Pediatric Residency About the Program

The Pediatric Residency Program at the Herman and Walter Samuelson Children’s Hospital takes a comprehensive approach to helping pediatric interns grow into leading authorities on healthcare for kids. From clinical development to integrated research, our residents enter the world of pediatric medicine with a well-rounded skillset and the knowledge they need to become field leaders.

Sinai Hospital of Baltimore’s Pediatric residency program has a strong academic affiliation with The Johns Hopkins University School of Medicine. Residents in our program gain extensive clinical experience by working with patients in inpatient and ambulatory settings at Sinai as well as through core and elective rotations at The Johns Hopkins Hospital.

Adolescent Medicine

The adolescent medicine rotation is a favorite of many residents. This month, residents work with Dr. Oscar Taube, a board-certified adolescent medicine specialist whose easy and eager teaching style makes this rotation a uniformly positive experience. The main highlights of this rotation are working at the local Loyola University Student Health Center and The Arrow Project, a residential diagnostic and treatment center for troubled adolescents.

Behavior and Development

During the first year of residency, residents will spend two weeks at the Kennedy Krieger Institute rotating through the following departments: Center for Autism and Related Disorders, Clinic for ADHD, Concussion Clinic, Neuro-genetics and Neuro-developmental disabilities clinics, and the Cerebral Palsy Clinic.

Continuity Clinic

All residents are assigned one half-day per week for their continuity clinic, which typically remains the same throughout the three years. All residents have their patient panel for which they are responsible. Residents can be scheduled for up to six health maintenance visits in each clinic. The continuity clinic teams and their preceptors quickly become a close-knit group, and, for many residents, the continuity clinic is something they look forward to every week.

Greenspring Pediatrics Outpatient Subspecialties/Outpatient with Call

In addition to weekly continuity clinics, each resident spends three months at Greenspring Pediatrics, our outpatient clinic located on campus. Residents gain insight and experience into the inner workings of an outpatient pediatric office and are responsible for all acute visits and some health maintenance visits. Third-year residents typically precept and supervise the first-year residents. Third-year residents take night calls for the clinic approximately every fourth night, including two weekends per month. In addition, there is a social worker and education coordinator present on site.

Emergency Medicine

All residents spend three months in our pediatric emergency department. Each resident typically has 14-18 twelve-hour shifts in a month. Residents not only see a wide variety of patients but can also master procedures, including lumbar punctures, peripheral intravenous catheterization, suturing, and splinting of fractures.

Well-Baby Nursery

This one-month rotation in the first year of residency allows the first-year residents to develop a sense of normalcy in the newborn, which is an essential step toward recognizing pathologies. Residents are responsible for examining all the neonates daily and rounding with the on-service neonatologist, who is readily available throughout the day to teach and answer any questions. Residents also attend all high-risk deliveries.

NICU

Our NICU is a 22-bed Level III facility with the ability to handle a variety of neonatal problems. Sinai Hospital has more than 2,500 deliveries each year, allowing residents ample opportunity to acquire neonatal resuscitation skills. In addition, admissions are received from many outside institutions. The residents' learning experience includes attending all high-risk deliveries, daily morning attending rounds with the staff neonatologists, weekly core neonatology conferences and resident presentations germane to the month. Also, a weekly perinatal conference is held with the Department of OB/GYN regarding management and follow-up of patients. Residents are expected to take call every fourth night with an on-call neonatologist as backup for any problems.

Inpatient Pediatrics

Each month the inpatient team consists of two interns and two senior residents. During the month, residents care for a variety of diseases in General Pediatrics, Oncology, Gastroenterology, Endocrinology and other subspecialties. Other subspecialties include our newest addition of the Rubin Institute of Advanced Orthopedics, which provides pediatric housestaff with an opportunity to post-operatively manage children with limb deformities. Residents gain invaluable experience in post-operative management of complex pediatric orthopedic patients, including pain management. In addition, pediatric housestaff follow all surgical admissions to ensure these patients receive appropriate care. Private pediatricians and our inpatient director, Dr. Joanne Lanzo, provide supervision. The management of all patients is discussed daily during Family Centered Rounds, which take place each morning. The interdisciplinary team of caregivers shares information at the patient's bedside so they can work effectively as a team. Call is taken as part of the night float system. Formal teaching sessions include family centered rounds and attending rounds. Residents are also responsible for the instruction of approximately four medical students per month.

Pediatric Intensive Care

The curriculum provides two months of intensive care experience in our state-of-the-art 7-bed Intensive Care Unit. During these months, residents are exposed to a variety of critically ill children, including patients with respiratory failure, metabolic and hematologic derangements, traumatic injuries, and critically ill post-surgical patients. Residents become familiar with ventilator management, conscious sedation and a variety of remote procedures under direct supervision of one of three critical care attendings. Instruction is provided during morning work rounds, didactic teaching sessions and throughout the day. Call occurs every fourth night.

