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Christian Wightman with his patients
Historically, the pediatric training of residents at this Family Medicine Program has been tightly integrated with the pediatric residency program of the University of Rochester. It's a wonderful environment for learning. The care of children is undergoing rapid transition, as new antibiotics, immunizations, and attitudes are introduced. The care of sick children is increasingly moving to an outpatient world. But pediatrics training at Rochester still has a wide base, including inpatient and outpatient services at Strong Memorial and Rochester General Hospitals, our office community practice, and community-based sites.
Special Care Nursery/Inpatient Night Float
During the R-1 year, residents spend two blocks at Rochester General Hospital. One block is an inpatient rotation split between a level II special care nursery and the inpatient pediatric floor. The SCN allows residents to learn the essentials of care for premature infants, newborns with sepsis, congenital problems, hyperbilirubinemia and other problems. The second two weeks is spent on the pediatric night float rotation admitting children, responding to the delivery room and covering the pediatric floor for acute issues. The PGY-1 works with an experienced pediatric PGY-3.
There is an additional structured 3rd year pediatric elective available to residents wishing more experience with newborn care. This 4-week rotation is situated at the Highland Hospital level II nursery. This is particularly useful elective for residents hoping to see newborns in their future practices and would like more experience.
Pediatric Emergency Department
The second block which is repeated in the second year is in the pediatric emergency department. The pediatric ED has attending presence 24 hours a day so there is easy access to teaching for residents. This very busy ED provides experience in a wide range of primary care problems including orthopedics. Residents primarily cover evening shifts (10 hours) when the census is at its busiest.
Golisano Children's Hospital Pediatrics
During the PGY-2 year there are two additional pediatric rotations. The first is a traditional inpatient rotation at Golisano Children’s Hospital at URMC. Residents are supervised by pediatric PGY-3s and gain experience in the work-up and diagnosis of childhood problems requiring inpatient treatment. This rotation has limited night duty as this is covered by a night float system staffed primarily by pediatrics. All of the residents on the pediatric service attend morning report and noontime teaching conferences.
The second PGY-2 rotation is an ambulatory block with experiences in outpatient pediatric cardiology, gastroenterology, developmental disabilities, school based health and primary care. The settings include URMC, community-based clinics, and local public and charter schools.
PGY-3 year has the last required pediatric rotation concentrating on acute pediatric issues seen in the office setting. This four-week rotation is based in the outpatient pediatric clinic at Strong Memorial Hospital. This rotation provides a same day and walk in clinic for children who use this practice as their primary care home. Precepting is provided by Pediatric faculty. A wide variety of pediatric issues are dealt with in this setting. Additionally, the resident on this rotation functions as a junior attending for pediatric patients admitting from our own outpatient practices helping to coordinate care and ensuring a smooth transition from the inpatient to outpatient settings.