Inpatient (Ward) Pediatrics

Senior residents are responsible for supervision of the floor rotations as a primary supervisor.

The floors are run by a team consisting of a PGY-2 or PGY-3 who supervise two or three first-year residents along with third-year students and occasionally, a fourth-year sub intern. There is a full time faculty attending whose assignment is to teach and often a community pediatrician who co-attends.

• perform a comprehensive history and physical exam, including an appropriate assessment, differential diagnosis, and management plan and review it with senior resident
• order and interpret appropriate laboratory and diagnostic studies
• identify and prioritize the patient’s medical problems
• request appropriate subspecialty consultation when necessary to optimize patient care
• recognize acuity in patient care and changes in the medical condition that warrant immediate intervention and/or transfer to a higher level of care.
• develop rational evidence-based management strategies
• works with colleagues and nursing personal to provide optimal care for the patient
• effectively anticipate, coordinate, and facilitate discharge planning including the proper utilization of social work and discharge planners
• supervise medical students in the delivery of patient care

• perform a comprehensive history and physical exam, including an appropriate assessment, differential diagnosis, and management plan on all admissions and review with the attending physician as necessary
• review the evaluation completed by in the emergency room and order and interpret appropriate laboratory and diagnostic studies
• identify and prioritize the patient’s medical problems
• request appropriate subspecialty consultation when necessary to optimize patient care
• recognize acuity in patient care and changes in the medical condition that warrant immediate intervention and/or transfer to a higher level of care.
• develop rational evidence-based management strategies
• works with colleagues and nursing personal to provide optimal care for the patient
• effectively anticipate, coordinate, and facilitate discharge planning including the proper utilization of social work and discharge planners
• supervise interns and medical students in the delivery of patient care including daily work rounds
• overnight admissions, diagnostic workups, and management plans should be reviewed with the attending at sign-out rounds
• direct and facilitate family-centered rounds

These are made weekdays with the assigned attending. The supervising resident conducts walk rounds (family-centered rounds) at the bedside. Formal presentations are made (the extent of which depends on daily circumstances) with the house staff and other team members (occupational therapy, physical therapy, nursing, discharge planners, etc.) depending on availability. Student and resident presentations are critiqued. Patients are examined and treatment plans are formulated in front of the patient/parents or in private, whichever is deemed appropriate.

Occur daily (seven days) with the senior resident. The attending is usually present five days a week. Work rounds cover topics pertaining to the specific patient’s care.

Patient bedside-based rounds which include the patient and parent, where appropriate, in the update and direction of patient care. Patient and parent participation is encouraged. These are incorporated in the work rounds and/or the attending rounds and are a major component of the resident teaching.

Faculty or guest speakers present up-to-date knowledge on various topics in pediatrics.

An academic half-day of various lectures or topics in pediatrics given by the faculty or residents. This includes evidence-based medicine, board review, and case discussions.

Six to 10 patients per day is typical.

• PGY-1 (intern): three modules (4 weeks each)
• PGY-2: one module (4 weeks)
• PGY-3: one module (4 weeks)
  
• PGY-4: two modules (4 weeks each)

There are three inpatient teams:

• Inpatient Hematolgy-Oncology
• Inpatient Hospitalist Service
• Inpatient Specialist Service and Private Practice Admissions

• pediatric patients from six counties, presenting with a broad range of common and uncommon pediatric acute conditions