Gastroenterology

As part of the first-year curriculum, every resident spends one month in pediatric gastroenterology. During the rotation, residents evaluate and treat patients with common GI complaints in the outpatient clinic and join the attendings in consults on the inpatient service. Residents are also able to observe procedures, including endoscopies and colonoscopies.

Advocacy

During this 2-week rotation, residents are afforded the opportunity to improve the health of children outside of the hospital/in clinic setting. Residents commonly get involved in administration of health legislature, bill defense at the state level, and are also able to work with the American Academy of Pediatrics.

Hematology/Oncology

During the second year, residents spend one month in the outpatient hematology-oncology clinic. Residents typically see all new referrals to the clinic, patients in active chemotherapy, long-term cancer survivors, and follow-ups for chronic hematologic diseases. Residents also attend interdisciplinary team meetings, review peripheral smears, and present a topic of their choice at the end of the rotation.

Cardiology

During their third year, residents spend one month at the pediatric cardiology clinic at the Johns Hopkins Outpatient Center, including exposure to fetal cardiac diagnoses and pediatric echocardiography. Residents may also attend cardiac catheterization procedures, round on the inpatient services, or join the clinical faculty at one of several off-campus offices where many of our patients are seen.

Individualized Curriculum (IC)

Our program has five subspecialties built into the curriculum: adolescent medicine, behavior and development, hematology-oncology, gastroenterology and cardiology. In addition, residents have 28 weeks through three years for which they can plan IC rotations based on their chosen curricular track along with the support of a track/career mentor. Johns Hopkins Hospital and the University of Maryland Medical Center are popular choices for scheduling electives locally. There are also opportunities to schedule electives outside the Baltimore area, along with global health trips.

Interns/PGY-1

Inpatient Pediatrics: Interns alternate short and long days with short days lasting approximately 10 hours and long days approximately 13 hours. Interns work 3 weekend shifts per inpatient floor block with one call-free weekend during the rotation.

NICU and Nursery: Interns work two 12-hour shifts on two Saturdays and two Sundays per month. Residents are completely off for two weekends.

Night Float: A total of one month over the course of the year separated into two-week blocks. There is one night off each week.

Outpatient/Elective Rotations: Interns cross-cover on the weekends on the general inpatient floor approximately two to three 12-hour shifts over the course of the rotation. Interns may have “jeopardy” or “at risk” for 2-week periods while on outpatient/elective rotations.

ER: Residents cover 8 shifts in a 2-week block and 15 shifts in a 1-month block.

PGY-2 and PGY-3 Residents

Inpatient Pediatrics: Senior residents rotating on the inpatient floor work two Friday 24-hour shifts and two Saturday day shifts during the inpatient rotation months.

Night Float: An average of one month over the course of the year separated into two-week blocks. There is one night off each week.

Intensive Care Units: Residents take call on average one night per week.

Electives: Residents cross-cover 1-2 times per month either on a Sunday or in the PICU for a 24-hour shift.

ER: Residents cover 8 shifts in a 2-week block and 15 shifts in a 1-month block.

Call schedules are fully compliant with all ACGME duty hour regulations including maximum shift lengths for PGY-1 residents, required call free/duty free periods and maximum hours worked per week for all residents.

The Herman & Walter Samuelson Children's Hospital offers a variety of pediatric specialty services for our residents.

• Adolescent Medicine/ Outpatient Services

• Neonatal Program

• Pediatric Cardiology

• Pediatric Endocrinology

• Pediatric Gastroenterology

• Pediatric Hematology and Oncology

• Pediatric Neurology

• Pediatric Surgery

Noon Conference

Noon conference is a core component of the didactic curriculum. Lectures are given by faculty as well as guest speakers from different disciplines. Core lectures (i.e., fluid and electrolytes, anemia, antibiotics, etc.) are covered on a yearly basis, and other topics are covered on a rotating one-and-a-half to two-year cycle. This daily conference provides a wonderful educational opportunity for residents in an active setting. This is fully protected time for the residents.

Discharge Conference

This popular weekly conference is attended by both faculty and house staff. Patients with interesting diagnoses or who have presented with diagnostic dilemmas are the focal points of this conference. Residents actively participate by presenting the selected cases along with a short discussion of the topic of interest. This conference stimulates exciting discussion among participants ranging from patient presentation and diagnosis to treatment/management. This conference is designed to facilitate and promote academic interaction between house staff and faculty and includes care from all inpatient, ICU and outpatient venues.

Ethics Conference

Monthly conference reviewing a case from our hospital (inpatient ward, PICU, NICU, ER, Outpatient) and the ethical dilemmas that arose during the care of the patient. The conference is led by residents and facilitated by the Chairman of the Sinai Ethics Committee.

Grand Rounds

The highlight of this weekly conference is the distinguished speakers from major academic centers who speak on contemporary issues in pediatrics.

Perinatal Conference

This is a weekly conference that is held every Thursday morning together with the Neonatal Intensive Care Unit team and the Maternal-Fetal Medicine team to discuss imminent high-risk deliveries. During one of these weekly conferences, Pediatric and Obstetrics and Gynecology residents will work together to create and deliver a lecture on a pre-selected topic.