In our more than 70 years of training pediatricians, we have trained many generalists throughout categorical residency program, but this is our first track specifically focused on training general pediatricians in community settings. This educational program focuses on teaching residents to become leading innovators in the Patient-Centered Medical Home, while still completing core components of general pediatrics training.
First year Primary Care residents complete the same requirements as our categorical residents. First year residents spend seven blocks on in-patent services (with only three of these being a "call" month), five blocks in an ambulatory setting, and two half blocks in elective time. In accordance with the 2011 ACGME duty hour restrictions, their longest “shift” is 16 hours, which occurs on an average frequency of every 6th night. To gain night experience, our interns do four total weeks on the night team that is broken up into two weeks at a time (with 5 days being the longest stretch of consecutive nights).
Second year Primary Care residents spend less time on inpatient and specialty services and instead spend six weeks at the MUSC Children’s Care Clinic Northwoods and three months at Georgetown Pediatric Center. Both of these sites provide experience working in the medical home serving underserved and at-risk children. Ambulatory experience at the Medical University is continued in the second year, with two month of ER and one month of adolescent medicine. Two and a half months of electives allows for the resident to focus on other outpatient specialty experiences useful to the future general pediatrician. In addition, three inpatient months round out the resident’s year, with time spent on the general wards, in the NICU, and in the PICU. Call responsibilities graduate to 28 hours maximum occurring at an average frequency of every fourth night in the PICU to 2-3 times a month during the general pediatrics ward month.
The final year of residency allows for continued community experience as well as additional elective time to focus on an individual’s interests.
The MUSC Pediatrics Residency Program recognizes that didactic learning is an important adjunct to clinical education. Our didactic curriculum includes both daily lectures as well as online resources for self-directed learning. All lectures are considered protected time – support staff are encouraged to refrain from paging residents during this time unless absolutely necessary.
In addition to daily conferences, Primary Care (PC) residents are involved in primary care-focused journal clubs and seminars designed specifically for this group. These sessions meet monthly. Because we also want PC residents to develop a sense of integration with communities and learn how to advocate for children, they attend the South Carolina Chapter of the American Academy of Pediatrics’ Annual Meeting in late July of each year. They also attend the annual meeting of the Pediatric Academic Societies, usually held in May of each year.
Morning Report occurs every Monday through Wednesday and is attended by medical students, residents, and faculty. This is a case-based, resident-driven conference with the primary educational goals of generating a differential diagnosis and management plan. It is an open forum such that all attendants are encouraged to participate, express their opinions, and share their knowledge. At the conclusion, a brief summary slideshow is presented highlighting the important aspects of the particular disease. The program’s educational website is used to archive each case presentation, the summary slideshow, references, and noteworthy commentary made by faculty, attendants, and guests for residents to review. Morning Report is consistently rated as a favorite conference by students and residents.
Board Review is scheduled every Thursday morning. This conference was started by residents and continues to be organized and run entirely by residents using an automated user response system. Upper level residents present questions taken directly from the Pediatrics Review and Education Program (PREP) and lead discussion on question analysis. Arranged by topic/organ system, Board Review marries academic knowledge with clinical experience. Subspecialists are invited to attend these Board Review sessions to promote further education.
Grand Rounds occurs every Friday in the Storm Eye Institute auditorium. Guest speakers are invited not only from the Medical University of South Carolina but also from institutions around the country. A wide range of topics and research are represented. All third year residents are also required to participate in a grand rounds warm up (15 minute lecture). All sessions are recorded and posted on the program’s educational website.
Noon Conference is held daily. Catered meals are provided to residents. Lecture topics are based on an 18-month curriculum designed to cover the content specifications listed by the American Board of Pediatrics. Speakers include faculty and specialized ancillary staff from all pediatric subspecialties. In addition, all second year residents give one presentation on a topic of their choice. Lectures are recorded and posted on the educational website so that residents may review them later. Those residents working at night or on rotations at off-campus locations are highly encouraged to “attend” lecture on their own.
Our Pediatric Simulation Laboratory opened during the 2008-2009 academic year and has become an important integrated part of our resident education. The state-of-the-art suite provides residents the opportunity to train and participate in mock codes and neonatal resuscitation using life-like simulation mannequins. Each mannequin provides real life experience with the ability to monitor vital signs, quality of chest compressions, and procedure practice. Residents also have the opportunity to teach medical students during their own course in the lab.
The Evidence-Based Medicine curriculum consists of a series of lectures during noon conference covering the basics of study designs, statistics and the use of relevant research in clinical practice. Residents participate by presenting their own critical analyses of journal articles. Over the course of three years, all residents develop and complete a Quality Improvement project. In addition, residents are encouraged to identify mentors and participate in other research projects. Many of our residents present their work at important national meetings each year, including the Pediatric Academic Societies annual meeting. A sample of publications and posters by our residents is below:
Becton L, Kalpatthi R, Rackoff E, Disco D, Orak J, Jackson S, Shatat I. Prevalence and clinical correlates of microalbuminuria in children with sickle cell disease. Pediatr Nephrol. 2010 Aug; 25(8):1505-11.
Fontenot B, Streck C, Hebra A, Cina R, Gutierrez P. Pyloric Atresia. Am Surg. 2011 Feb;77(2):249-50.
Ngwube A, Jackson S, Dixon T, Spampinato M, Losek JD. Disseminated Salmonella Osteomyelitis in a 2-Year-Old With Sickle Cell Disease. Clin Pediatr. 2011 May 18. [Epub ahead of print]
Scahill C, King K, McElligott J, Randazzo W. Implementing Physical Activity in a Public Elementary School and Its Effect on Academic Achievement. Poster and Platform Presentation. Pediatric Academic Society Annual Meeting. Denver, CO. May 2011.
The MUSC Pediatrics Residency training program is becoming a leader in electronic education and this year we have taken another leap forward. With the introduction of Moodlerooms© to the University we are able to post every educational conference on the original date for review at a later time. With the implications of the 2011 ACGME duty hour restrictions on conference attendance we are able to act preemptively by providing conference viewing electronically. This is in addition to contributions from each division that typically include rotation objectives, up-dated literature, and other professional tools.