The goal of the first year of pediatric training is to provide the new resident with the experience and skills necessary to care for patients with competence and compassion. To achieve this goal, a variety of opportunities for the resident exist.
In the clinics and on the inpatient units, the 1st year resident works under the supervision of senior residents and pediatric faculty members to provide primary care to all pediatric patients. An extensive schedule of educational conferences and lectures is developed for each academic year. Conferences in July and August are designed to review important aspects of acute pediatric care for incoming 1st year residents. Throughout the year, we have weekly protected time for resident conferences including morning reports, and Tuesday afternoon half-day didactic conferences which covers a core curriculum in all aspects of pediatrics. A full schedule of departmental and subspecialty conferences maintains the foundation of instruction by providing the resident with basic problem-solving skills and introducing them to new frontiers in pediatric practice.
Each inpatient service also provides learning experiences during daily work rounds with the ward resident and during regular teaching rounds with the attending. Ancillary health team members, including nursing staff, social service personnel, chaplains, hospital teachers, occupational and physical therapists, dietitians and pharmacists, often join the medical staff during rounds. First-year residents on inpatient services participate in teaching third-year medical students.
First-year residents have four weeks of night shift under the supervision of upper-level residents which allows for the practice of acute care management in a supervised manner while maintaining some personal autonomy.
The 2nd year program provides the resident with intensive training through manager-style clinical rotations in various pediatric subspecialties, including adolescent medicine and inpatient hematology/oncology. Each subspecialty has a core curriculum consisting of specific readings, self-teaching units, slides, lectures and discussion sessions. The resident performs consultations for hospitalized patients and works closely with the faculty in managing subspecialty clinics and evaluating patients.
Second-year residents will select an individualized longitudinal experience to create flexibility in their residency curriculum and encourage them to develop overall career goals early in their residency career. These tracts include primary care or adolescent medicine, public health/global health/advocacy, and subspecialty tracts. The longitudinal experience includes two weeks of half-day didactics with curricula developed by a tract director.
On the inpatient wards, the 2nd year residents spend four weeks on the hematology/oncology service, occasionally with an intern or fellow. The residents use the skills attained during their 1st year to serve as the primary care provider while having direct support and supervision as they take on more independent roles in patient management. In addition, the 2nd year resident serves as the junior house officer and shares duties with the 3rd year on inpatient ward rotations. During this rotation, they also act as the designated teaching resident, with responsibility for leading teaching sessions for medical students and performing literature searches on clinical questions that arise during rounds. Each 2nd and 3rd-year resident does a maximum of one 24-hour shift per week on the inpatient ward rotations.
In most cases, overnight coverage for the inpatient ward teams is provided by a night shift system. Each 2nd year resident does four weeks of night shift over the course of the year. Night shift duties consist of supervising the 1st year residents in their clinical decisions and managing the inpatient hematology/oncology team and newborn nursery. The 3rd year resident managing the other teams is available for assistance.
On the neonatology service, the 2nd year residents fill a variety of roles – during the day they are responsible for managing their own assigned intermediate and intensive patients. At night the 2nd year residents provide coverage five days per week alongside a neonatal nurse practitioner, and a fellow or attending physician. This provides them the added exposure to procedures and delivery room activities.
The daytime Pediatric Intensive Care Unit (PICU) is staffed by multiple residents and NPs who are the primary caregivers to all patients admitted. At night, there is a PICU attendings, provide supervision and teaching and there is frequently a fellow as well. The majority of 2nd year residents are assigned daytime rotations only in the PICU in order to gain experience with management of respiratory failure, sepsis, trauma and multi-organ system dysfunction. For more information, see our PICU section.
In addition to their one half-day session per week in the Pediatric Group Practice while on outpatient and elective blocks, 2nd year residents spend one half-day per week while on subspecialty and outpatient rotations either in research activities or assigned to a clinic in the field that is related to their longitudinal tract.
While on outpatient rotations, call primarily consists of answering phone calls at home from continuity clinic patients and parents. All residents have one call-free month per year.
The third-year provides the resident with extensive supervisory experience that builds on the 2nd year foundation. The 3rd year resident supervises one of the inpatient teams in the Children’s Hospital of Richmond at VCU and follows the progress of all patients on non-surgical services. The 3rd year resident is responsible for organizing and conducting daily work rounds, facilitating discussion during attending rounds, providing guidance to the 2nd year resident in their teaching role and providing direct oversight of the 1st years and medical students. The PGY-3 also responds to rapid response calls, code blues, and general pediatrics consults.
Like the 2nd year resident, 3rd year residents will continue in their individualized longitudinal experiences, although they have the option to switch tracts as well. The longitudinal experience during this year includes two weeks of half-day didactics with curricula developed by a tract director. In total, each tract member will have four weeks of specific tract-directed didactics between the 2nd and 3rd years.
During the year, the 3rd year resident continues to have exposure to a variety of pediatric subspecialties. There also are elective opportunities to work on other services in the medical center such as dermatology, orthopedics, child psychiatry, and radiology. Third-year residents to spend one half-day per week on research or a clinic in the field of their longitudinal tract while on all outpatient or elective rotations, in addition to their one half-day in the resident continuity clinic during those weeks.
In general, the 3rd year works one 24-hour shift per week while on the inpatient ward teams. Third-year residents are assigned to PICU nights for one of their 3 two-week blocks. Night shifts are also covered by rotating 3rd year pediatrics residents from other programs as well as 3rd year EM residents. Third-year residents also provide weekday overnight coverage for the two inpatient ward teams through a night shift system. Night shift duties consist of supervising the 1st years in their critical decisions, teaching and managing of the ward teams. The 3rd year is also available to assist the 2nd year resident who manages the hematology/oncology service and newborn nursery. Each 3rd year resident does four weeks of night shift over the course of the year. In addition, the night shift resident acts as the House Officer of the Day and plays a backup role to assist across the hospital in the event of an emergency.
VCU utilizes New Innovations, an online evaluation program. Each month faculty and residents are required to complete evaluations through New Innovations; faculty evaluate residents and residents anonymously evaluate the faculty and other residents. The evaluations committee is comprised of faculty members who review the residents’ evaluations as well as their fulfillment of residency requirements. Residents meet four times a year with a member of the evaluations committee to review their files and receive feedback.
Residents log all patient encounters into New Innovations. This includes all inpatient, continuity and subspecialty patient encounters.
Pediatric and medicine-pediatrics residents are required to document procedures as proof of technical skill. Only successful procedures need to be logged. Certification and proficiency in procedural skills will be determined according to the Department of Pediatrics policy on procedural competence.
Our curriculum emphasizes the delivery of compassionate medical care, an active role in child advocacy, a dedication to community service, a plan for lifelong learning and a desire for the advancement of medical knowledge. These are the essential qualities that we believe define an exceptional pediatrician.
Learn more about our curriculum:
Residents are selected through the National Resident Matching Program. You must apply using the ERAS System.