Pediatric Residency Program
Categorical Rotations

Categorical Rotations

Clinical rotations are a key component of the Pediatric Residency Program. By experiencing a diverse assortment of clinical services, residents develop the skills they need to be effective pediatricians. The rotations also expose residents to different sub-specialty areas, helping them choose interests and chart their future career paths.

Thanks to the size and diversity of care offered at Cincinnati Children’s, our residents get to experience rotations that cover the spectrum of pediatric care. From community-based outpatient rotations to time spent in our pediatric and neonatal critical care units, residents gain unparalleled experience during their training. Our program features a 13-block per year schedule. Each block is 4 weeks long. Individual blocks scheduled outside of the core inpatient rotations can be split in half offering additional elective flexibility.

PL-1 Schedule

The PL-1 year emphasizes broad practical experiences in both inpatient and ambulatory settings. You will be responsible for the direct care of patients admitted to you and take an active role in formulating their treatment plans. You will be the first to evaluate and initiate proper therapy for patients experiencing problems. Senior residents are in-house and readily available to provide backup and answer questions. Residents do not take 24-hour call during the PL-1 year.

A combination of general pediatric and sub-specialty services. PL-1 residents serve as the first point of contact for patients, families, consultants, nursing, and ancillary staff. They complete the initial history and physical, develop a differential diagnosis and treatment plan, write orders, and initiate care for their patients. Senior residents supervise PL-1 residents on all inpatient ward teams. The Hospital Medicine teams admit patients with general pediatric problems. They are staffed by Hospital Medicine attendings and also admit patients of community pediatricians. Additionally, all residents will rotate on the complex care team which manages patients with technology dependence and/or neurological impairment. Sub-specialty teams for interns are as follows: Cardiology, Neurology, Pulmonary and Nephrology / Endocrinology. On all of these services, interns work on shift schedules and take day and overnight shifts.

Intern-only team located at University Hospital. Here PL-1 residents learn the care of well infants in the newborn nursery and are supervised by a Neonatal Attending.

PL-1 residents rotate at one of two level 3 NICUs – University Hospital or Good Samaritan Hospital. They function as a team member alongside senior residents and carry a panel of preterm neonates and term newborns with medical complications. A NICU fellow and attending serve as leadership for all NICU teams.

All PL-1 residents spend 1 month, in either two 2-week blocks or one 4-week block, rotating in the Cincinnati Children’s Emergency Department. One of the busiest Emergency Departments in the country, PL-1 residents learn emergency care, triage of care levels and general management of initial presentation of disease manifestations. They will work alongside senior residents, nurse practitioners and clinical staff. Residents are supervised by Pediatric Emergency Medicine fellows and attendings.

An immersion experience for PL-1 residents to learn about community resources for under-served populations, global health initiatives, safety and injury prevention. A lecture series, as well as community involvement experiences, give residents insight into their role in community and worldwide advocacy.

A clinical experience for all PL1 residents spent in one of three clinics within the Cincinnati Children’s primary care clinics that primarily serve the Medicaid population. During these two weeks, residents will gain knowledge in the care of the under-served general pediatric population as well as exposure to ancillary clinical experiences.

A clinical experience for all PL1 residents spent in a community pediatrics office in the greater Cincinnati area. All PL1 residents spend 1 month, in either two 2-week blocks or one 4-week block on Private Practice. During this rotation residents will gain clinical knowledge in the care of general pediatric patients in the ambulatory setting.

All residents receive 1 month vacation, taken in two 2-week blocks.

All residents are assigned to a continuity clinic site where they will build their own patient panel and care for patients in the ambulatory setting. Residents can work with the under-served patient population in the Cincinnati Children’s Primary Care Clinic, Hopple Street Clinic or Community Health Centers. They can also work with the general pediatric population in various private practice locations around the greater Cincinnati area. Residents do not attend clinic post overnight shifts.

All residents participate in our RESUS (Resident Educational Sessions Using Simulation) curriculum. Resident teams work together in a simulated setting to learn the art of pediatric resuscitation with teaching from dedicated faculty members. During these sessions, there are various skill-based training opportunities for procedures such as IO and IV insertion, bag mask ventilation, endotracheal intubation, and defibrillation. Residents attend these sessions 2-4 times throughout each academic year.

