Clinical Experience

Inpatient Pediatrics

The inpatient team consists of a pair of senior residents and a pair of junior residents. All specialty patients except for hematology-oncology patients are admitted to the general pediatrics service.

This general pediatric service is led by an academic pediatrician and occasionally by a pediatric specialist. The hematology-oncology patients are admitted to the pediatrics heme-onc service under a pediatric hematologist-oncologist. No patients are admitted to the hospital under a faculty-only service. Pediatric residents take care of all inpatients.

The pediatric inpatient service practices family centered rounds. This means that rounding is done at the bedside with the patient and family at the center. All members of the care team — including physicians, medical students, nurses, pharmacists, and social worker — are present in the room for these rounds. Both patient care and teaching are done with the patient. FCR allow for improved communication both within the care team and with the families and have been shown to increase family satisfaction.

• PL1 residents will do three months of inpatient, including 2 weeks of junior night service during one of those months.
• PL2 residents will do two months of inpatient, the first one paired with a PL3 co-senior when possible.
• PL3 residents will do one to two months of inpatient and four to six weeks of night service.

KU Pediatric Intensive Care Unit

PICU team participates in the care of critically ill and injured children not only in the PICU but also in the Burn ICU, Surgical ICU and Neuro ICU. The Pediatric Procedure Room is also located in the PICU and the PICU senior assists with pediatric procedures and sedations when patient care responsibilities permit.

PL2 residents will do one month of KU PICU. The sixth ICU month in the PL3 year may be spent in the NICU, PICU, or a combination of the two.

Children's Mercy Pediatric Intensive Care Unit

PL3 residents will complete their second required PICU month in the PICU at Children's Mercy. During this rotation, residents will be expected to perform at or above the level of a PL2 resident. Prior to rotating to the CMH PICU, residents will have completed the following prerequisites: Cardiology rotation, KU PICU, supervisory inpatient experience, and PICU on-line learning modules.

Pediatric Surgery

The pediatric surgery service at KU covers the gamut of general pediatric surgical cases. The pediatric surgery rotation is a required specialty rotation for all pediatric residents typically at the senior level. During this rotation, the pediatric resident will learn to recognize and diagnose common surgical problems, evaluate post-operative outcomes, determine when to refer a patient to a pediatric surgeon, and will be given the opportunity to see the pathology directly in the operating room.

Neonatal Intensive Care Unit

The NICU service consists of one senior supervising resident and one to two junior residents under the supervision of neonatologists. Neonatal nurse practitioners serve a diverse role, including teaching and 24/7 patient care with coverage of overnight and weekend calls.

PL1 residents will do two months in the NICU and PL2 residents will do one month. The sixth month of ICU in the PL3 year may be done in the NICU, the PICU, or in a combination of the two.

Full Term Nursery

The FTN service will have one senior resident every month and one to two junior residents, one of whom may be a Family Medicine resident. General pediatricians will serve as the attending physicians. Our pediatric nurse practitioner serves the nursery in a diverse role including teaching and patient care.

PL1 residents will do one month in the FTN, and PL2 residents will do one month. PL3 residents may also do an additional two to four weeks in the FTN.

Emergency Services

Our Emergency Department is staffed by both EM trained faculty as well as IM, FM and Med-Peds trained faculty. Residents will be assigned to see patients by the attending. Although the ED serves pediatric and adult patients, every effort will be made to have pediatric patients seen by the pediatric resident. The focus of the ED triage process when there is a pediatrics resident on should be for the pediatric resident to see all the children. The ED is a particularly busy place for gynecology cases, lacerations, and simple injuries requiring casting and splinting that are similar in adults and children and which provide opportunities for required procedures. Residents will also be assigned a procedures shift for additional experience in performing procedures such as IV starts, venipuncture, arterial sticks, and bladder catheterizations.

Same Day Sick Clinic (also known as Acute Care or Urgent Care)

The Same Day Sick Clinic serves children who are sick or who have minor injuries. There is usually as senior resident and one to two junior residents assigned to the clinic. Often there is also a Family Medicine resident (or two) scheduled. Medical students are also assigned to Urgent Care on a weekly basis. This clinic is staffed by general pediatricians.

Center for Child Health and Development

The CCHD is a training, service and research facility represented by the disciplines of developmental pediatrics, audiology, speech pathology, psychology, special education, physical therapy and occupational therapy, nursing, social work, nutrition and neurology. The CCHD sees over 3,000 children a year for multi-disciplinary evaluation of neurodevelopmental disorders or children with special health care needs.

Continuity Clinics

The continuity clinic is designed to provide each resident the experience of providing longitudinal, continuous and comprehensive pediatric care over the duration of their three-year training period. Continuity clinic permits the opportunity of delivering both acute and chronic care as well as well child supervision and anticipatory guidance. Each resident's panel of patients will be accrued from a variety of sources, which may include hospital discharges, newborns discharged from the nurseries, patients seen in the ED or Urgent Care Clinic, and patients who had previously been followed by a resident completing training. Each half-day is assigned a general pediatrician who serves as the preceptor for that clinic. A primary clinic can be at KU or at the Prairie Village office so long as at least 36 weeks of clinic are done at the same location.

Call and Junior and Senior Night Service Rotations

Inpatient Calls: Call on inpatient includes the Inpatient Pediatrics Service and the PICU as well as occasional calls to the term nursery. Four to five nights a week, overnight call is covered by a night senior and this year, the program is experimenting with the best way to implement a night junior schedule so as to maintain compliance with the new duty hour guidelines starting in July 2011. Residents on the inpatient will average one call per week with full night service coverage and residents on outpatient rotations will average two to three calls per month.

NICU Calls: Only residents scheduled in the NICU take call in the NICU averaging one call per week.

Home Call, Back Up Call, and Professionalism Call: Senior residents and junior residents in their fourth quarter of training take Mommy Call from 4:30 to10 p.m. Monday through Friday and from 8 a.m. to 10 p.m. on weekends. These calls are spread amongst all residents available for call in a given month and are not so frequent as to preclude adequate rest or personal time. The resident assigned to Home Call also serves as the back-up resident for cases when coverage is needed for resident illness or busy volumes.

Professionalism call is assigned to residents with lapses in professionalism such as incomplete educational assignments or clinical lapses such tardiness to a scheduled clinic. Calls are typically taken from residents who go out of their way to help colleagues or the program.