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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

A Pediatric Advanced Life Support (PALS) certification course and a Neonatal Resuscitation Program (NRP) course will be held during orientation.

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
Outpatient Continuity Clinic 0.5 day/week
Elective 2 months
Vacation (taken during elective or non-call weeks) 3 weeks
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
Neonatal Intensive Care Unit 1 month
Pediatric Intensive Care Unit 2 months
Neonatal Intensive Care Unit night team coverage 0.5 month
Outpatient Continuity Clinic 0.5 day/week
Elective 4 months
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
General Pediatric Hospital Service senior night team 2 months
Outpatient Continuity Clinic 0.5 day/week
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. The 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, trainees receive supervision and daily teaching from a faculty member assigned to the team. 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. Residents provide comprehensive health care to the children of Rochester and Olmsted County, Minnesota, and the surrounding region. In addition, during community pediatric rotations, residents have an opportunity to attend site visits in the community, including visits to the health department, refugee clinic and local schools.

These community pediatrics rotations also give trainees 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 — Rochester, Saint Marys Campus. During NICU rotations, residents train in a 24-bed neonatal intensive care unit and a 12-bed step-down nursery designated as an intermediate care nursery.

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

Residents 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

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

Residents also provide care for and manage all babies in the Newborn Nursery and offer discharge advice to families. Trainees 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 the months in the Newborn Nursery, residents 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 critically ill 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.

Pediatric and adolescent medicine residents join a team led by fellowship-trained pediatric critical care faculty, fellows and pediatric emergency medicine residents, as well as nursing, transport, respiratory therapy, pharmacy, nutrition and social work staff.

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 taking rotations on the General Pediatric Hospital Service, trainees are part of a team consisting of residents from all years of training in conjunction with residents from psychiatry and family medicine.

Two-day teams are formed 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.

Junior pediatric and adolescent medicine residents discuss diagnoses, treatment plans, psychosocial issues and general patient welfare on family-centered rounds. Together, the team makes decisions about the diagnosis and treatment of patients on the service from around the community, region, nation and world. Residents serve as the primary physician for hospitalized patients, with consultation from pediatric subspecialists and surgical teams.

Emergency medicine

The Mayo Clinic Emergency Department at Mayo Clinic Hospital, Saint Marys Campus, sees more than 15,000 visits a year by children. 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, residents manage common acute pediatric illnesses, such as asthma and dehydration, 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 junior and supervising senior resident work directly with the pediatric hematology/oncology faculty consultants and fellows in evaluating and providing care for children hospitalized for hematologic/oncologic problems.

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

Adolescent medicine

During this block month, residents 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 the block month rotation in developmental and behavioral pediatrics, trainees 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.

Residents are supervised by fellowship-trained developmental and behavioral pediatric faculty, and also have an opportunity to work with child psychiatrists and psychologists, speech-language pathologists, medical social workers, and both 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
  • Child abuse
  • 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
  • Ophthalmology
  • Orthopedics and sports medicine
  • Otolaryngology
  • Physical medicine and rehabilitation
  • Radiology
  • Surgery
  • Procedure elective (IV team, respiratory therapy)

During either the PL-2 or PL-3 year, trainees 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,. Housing and an automobile are provided during these rotations at no charge. Off-site rotations are elective and not required.

Residents 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. Residents 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 (ACGME) pediatric core competencies.
  • Simulation center experiences. All residents participate in state-of-the art teaching and learning at Mayo Clinic's Multidisciplinary Simulation Center. Faculty experts have implemented a pediatric case-based curriculum. Residents participate quarterly in simulation cases and debriefing.

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 are presented. Our primary care physicians are excellent teachers, who enjoy focusing on the common issues faced by the primary care clinician.
  • Tuesdays. A variety of didactic lectures from subspecialists focus on the core topics of pediatrics.
  • Wednesdays. At the morning conference, either the chief or a senior resident presents pediatric cases. This is an interactive conference with participation from faculty and residents. Twice monthly, an evidence-based medicine discussion is led by a general pediatrician. This is an interactive review session using iPads to learn how to answer clinical questions in relevant situations. The other Wednesdays of the month focus on our ethics and genetics curriculum.
  • Thursdays. The noon Baldwin Conference series provides each resident with the opportunity to present on a topic of interest related to primary care 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.

Department Grand Rounds

Grand Rounds are presented every Friday afternoon at the downtown Saint Marys Campus, where the 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. Since physicians are often called upon to speak publicly in many forums for various audiences, the primary objective of this series is to provide a unique opportunity to practice and improve academic presentation skills under faculty supervision and guidance. During each year of residency, trainees present once at a Baldwin Conference.

Residents have the opportunity not only to practice presentation style and organization but also to 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 resident peers.

Journal club

Every two to three months, our 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 the residency, there are ample opportunities for providing community service for area children:

  • Salvation Army Good Samaritan Health Clinic. This Rochester-based 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. Residents can participate in a community needs assessment and work on a project targeted toward those needs. Trainees work directly with community resources, including Head Start, the public school system, child protective services and the Olmsted County Health Department. Community projects have become a springboard into opportunities for scholarly activity.
  • Boys and Girls Club. Residents can participate in serving and mentoring underprivileged youth in a casual and friendly environment and help to build the character of Rochester youth through leadership and guidance in behavior and attitude. Trainees interact with people from all ages, nationalities, races and creeds at the club.

Research training

Residents participate in scholarly projects during the Pediatric and Adolescent Medicine Residency. Trainees 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 through 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 ACGME 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 the noon core conference schedule and annual resident retreats.

Additional training

At the conclusion of residency training, residents 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

Practice examinations

Mayo Clinic's Pediatric and Adolescent Medicine Residency includes annual American Board of Pediatrics in-training examinations to help assess 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

Trainees have the opportunity to gain experience in a number of administrative capacities. For example, residents serve on the 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.

ClinicalKey, 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 the residency. In addition, residents may use up to 10 additional days each year to present results of their 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.

Evaluation

To ensure that trainees acquire adequate knowledge and develop technical skills, performance is monitored carefully during the course of the program training. Residents are evaluated formally by their supervising faculty members after each clinical rotation and meet with their faculty advisers and program leadership to review these evaluations.

In addition, trainees regularly evaluate the faculty to ensure that their educational needs are being met. This program has integrated the ACGME outcome project ("competencies" and "milestones") measures as a routine part of the evaluation process.

  • Sep 22, 2016
  • ART348989