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Curriculum

Mayo Clinic's three-year Pediatric and Adolescent Medicine Residency includes extensive clinical training, unmatched elective opportunities, and an option for either laboratory-based or clinical research.

Through nominations by faculty and residents, two third-year residents are selected each year to serve as the pediatric and adolescent medicine chief residents, extending the residency to a fourth year.

Rotation schedule

A typical schedule includes:

PL-1
Rotation Length
General Pediatric Hospital Service 3 months
Pediatric Hematology/Oncology Service 1 month
Neonatal Intensive Care Unit 1 month
Intermediate care nursery (level 2) 1 month
Pediatric emergency department 1 month
Community pediatrics and Newborn Nursery 1 month
Developmental and Behavioral Pediatrics 1 month
General Pediatric Hospital Service junior night team 1 month
Elective 2 months
Vacation (taken during elective or non-call weeks) 3 weeks

A Pediatric Advanced Life Support (PALS) certification course and a Neonatal Resuscitation Program (NRP) course will be held during orientation. You must complete the neonatal resuscitation course before taking the PL-1 Newborn Nursery rotation.

PL-2
Rotation Length
General Pediatric Hospital Service senior 1 month
Pediatric Hematology/Oncology Service supervisor 1 month
Newborn Nursery 1.5 months
Pediatric emergency department 1 month
Pediatric Intensive Care Unit 2 months
Elective 4 months
Neonatal Intensive Care Unit night team coverage 0.5 month
Vacation (taken during elective or non-call weeks) 3 weeks
PL-3
Rotation Length
General Pediatric Hospital Service senior 1 month
Pediatric Intensive Care Unit senior 1 month
Newborn Nursery 1.5 months
Community pediatrics 1 month
Adolescent medicine 1 month
Pediatric emergency department supervisor 1 month
Senior night team 2 months
Electives 3.5 months
Vacation (taken during elective or non-call weeks) 3 weeks

In addition to usual vacation time, each resident is allotted up to 10 days each year to present at national meetings, and during the course of the residency, each resident may attend one national continuing medical education (CME) meeting.

The Continuity Clinic serves as the backbone of the curriculum and takes place one half-day each week. Each resident serves as the primary care provider for his or her Continuity Clinic patients with graduated supervision from staff general pediatricians. Our Continuity Clinic is fully integrated into the Mayo Clinic Division of Community Pediatric and Adolescent Medicine primary care practice.

There are no private patients or community private attending physicians at Mayo Clinic. Each hospitalized patient is assigned to a resident physician who is responsible for that patient's care in the hospital and, when appropriate, for follow-up care in the resident's Continuity Clinic.

While on a hospital team, you receive supervision and daily teaching from a faculty member assigned to the team. While on service, the team is that faculty member's primary responsibility, and the faculty member acts as both the attending-of-record and the teaching attending for the service. Subspecialty services also contribute to the teaching experience.

Rotation descriptions

Community Pediatric and Adolescent Medicine Service

Mayo Clinic's Community Pediatric and Adolescent Medicine Service is an office-based primary care pediatric program serving the region. You provide comprehensive health care to the children of Rochester and Olmsted County, Minnesota, and the surrounding region. In addition, during your community pediatric rotations, you have an opportunity to attend site visits in the community, including visits to the health department, refugee clinic and local schools.

Your community pediatrics rotations also give you an opportunity to provide acute primary pediatric care services at the Salvation Army Good Samaritan Health Clinic, which serves children in the local community who do not have medical insurance.

Neonatal Intensive Care Unit

The Neonatal Intensive Care Unit (NICU) is located in Mayo Eugenio Litta Children's Hospital at Mayo Clinic Hospital, Saint Marys Campus. During your NICU rotations, you train in a 24-bed neonatal intensive care unit and a 12-bed step-down nursery designated as an intermediate care area.

You join a team consisting of a neonatologist, neonatal fellows, neonatal nurse practitioners and other residents. As you learn to manage sick neonates, you perform procedures such as endotracheal intubation, umbilical artery catheter and chest tube placement, and exchange transfusions.

You also learn ventilator management under the guidance of the neonatologists and pediatric respiratory therapists. Extracorporeal membrane oxygenation (ECMO) opportunities are available in the cardiac ICU.

Newborn Nursery

You spend three months on rotations in the Newborn Nursery at Mayo Clinic Hospital, Methodist Campus. During these rotations, you attend high-risk deliveries and are responsible for the immediate stabilization and care of all newborns requiring assistance.

