpatient pediatric and normal newborn care is provided in a multidisciplinary educational and clinical team including faculty board-certified pediatric hospitalists, pediatric advanced practice providers, pediatric registered nurses, and 3rd-year medical students on their inpatient pediatric clerkship.
      • With access to telephone support from the full complement of Connecticut Children's pediatric specialties, patients are admitted to this unit for a wide array of common pediatric conditions, including hyperbilirubinemia, failure to thrive, status asthmaticus, pneumonia, respiratory failure, skin and soft tissue infections, sepsis, neonatal fever, dehydration, and seizures.
      • All newborns admitted to the newborn nursery, or roomed-in with their birthing parent, receive normal newborn evaluation and care, as well.
      • A full NICU team is available for clinical deterioration and/or delivery-rated complexity.
      • Given the presence of 3rd year medical students as part of the care team, the PHM fellow will have additional opportunities to provide bedside clinical teaching, informal and formal didactic teaching, and potential mentorship for the junior medical students.

        Pediatric Palliative Care

        • Fellows have 1 block (4 weeks) in their first year on the pediatric palliative care service, working in a multidisciplinary team of board-certified palliative care physicians, advanced practice providers, and nurses.
        • Opportunities for longitudinal care for a child receiving palliative care will be offered, with specific education and supervision provided for end-of-life care, as applicable.
        • A supportive environment for debriefing difficult conversations and patient issues is provided throughout the program, emphasized during this block to support fellow well-being.

          Procedural Sedation and Pain Management

          • Fellows have 4 weeks in procedural sedation and pain management during their second year of fellowship.
          • Fellows will learn procedural sedation basics through an interactive in-person simulation curriculum.
          • Fellows will provide care for patient’s requiring procedural sedation for inpatient or outpatient procedures in the Procedural Sedation unit, a Center for Excellence in pediatric sedation care.  Fellows will be supervised directly by pediatric sedation physicians from the divisions of PHM, EM, and PICU.
          • In addition, time spent in inpatient pain management consultations with the pain management multidisciplinary team where more advanced pain management techniques and modalities are explored for children with.

          Individualized Curriculum/Electives

          • Each fellow has 8 blocks (32 weeks) of individualized curriculum throughout the two years of fellowship, offered 4 blocks each during both 1st and 2nd year of the PHM fellowship to allow for early exploration or new exposure to areas not encountered in pediatric residency, as well as deepening of skills as the fellowship progresses toward graduation to solidify a firm foundation for the transition to junior attending level.
          • The individualized curriculum is designed to meet the fellow’s personal goals. At the start of the academic year, fellows will complete an individualized learning plan, outlining their strengths and their areas of desired focus.
          • Elective rotations in both clinical pediatric medicine at the tertiary care and community sites will be offered to supplement higher-level understanding for inpatient management of specific patient subtypes.
          • Non-clinical elective rotations in medical education, healthcare administration, quality improvement and patient safety, and advocacy/global health will be offered in 2-4 week blocks, with longitudinal components, as applicable to the specific content, to allow for further development of the fellows’ professional skills.
          • Upon entry to the program, the fellow will be matched with a career mentor within the PHM division with expertise in coaching to achieve professional goals.  This person will serve as a mentor in guiding the fellows’ selection of elective rotations to suit their needs.  experiences that will provide the optimal, individualized curriculum for each fellow.