Curriculum

Curriculum

The University of Connecticut Pediatric Residency Program is designed to provide its residents a progressive educational experience with increasing patient care and supervisory responsibility over a three-year period. The ultimate goal of the program is to provide educational experiences that prepare residents to be competent general pediatricians, able to provide comprehensive coordinated care to a broad range of pediatric patients. The educational experiences are designed to develop competencies and skills needed to practice general pediatrics of high quality in the community, and to have sufficient familiarity with the fields of subspecialty pediatrics to participate as a team member in the care of patients with chronic and complex disorders.

Written goals and objectives have been established for each of our experiences, created using the ACGME subcompetencies and milestones and with specific objectives for each level of training. Our individualized, mentored curriculum is tailored to each resident and provides flexibility in timing and experiences in preparing for the transition for the next step in their careers.

Individualized Curriculum

During their progression through the program residents will select a concentration and a pathway, at least by the end of their second year, and they will complete 6 educational units of activities plus the didactic instruction for their areas of pursuit. The concentrations are: primary care (community practice, general academic pediatrics), acute care (neonatal-perinatal medicine, critical care, hospital medicine and pediatric emergency care), subspecialty care (all other subspecialties) and population health (advocacy, global health), and the pathways are noted in parentheses. An educational unit is defined as one block rotation or 32 half days of longitudinal experience.

The 6 educational units and 7 required subspecialties are scheduled during 3 discretionary choices in the first year, 4 in the second and 5 in the third. This allows for early, delayed or changed decisions. The process of selecting individualized pathways will be a mentor-guided process, with the opportunity to incorporate some longitudinal activities as warranted. Each choice will have a required subspecialty and an open selection, and the rest will be guided by the menu of options developed specifically for the pathway selected and the resident’s interests.

Curriculum Selectives

Yearly Rotation Schedule

Yearly Rotation Schedule

Night Float:
All residents do 4 weeks of night team during the PL-1 year, 6 weeks during the PL-2 year and 5-6 weeks during the PL-3 year. The PL-1 assignments are done one week at a time as part of each 4-week inpatient assignment. The PL-2 and PL-3 assignments are done in two week assignments to the inpatient service and one-week assignments to the PICU. The night team resident is on call Sunday night through Friday night for PL-1 residents and Sunday night through Thursday night for PL-2 and PL-3 residents, from 5:45 p.m. to 7:15 a.m.

Inpatient Service Structure:
The inpatient teams assume primary responsibility for both general pediatric and medical subspecialty inpatients. Some surgical subspecialty patients are followed by pediatric residents in co-management, allowing exposure to these fields. General pediatric surgery is taught in the ED, via consults in the PICU, NICU, and inpatient services, and through elective experiences.

Residents participate on 5 inpatient teams:

Purple: provides care for mostly general pediatric patients admitted to the 7th floor, including the hospitalist service (Inpatient Management Team), as well as a few other medical subspecialties. It consists of a PL-3 senior resident and two PL-1 residents or equivalents (family medicine residents or Sub-Interns).

Silver: provides care for primarily subspecialty patients on the 7th floor including pulmonology, cardiology and neurology. It consists of a PL-3 or PL-2 senior resident and two PL-1 residents or equivalents.

Blue: provides care for primarily general pediatric patients on the 6th floor, including the hospitalist service (Inpatient Management Team), as well as a few other medical subspecialties. It consists of a PL-2 senior resident and two PL-1 residents or equivalents. An advanced practitioner is a member of this team who helps to make the assignments manageable, enhance education and facilitate compliance with duty hour standards.

Green: provides care for primarily subspecialty patients on the 6th floor including gastroenterology and nephrology patients. It consists of a PL-3 senior and two PL-1 residents or equivalents.

Red: provides care to patients admitted to the 8th floor, which are primarily Hematology/Oncology patients. It consists of a PL-3 senior and 1-2 PL-1 residents as well as advanced practitioners.

Yellow: staffed by advanced practitioners, provides care for patients admitted to the 7th floor including epilepsy monitoring unit and cardiac catheterization patients as well as hospitalist team patients, allowing a pop-off for rapid turnover of many of the low-acuity and observation admissions.

Evaluation

Resident evaluations are completed electronically and based on a competency-based curriculum for each experience with a clear delineation of expectations. The use of milestones helps residents know where they are performing and next expected skills. Feedback by the faculty is provided during each rotation, and final verbal and electronic evaluations are part of each block rotation. Electronic and oral progress reports are also provided by the program director. Each rotation has a designated core teaching faculty to facilitate orientation, curriculum development, feedback and evaluation. The Clinical Competence Committee tracks milestones in the areas of subcompetence, oversees the feedback and evaluation process and ensures that any remediation needs are addressed in the rare event this is needed. The spirit of this evaluation program is to promote the optimum growth and success for all residents in the program.

Work Duty Hours

The program is in full compliance with the ACGME Duty Hour standards. This is accomplished through the joint effort of faculty and residents, and includes the addition of senior night float assignments. We continually review our compliance and make adjustments as required. The changes have been favorably received and our duty hours policy is stated below.

University of Connecticut Pediatric Residency Program Duty Hour Policy

As required by the ACGME and the University of Connecticut, the Pediatric Residency Program has developed the following policy: It should be noted that the University of Connecticut Office of graduate Medical Education has an existing institutional policy that is applied in full with this policy and the institutional policy adds the opportunity for residents to report duty hour violations via a hotline telephone reporting system.

The duty hours policy is designed to help meet the educational needs of the resident, the needs of patients and families, including patient safety, and continuity of care. This policy is in compliance with institutional policies as well as with requirements of all relevant accrediting bodies, including the ACGME and Review Committee for Pediatrics.

Edwin L. Zalneraitis, M.D.
Director, Pediatric Residency Program

University of Connecticut Pediatric Residency Program, Connecticut Children's Medical Center.

Medical Education, 4H, 282 Washington Street, Hartford, CT 06106