You also provide care for and manage all babies in the normal newborn nursery and provide discharge advice to families. You are supervised by neonatologists in the delivery room and by general pediatricians from our Division of Community Pediatric and Adolescent Medicine for general newborn care.

Finally, during your months in the Newborn Nursery, you provide phone advice to parents of patients in our community pediatric practice.

Pediatric Intensive Care Unit

The Pediatric Intensive Care Unit (PICU) is located in Mayo Eugenio Litta Children's Hospital at Mayo Clinic Hospital, Saint Marys Campus. The PICU provides intensive care for patients from pediatric cardiology, pediatric neurology, the general pediatric hospital service, and several surgical services, such as pediatric surgery, neurosurgery, cardiovascular surgery, otorhinolaryngology, orthopedics and urology.

You work with pediatric and emergency medicine residents during this rotation and are supervised by fellowship-trained pediatric critical care faculty.

General Pediatric Hospital Service

The General Pediatric Hospital Service is located in Mayo Eugenio Litta Children's Hospital at Mayo Clinic Hospital, Saint Marys Campus. When you take rotations on the General Pediatric Hospital Service, you are part of a team that consists of residents from all years of training in conjunction with residents from psychiatry and family medicine.

There are two day teams that consist of two first-year residents and an upper level resident who serves as the supervising resident during the day. The night team consists of two third-year pediatric residents who serve as senior night supervisors along with residents from the first class. All teams are led by a pediatric faculty consultant who is readily available and approachable.

Together, your team makes decisions about the diagnosis and treatment of patients on the service from around the community, region, nation and world. You serve as the primary physician for hospitalized patients, with consultation from pediatric subspecialists and surgical teams.

As a junior pediatric and adolescent medicine resident, you discuss diagnoses, treatment plans, psychosocial issues and general patient welfare on family-centered rounds with the rest of the team, the general pediatric hospital service faculty consultant and with the patients' family members.

Emergency medicine

There are more than 15,000 visits a year by children to the pediatric emergency corridor of the Mayo Clinic Emergency Department at Mayo Clinic Hospital, Saint Marys Campus. More than 2,000 children are admitted to Mayo Eugenio Litta Children's Hospital from the Emergency Department each year.

Working directly with a pediatric emergency physician consultant, you manage common acute pediatric illnesses, such as asthma and dehydration, and learn to suture lacerations, evaluate musculoskeletal injuries and perform trauma evaluations.

Pediatric Hematology/Oncology Service

The Pediatric Hematology/Oncology Service is an inpatient service located at Mayo Eugenio Litta Hospital at Mayo Clinic Hospital, Saint Marys Campus. A PL-1 and supervising PL-2 resident work directly with the pediatric hematology/oncology faculty consultants in evaluating and providing care for children hospitalized for hematologic/oncologic problems.

When not on day call or in Continuity Clinic, you may spend afternoons evaluating hematology/oncology patients in the outpatient setting.

Adolescent medicine

During this block month, you evaluate adolescent patients in the ambulatory setting and have an opportunity to provide inpatient consultations. Training in adolescent gynecology is a focus during this rotation.

Developmental and behavioral pediatrics

During your block month rotation in developmental and behavioral pediatrics, you evaluate children and adolescents with the full spectrum of developmental and behavioral issues encountered in primary care, ranging from common behavioral concerns, learning problems and attention-deficit/hyperactivity disorder (ADHD) to mental retardation, autism and cerebral palsy.

You are supervised by fellowship-trained developmental and behavioral pediatric faculty, and you also have an opportunity to work with child psychiatrists and psychologists, speech-language pathologists, medical social workers, and occupational and physical therapists. This rotation also includes community site visits to local preschool programs and to a behavioral treatment center for children with autism.

Elective rotations

These pediatric subspecialty electives are available at Mayo Clinic:

  • Pediatric allergy and immunology
  • Pediatric cardiology
  • Pediatric endocrinology
  • Pediatric gastroenterology
  • Pediatric genetics
  • Pediatric hematology/oncology
  • Pediatric infectious diseases
  • Pediatric nephrology
  • Pediatric neurology
  • Pediatric pulmonary
  • Pediatric rheumatology

A wide array of electives is available in related medical areas, including:

  • Anesthesia
  • Child psychiatry
  • Dermatology
  • Ear, nose and throat (ENT)
  • Ophthalmology
  • Orthopedics and sports medicine
  • Physical medicine and rehabilitation
  • Radiology
  • Surgery
  • Procedure elective (circumcisions, cath team, IV team, respiratory therapy)

You also may choose to pursue an elective rotation at Mayo Clinic's campuses in Jacksonville, Florida, and Phoenix/Scottsdale, Arizona, as well as at Sanford Children's Hospital in Sioux Falls, South Dakota, during either your PL-2 or PL-3 years. Housing and an automobile are provided during these rotations at no charge to you. Off-site rotations are elective and not required.

