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Training and Curriculum

Pediatrics residency

Overview

The curriculum in general pediatrics fulfills the requirements specified by the American Board of Pediatrics. For an overview of this curriculum, please see the rotation and conference descriptions below. Our goal is to provide the highest quality education in general pediatrics to allow residents to be successful leaders in all fields of pediatrics. The Curriculum Committee oversees the innovative Education Manager (EM) System, which has gained national attention. The EM System is based on fourteen Educational Areas that represent the key practical areas for resident education, integrated throughout the entire curriculum. Each Educational Area is led by an Education Manager, a Duke faculty member specially trained in graduate medical education. The Education Managers are supported by the Curriculum Committee in developing meaningful goals, objectives, instructional strategies, and evaluation strategies to promote resident learning. The pediatric residency curriculum is available as the “Curriculum Online for Resident Education” or CORE. CORE is accessed from our Residency Management System called MedHub. Before the start of each rotation, MedHub will email each resident all corresponding curriculum documents for that rotation six days prior to starting. Residents will have access to all CORE documents for all rotations any time during the training year.

Hands-On, Team-Based Training

The three-year residency curriculum is designed to develop outstanding pediatricians that are well-prepared to take their training in pediatrics in whatever direction they choose. During the training period, resident responsibilities are increased to develop confident, independent physicians. Residents are supervised by a faculty committed to teaching, clinical care, and research.

Each of the recognized pediatric sub-specialty services is available at Duke Children's Hospital & Health Center. The Department encompasses the Divisions of Allergy and Immunology, Cardiology, Child Development and Behavioral Health, Child Abuse, Critical Care, Education, Endocrinology, Gastroenterology, General Pediatrics, Infectious Diseases, Hematology-Oncology, Metabolism-Genetics, Nephrology, Neurology, Perinatal Medicine, Pulmonary, Rheumatology, and Global Health.

The Division of Pediatric Surgery within the Department of Surgery offers a full complement of surgical faculty and services to pediatric patients. The Department of Radiology supports a dedicated Pediatric Imaging Center staffed by trained pediatric radiologists. Likewise, the Duke Emergency Department contains a separate Pediatric Emergency Center with dedicated staff.

Since the Durham area is a true "melting pot" of cultures, races, and ethnicities, a goal of the training program is to prepare trainees to participate in the global care of children. Philanthropic support from the Burroughs Wellcome Fund, Dr. John P. McGovern, and the Lenox Baker Children's Hospital Foundation, Inc. allows the program to offer experiences in select sites for trainees to explore healthcare in other countries.

Throughout their residency training, residents spend one half day a week in their Continuity Clinics, where they provide primary care for patients and families. The Continuity Clinics are patterned after a group practice model and are supervised by attending physicians within Duke Children's Primary Care. One of these faculty members is dedicated to the overall functioning of the Continuity Clinics with the help of appropriate support personnel. To emphasize the importance of the resident as a primary care provider, residents are provided with personalized business cards to distribute to their patients.

The residency curriculum is evaluated continuously by a curriculum committee composed of faculty and chief residents. The Residency Council (a resident-run organization) also meets regularly to discuss any proposed changes. Changes are discussed and implemented based on committee recommendations.

Commitment to Fostering Excellence

As all physicians are committed to fostering excellence and leadership in teaching, residents play important roles in this process, both as learners and as teachers. Educational activities sponsored by the Department include daily rounds with faculty members, didactic conferences, and weekly Grand Rounds. As part of its commitment to excellence in training, the program realizes that no single approach can encompass how individuals learn and respond to the experiences they will encounter in a pediatric residency. The program utilizes measures of learning styles to help each resident maximize his or her learning experience.

Duke residents provide much of the teaching for medical students, with appropriate faculty backup. Second-year students, during their required six-week clerkship in pediatrics, spend time with residents on the wards, in the nursery, in the Emergency Department, and in the outpatient clinics. Annually, the students honor a pediatric resident at each level of training for excellence in teaching.

While residency training can be challenging, training program leaders are attentive to the multitude of issues that affect a resident's life. Every resident is assigned an advisor and a mentor. In addition, each resident has time to meet regularly with the program director and chief residents. The Department of Pediatrics also sponsors many social functions throughout the year. These have included resident retreats, picnics, gatherings and holiday parties. 

