Primary Care Opportunities:
Inpatient | Outpatient| Elective Opportunities | Didactic Teaching Sessions

Curriculum

There are several components in our residency curriculum. Each of these serves a distinct purpose and all are necessary for a superior training. The components are:

A. Education

1. Orientation/Emergency Lecture Series
   For new residents each July and August, covering the basics and emergency measures in pediatric care.
2. Core Curriculum Conference Series
   A series of didactic lectures, given by faculty, covering a specific planned core curriculum that extends over 18 months and repeats. Three sessions a week.
3. Therapeutics and Toxicology Conferences
   Presentations that cover drug selection and pharmacokinetics, as well as toxins and their management.
4. Inpatient Teaching Rounds
   Everyday ward/bedside teaching by faculty regarding patients' diagnoses and management.
5. General Pediatrics CHC Conferences
   Primary care topics of relevance presented by General Pediatrics and Adolescent Medicine Faculty and incorporated into the Core Curriculum Series.
6. Radiology Conferences
   Weekdays each inpatient service reviews all imaging studies obtained on their patients with a pediatric radiologist.
7. Morning Report
   Two mornings each week, residents and faculty discussions focus on the differential diagnoses and management a broad variety of patients from the inpatient and outpatient settings.
8. Grand Rounds
   Weekly state-of-the-art clinical science presentations by faculty and guest speakers.
9. Case Conferences
   Monthly multidisciplinary discussions of interesting cases that demonstrate important aspects of disease process and therapy presented by PL-3s.
10. Morbidity and Mortality Conferences
    Monthly examinations of instructive cases presented by PL-2s, a pathologist and pediatric faculty.
11. Subspecialty Conferences
    Each division's periodic conferences attended by faculty, fellows, and residents on that particular subspecialty service.
12. Societal, Professional and Ethical Issues Conferences
    Periodic examination of legal, ethical and fiscal issues relating to the practice of pediatrics.
13. Board Review - Jeopardy
    A monthly topic review based on articles from Pediatrics In Review. Organized by the chief resident in a game show format.
14. Evidence-Based Medicine Curriculum
    A series of monthly presentations on EBM by means of Journal Club presented by PL-3’s.
15. Personal and Professional Development Curriculum
    Three vertical communities of residents gather monthly to discuss topics geared toward their complete development as pediatricians.
16. University of Iowa Children's Hospital Symposium
    All first-year residents, and other residents who are able to, attend this two-day continuing education course held in Iowa City with several practitioners from the region.
17. Pediatric Academic Societies Yearly Meeting and Other Professional Educational Meetings
    Residents elected as teachers of the year have the opportunity to witness the cutting edge of information relevant to pediatrics. Residents have presented their research at these/other meetings.
18. Pediatric Residents Computer Access
    Both IBM and Macintosh computers, linked to a medical database for residents to obtain up-to-date literature searches and information quickly, are in the resident lounge and call rooms. Educational CD-ROMs are available.
19. Membership in American Academy of Pediatrics
    Resident membership includes a subscription to Pediatrics, Pediatrics in Review, and other AAP literature.
20. Book/Meeting Allowance
    Can be used for the purchase of books, journals, educational software and/or attendance at an educational meeting. All incoming residents are provided with a PDA to facilitate case log/procedures/work hours monitoring.

B. Patient Management Experience

1. Inpatient and ambulatory diagnostic evaluations
2. Treatment/management of acute and chronic illnesses in hospitalized and ambulatory patients
3. Treatment/management of life-threatening emergencies and illnesses in intensive care units
4. Treatment/management of acute trauma and medical problems in the emergency room
5. Treatment/management of developmental and behavioral disorders
6. Triage and transport care of patients referred to UIHC
7. Planning for discharge from tertiary care hospital to coordinated community care
8. Verbal and written communications between physicians
9. Dealing with gatekeepers and third-party payors
10. Field clinics in general pediatrics and subspecialties in communities throughout Iowa
11. Private community practice rotations in Burlington and Ottumwa, Iowa
12. Full spectrum subspecialty patient encounters
13. Care of adolescents and their issues
14. A broad array of elective opportunities
15. Mock codes held monthly on the inpatient wards

C. Evaluation and Feedback

1. American Board of Pediatrics In-training Examination
   Given each year, provides specific analysis of areas of knowledge weakness for individual resident
2. Monthly Performance Evaluations of Competence
   Conducted by faculty supervisors all year for every rotation
3. Monthly evaluations of residents by peer residents, nursing personnel on several rotations. Biannual evaluations by families.
4. Video-taped resident encounters with patients in General Pediatrics, with evaluation and feedback given.
5. Evaluations and discussions with faculty advisors at least twice a year. Review of all residents progress at a quarterly Resident Evaluation Committee meeting with feedback to residents.