You are also encouraged to consider an international elective opportunity to serve the underserved through the Mayo International Health Program.

Didactic training

Clinical conferences, seminars, evidence-based medicine journal clubs and one-on-one instruction are integral parts of the Pediatric and Adolescent Medicine Residency. You participate in these didactic opportunities:

  • Educational programs. The residency has a very active education conference schedule that includes evidence-based medicine, chief case conference, management conferences, board review sessions, Grand Rounds and mock codes, in addition to a core curriculum that provides a didactic experience across all the Accreditation Council for Graduate Medical Education core competencies.
  • Simulation center experiences. All residents participate in state-of-the art teaching and learning at the Mayo Clinic Multidisciplinary Simulation Center. Faculty experts have implemented a pediatric case-based curriculum. Residents participate in simulation cases and debriefing without on-call responsibilities.

Conferences

Educational conferences and small-group teaching sessions are offered:

  • Daily. A noontime education conference is held Monday through Friday at 12:15 p.m.
  • Mondays. Primary care topics. Our primary care physicians are excellent teachers who enjoy focusing on common issues faced by the primary care clinician.
  • Tuesday mornings. Pediatric cases are presented by either the chief or a senior resident. This is an interactive conference with participation from faculty and residents.
  • Tuesdays. A variety of didactic lectures from our subspecialists that focus on the core topics of pediatrics.
  • Wednesdays. Twice monthly, an evidence-based medicine discussion is led by our department chair. This is an interactive review session using iPads to learn how to answer clinical questions. The other Wednesdays of the month focus on our ethics and genetics curriculum.
  • Thursdays. The Baldwin Conference series provides each resident the opportunity to present on a topic of interest once yearly in a CME-approved conference.
  • Fridays. In these noon board review sessions, board-style questions are answered anonymously utilizing an audience-response system or team jeopardy with important board topics. Once a month, the residents meet with program leadership in town hall meetings.

Case conference

One morning a week at 7 a.m., residents, fellows and faculty present cases from various specialties. This is an interactive conference with participation from faculty and residents.

Grand Rounds

Grand Rounds are presented every Friday morning at 7:45 a.m. at Mayo Clinic Hospital, Saint Marys Campus, where our entire pediatric practice is invited to assemble for a CME-quality conference. Visiting clinicians and Mayo Clinic faculty speak on a variety of clinical, educational and research topics.

Ward teaching

During inpatient assignments, the attending physicians facilitate small-group teaching sessions on various pertinent topics as part of teaching rounds.

Baldwin Conference

The Baldwin Conference series is conducted every Thursday at noon in the Baldwin Building. As a physician, you are called upon to speak publicly in many forums for various audiences. This series' primary objective is to provide a unique opportunity to practice and improve your academic presentation skills under faculty supervision and guidance.

You have the opportunity to not only practice presentation style and organization but also become comfortable in preparing and making future presentations. In addition, the conferences provide continuing medical education for faculty consultants in the department and ongoing education to your resident peers.

During each year of your residency, you present once at a Baldwin Conference. You may present the pertinent information of an interesting case, conduct an in-depth discussion of that case, or provide an overview of research or the current literature on any pediatric-related or medical education-related topic.

Journal club

Every two to three months, the program director hosts an informal discussion to review a recent pediatric journal. Each attending member reviews a specific article and shares the findings with the group.

Service opportunities

During your residency, there are ample opportunities for providing community service for area children:

  • Salvation Army Good Samaritan Health Clinic. This Rochester clinic seeks to provide short-term medical care or appropriate referrals or both at no cost to clients who meet certain eligibility guidelines. Essential services focus on assessment, evaluation and basic screening for medical problems.
  • Community service project. You can participate in a community needs assessment and work on a project targeted toward those needs. You work directly with community resources, including Head Start, the public school system, child protective services and the Olmsted County Health Department. Community projects have been a springboard into opportunities for scholarly activity.
  • Boys & Girls Club. You can participate in serving and mentoring underprivileged youth in a casual and friendly environment. You can help build the character of Rochester youth through leadership and guidance in behavior and attitude. You interact with people from all ages, nationalities, races and creeds at the club.