Chief Residents

The chief residents are faculty members of the Office of Pediatric Education and work closely with the program director and the Vice Chair of Pediatric Education in planning and conducting the teaching and patient care activities of the department. Additional duties include overseeing the resident staff activities and arranging resident schedules and conferences.

House Office Continuity Clinics

Continuity clinic is a core facet of pediatric residency training.  At Duke Pediatrics, residents are assigned to either the Roxboro Road or South Durham clinic site at the start of their residency training and continue at this same site for all 3 year.  Each resident inherits a panel of patients from a graduating resident and continues to add to this panel as they rotate through the full term nursery, NICU, same day clinic, emergency department and the ward.  By the end of 3 years you will be sad to say good bye to families who you have gotten to know well and they will sorry to be saying good bye to you as well.  Our primary care medical home has an incredible multi-disciplinary team.  You will have the opportunity to work with a great group of faculty preceptors, fabulous Spanish interpreters, lactation nurses, mental health professionals, nurse clinicians and social workers.  All in all we care for the majority of patients covered by Medicaid in Durham and our patients also come from a number of surrounding counties. Click here for a brief tour of the clinics.

 

Rotations

PL-1

The PL-1 rotations include the full-term nursery, the intensive care nursery, inpatient services, ambulatory clinics, a community hospital, the emergency department and two to three subspecialty experiences. The PL-1 has primary responsibility for the care of inpatient and outpatient infants and children. PL-1s work as part of an interdisciplinary team that includes senior residents, faculty, and other personnel.

PL-2

The PL-2 year currently includes supervisory rotations on the wards, both at Duke and at a community hospital. During supervisory rotations, PL-2s oversee PL-1s and medical students. In addition to subspecialty experiences, PL-2s have rotations in adolescent medicine, behavior and development, community outreach and advocacy, the emergency department, and the pediatric intensive care unit. PL-2s also may rotate at Lincoln Community Health Center (LCHC)--a community health center dedicated to the care of a large medically underserved urban pediatric population.

PL-3

The PL-3 year currently includes a wide variety of required and elective experiences. PL-3s serve as the senior supervisory resident in the intensive care nursery, on the general inpatient services, and in the general pediatric ambulatory facility on Roxboro Road. PL-3s also have rotations in the emergency department and at Duke’s Lenox Baker Children’s Hospital where residents learn the principles of rehabilitative medicine. They also have the opportunity to work 1:1 with a hospitalist for 2 weeks on the inpatient complex care service. The program also includes many individualized elective rotations during the PL-3 year to add breadth and depth to each resident’s experience, while also allowing the resident to tailor his or her education to his or her personal and career goals.

Representative Pediatric Rotations

     
PL-1
Rotation Months Duty Period
General Inpatient Wards 3 Day/Night Teams
Inpatient Subspecialty Wards 1.5 Day/Night Teams
Full Term Nursery 1 Day Team
NICU 1 Day Team
Community Hospital 1 Day/Night Teams
Acute Care Clinic 1 Day Only
Emergency Medicine 1 Shifts
Electives/Individualized Curriculum 2.5 Jeopardy
PL-2
Rotation Months Duty Period
Inpatient Subspecialty Wards 2 Day/Night Teams
Community Hospital 1 Day/Night Teams
PICU 2 Day/Night Teams
NICU 1 Night Team (in 2 week blocks)
Emergency Medicine 1 Shifts
Community Health Center 1 Day Only
Behavior & Development 1 Day Only
Electives/Individualized Curriculum 3 Jeopardy
PL-3
Rotation Months Duty Period
General Inpatient Wards 2-3  Day/Night Teams
Community Pediatrics 1 Day Only
Emergency Medicine 2 Shifts
Acute Care Clinic Chief 1 Day Only
Adolescent 1 Day Only
NICU 1 Day Only
Electives/Individualized Curriculum 3-4 Jeopardy

Jeopardy Call: Home call to come in and cover if one of your colleagues is unable to work.

Night Team: Variable hours depending on rotation. Shift begins between 4p-6p and ends between 8a-12p.