D. Support and Social Opportunities

1. Weekly residents' lunch meeting with Program Director/Associate Program Director/Program Coordinator/Chief Resident
2. Weekly lunch meeting of residents by year in program
3. Annual retreat for PL-1s focusing on team building, stress management, and end-of-life issues.
4. Annual retreat for PL-2s focusing on teaching and supervisory skills
5. Annual retreat for PL3s focusing on life after residency
6. Annual Career Day for PL-2s discussing careers in general private/academic pediatrics, and fellowship training
7. Faculty preceptor system
8. Counseling available
9. Social activities: Welcome dinner for PL-1’s, All residents and family picnic in June

E. Recognition

1. All expenses paid attendance at annual Pediatric Academic Societies national pediatric meeting for the PL-2 and PL-3 voted as best teachers in their respective groups by all residents.
2. Outstanding PL-2 and PL-3 Awards for Pediatric Clinic-presented by faculty in General Pediatrics and Adolescent Medicine Division.
3. Gilbert Cuthbertson Award-monetary award to a PL-3 to acknowledge overall excellence as a pediatrician. Recipient selected by vote of all residents.
4. Riesz Award-monetary award to a PL-2 with exceptional communication skills. Recipient selected by faculty.
5. Krause Award-monetary award to the PL-3 who demonstrates special dedication to the health of adolescents. Chosen by Adolescent Medicine faculty, Chief Resident and Program Director.
6. McGuinness/Bell Award- monetary award to the resident who achieves the highest in-training exam score for the year.

Primary Care Opportunities

Pediatric residents at the University of Iowa Hospitals and Clinics participate in primary care activities throughout their three years of residency training.

A. Inpatient Experience

1. General Pediatrics Inpatient Service
   Residents participate in the management of a broad range of general pediatric problems requiring inpatient care, during a block month as PL-1s, as the senior in-house as PL-2s, and in a supervisory role as PL-3s.
2. Newborn Nursery
   The newborn nursery provides residents an opportunity to become familiar with the perinatal homeostasis of the normal newborn and the provision of participatory guidance to families. Residents gain experience working with pediatric nurse practitioners in this setting.
3. Medical Consultation Service
   Second and third year residents provide general pediatric consultation to other inpatient medical services at UIHC.

B. Outpatient Experience

1. Child Health Clinic
   Child Health clinic (CHC) is the cornerstone of the primary care program. All residents participate in a continuity clinic one-half day a week for the duration of the training program; 3 rotations have 2 half-days a week. Special attention is given to anticipatory guidance and developmental behavioral issues. Approximately 16,500 patients are served annually in the Child Health Clinic.
2. General Pediatrics Clinic/Acute Care Clinic
   Residents participate in the general diagnostic clinic, growth clinic, travel clinic, and encopresis clinic, as well as manage acutely ill pediatric walk-in patients of all ages.
3. Emergency Treatment Center
   Third year residents have a block rotation in the Emergency Treatment Center at UI Hospitals and Clinics and second year residents provide consultative care to pediatric and young adult patients during night call. Common acute problems managed include minor and major trauma, lacerations, respiratory infections, asthmatic attacks, seizures, and dehydration. Senior residents serve as active participants on the Pediatric Trauma Team.
4. 4. Emergency Room at Blank Children's Hospital
   Second year residents have a block rotation in a busy pediatric emergency room located in Des Moines, Iowa.
5. Adolescent Medicine Rotation
   Third year residents provide medical care to adolescents with a wide variety of problems including sexually transmitted diseases, substance abuse, depression, eating disorders, common dermatologic disorders, and common orthopedic diseases and injuries. In addition to experiences in the Adolescent Psychosocial and Primary Care Clinic, residents participate in an Eating Disorders Clinic, a Sports Medicine Clinic, a school-based clinic at an alternative high school and at the University of Iowa Student Health Clinic which serves college students.
6. Child Health Specialty Clinics
   Operating in conjunction with the Iowa State Department of Health, these clinics provide residents with the opportunity to participate in the care of children with special needs at clinics located throughout the state.
7. Other Outpatient Rotations
   Other clinics provide residents with the opportunity to increase their medical knowledge and enhance their proficiency in managing problems such as asthma, diabetes, seizures and behavioral problems which constitute a large portion of the children and adolescents seen in an ambulatory care setting. Time is devoted to the adjustment problems of adolescents with chronic diseases, such as renal failure, cancer, hemophilia, and cystic fibrosis.
8. Telephone Consultation
   Second and third year residents respond to telephone calls from parents. These calls are all triaged by nurses before the resident is contacted.
9. Developmental and Behavioral Pediatrics
   Second year residents participate in structured experiences jointly directed by faculty in the divisions of Developmental Disabilities, General Pediatrics, and Psychology. Experiences include management of children with attention deficit disorders, psychosomatic diseases, behavior and school management problems, and learning disabilities. Exposure to children with more severe physical and mental disabilities occurs in the Myelodysplasia Clinic, the Metabolic Genetics Clinic and the Child Development Clinic.
10. Community Pediatrics Rotations
    Residents participate in required rotations in the community during their second and third years of residency to gain exposure to the practice of general pediatrics in a private setting.

C. Elective Opportunities in Primary Care
Residents at the first, second and third years of training have a number of months available for elective opportunities. Those who are oriented towards primary care are encouraged to explore electives in dermatology, ophthalmology, sports medicine, and otolaryngology, as well as additional exposure in the areas of pediatric psychology and developmental and behavioral medicine. Additional experiences in community pediatrics can be arranged as well.

D. Didactic Teaching Sessions
Throughout the year, there is a series of didactic lectures covering a core curriculum developed by the residency program. Many of the topics in this series are oriented towards general pediatrics and adolescent medicine. In addition, primary care topics of relevance are presented in a special lecture series designed to orient new PL-1s.

At the conclusion of the three year residency in the Department of Pediatrics, residents have seen a sufficient volume and variety of patients to manage the common problems of pediatrics while recognizing those more rare or complex cases which require consultation or referral.

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