Research training

You participate in scholarly projects during the Pediatric and Adolescent Medicine Residency. You may complete a chart review of a disease or condition or become involved in a clinical project or laboratory research. Mayo Clinic pediatric residents typically complete several scholarly projects during their training, resulting in publications and national or international presentations.

The Rochester Epidemiology Project is also a unique resource for resident epidemiologic research projects. Residents are encouraged to submit abstracts to scientific meetings. Mayo Clinic provides up to 10 travel days each year and expense reimbursement for all abstracts accepted for oral or poster presentations at national meetings.

Call frequency

The Community Pediatric and Adolescent Medicine rotation and the Developmental and Behavioral Pediatrics rotation are call-free. Electives are also call-free; rarely, certain electives incorporate home pager call.

Call responsibilities by rotation:

  • General Pediatric Hospital Service (PL-1) — 12- to 14-hour shifts with every fourth day admitting (no in-house night call)
  • Night team (PL-1) — 12- to 14-hour night shifts on Sunday-Thursday nights (five each week)
  • General Pediatric Hospital Service supervisor (PL-2 and PL-3) — 12- to 14-hour day shifts
  • Newborn Nursery (PL-2 and PL-3) — in-house call every fourth night
  • Neonatal Intensive Care Unit (PL-1) — 12-hour day shifts (no in-house night call)
  • Neonatal Intensive Care Unit (PL-2) — in-house call every fourth night
  • Pediatric Hematology/Oncology Service — 12-hour day shifts with every other day admitting (no in-house night call)
  • Emergency department — shifts
  • Pediatric Intensive Care Unit (PL-2 and PL-3) — in-house call every fourth night

Mayo Clinic College of Medicine strictly follows the recommendations of the Accreditation Council for Graduate Medical Education regarding duty hours.

A backup call system consisting of residents on elective rotations provides coverage in event of illness or family emergency.

Teaching opportunities

Residents are responsible for teaching Mayo Medical School students and visiting senior medical students through bedside instruction and formal didactic lectures. Formal instruction in teaching skills is included in our noon core conference schedule and annual resident retreats.

Additional training

At the conclusion of your residency training, you may wish to continue training at Mayo School of Graduate Medical Education. Fellowships are currently offered in:

  • Allergy and immunology
  • Child neurology
  • Medical genetics
  • Neonatology
  • Pediatric cardiology
  • Pediatric critical care
  • Pediatric dermatology
  • Pediatric endocrinology
  • Pediatric gastroenterology
  • Pediatric hematology/oncology
  • Pediatric infectious diseases

Evaluation

To ensure that you acquire adequate knowledge and develop technical skills, your performance is monitored carefully during the course of the program training. You are evaluated formally by your supervising faculty member after each clinical rotation and meet with your faculty adviser and program leadership to review these evaluations.

In addition, you regularly evaluate the faculty to ensure that your educational needs are being met. This program has integrated the Accreditation Council for Graduate Medical Education outcome project ("competencies" and "milestones") measures as a routine part of the evaluation process.

Practice examinations

Mayo Clinic's Pediatric and Adolescent Medicine Residency includes annual American Board of Pediatrics in-training examinations to help you assess your progress toward board certification.

Career development

Periodic meetings with faculty members and program directors are conducted to discuss the achievement of each resident's professional goals.

Committee assignments

You have the opportunity to gain experience in a number of administrative capacities. For example, residents serve on our department's curriculum committee.

Textbooks and journals

Each PL-1 resident receives the latest edition of the board review manual MedStudy and a subscription to the journal Pediatrics. In addition, each second- and third-year resident receives $200 each year as book funds.

MD Consult, a collection of more than 40 electronic medical texts, can be accessed from any of the 18,000 physician workstations throughout Mayo Clinic, or from home when connected to the Mayo Clinic network. Textbook collections are available at multiple sites in the hospitals for reading and reference while on duty. The library provides access to a variety of Web-based texts and databases and access to UpToDate, PubMed and Medline.

Conferences and trips

The Department of Pediatric and Adolescent Medicine provides one educational trip or conference during your residency. In addition, you may use up to 10 additional days each year to present results of your research or scholarly activities at national meetings.

Resident and fellow appreciation dinner

An annual formal department dinner (with staff coverage of clinical services) honors and acknowledges residents and fellows.

  • Aug 25, 2014
  • ART348989