PL-2 and PL-3 Schedule

Experiences during the PL-2/-3 years emphasize continued development of your clinical skills. Senior residents spend time on sub-specialty electives and rotate through the emergency department and intensive care units to gain valuable experience in these aspects of pediatric medicine. During the inpatient wards, you will become an active leader. Ward senior residents directly supervise patient care and educate interns and medical students. Select rotations include 24-hour call during the PL-2 and PL-3 years.

A combination of general pediatrics teams and sub-specialty services. PL-2 and PL-3 residents serve as the direct supervisor of the inpatient team, coordinating rounds, educating PL-1 residents and medical students. On these services senior residents work on the shift schedules and take day and overnight shifts.

Senior Residents continue their experience in the Cincinnati Children’s emergency department with 3 months of clinical time. They expand their care of emergency conditions with more dedicated coverage of the trauma and higher acuity patients. They will work alongside PL-1 residents, nurse practitioners and clinical staff and are supervised by Pediatric Emergency Medicine fellows and attendings.

Senior residents rotate at two NICU sites: University Hospital and Good Samaritan Hospital. The Cincinnati Children’s NICU (a tertiary care referral NICU with neonates who have more complex medical and surgical illnesses) is available for elective rotations. A NICU fellow and attending serve as leadership on all NICU teams.

In the PICU, residents learn the art of caring for critically ill pediatric patients. Residents are exposed to a wide range of patients with both medical and surgical issues, including acute trauma, solid organ/bone marrow transplant patients, and patients requiring ECMO. The PICU rotation has its own set of didactics given monthly on topics such as mechanical ventilation, shock and inotropes, electrolyte abnormalities, renal failure, and bioethical dilemmas. Residents take 24-hour call with a PICU Fellow.

PL-2 residents spend 1 month on the Gastroenterology (GI) service caring for patients with gastrointestinal concerns – short bowel syndrome, liver and small bowel transplants, feeding difficulties, IBD, constipation, and diarrhea. They gain experience in the ambulatory setting by attending clinics throughout the month with various faculty. Senior residents work independently and are supervised by Pediatric GI fellows and attendings. Residents on GI work on shift schedules and take day and overnight shifts.
PL-2 residents spend 1 month on the Hematology/Oncology (Heme/Onc) service. The service is split into Heme and Onc and residents spend time on both sides during the course of the month. Bone marrow transplant patients are not covered on this service, although residents will care for this population in the PICU and may do a BMT elective. Residents gain experience in the ambulatory setting by attending clinics throughout the month with various faculty. Senior residents work independently and are supervised by Pediatric Heme/Onc fellows and attendings. Residents on Heme/Onc work on shift schedules and take day and overnight shifts.

During the PL-2 and PL-3 year each resident will spend one month in Adolescent Medicine and Developmental Pediatrics. In the Adolescent rotation, residents will attend Teen Health Center clinics and gain experience in the general and ambulatory care of Adolescents, as well as in the management of eating disorders, and the care of transgender patients. In the Developmental Pediatrics rotation, residents attend various clinics within the department of Developmental and Behavioral Pediatrics to learn the diagnosis and care of ADHD, behavioral disorders, developmental delay and autism spectrum disorders.

Residents get 6 months of elective time during their senior years, taken in either two 2-week blocks or one 4-week block at a time. These electives allow residents to explore the different career pathways and gain exposure to areas of pediatrics suited to their career goals. During these months residents will take Jeopardy call and rounder shifts.

Residents continue their continuity clinic experience in their PL-2 and PL-3 years. Residents do not attend clinic post call. There is an optional “second clinic” experience – one additional half day per week in a clinic of your choice, which can be done while on elective.

Senior residents take “Jeopardy Call” during elective months to serve as back-up for other residents on Inpatient services and in the Emergency Department who might need to call out for illnesses and other emergencies. Residents are typically scheduled for 2-3 calls per elective month. “Rounder” shifts are to assist in senior coverage for the inpatient service on weekend days. Residents are typically scheduled for 1-2 rounder shifts per elective month. Residents are free from additional off-service call assignments during required rotations (Adolescent Medicine and Developmental & Behavioral Pediatrics) and during their elective time.
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