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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 pediatric physicians. The rotations also expose residents to different areas of specialty, 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 ICU and neonatal care units, residents gain unparalleled experience during their training.
Learn more about this central part of the Pediatric Residency Program at Cincinnati Children’s:
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. While on call, 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.
A combination of general pediatrics teams and subspecialty services. PL1 residents serve as the first point of contact for patients, families, consultant, nursing and ancillary staff. They will complete the initial history and physical, develop a differential diagnosis and treatment plan, write orders and initiate care for your patients. Senior residents supervise the PL1 residents on all inpatient ward teams. The hospital medicine teams admit patients with general pediatric problems. They are staffed by the Hospital Medicine service and also admit patients of Community Pediatricians. Subspecialty teams are as follows: Cardiology, Neurology, Pulmonary and Nephrology / Endocrinology. On these services, interns work on shift schedules and take day and overnight shifts.
Intern only team located at University Hospital. Here PL1 residents learn the care of well infants in the newborn nursery, supervised by a Neonatal Attending. There are no overnight shifts on Newborn Nursery, PL1 residents sign the patients out to the NICU fellow for overnight coverage.
PL1 residents rotate at one of our 2 community NICU’s – University Hospital or Good Samaritan Hospital, both Level III NICU’s. They function as a team member alongside Senior Residents, all taking primary care of preterm neonates and term newborns with medical complications. A NICU fellow and Neonatologist serve as leadership of all NICU teams. In the NICU all residents work on the shift schedules and take day and overnight shifts.
All PL1 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, PL1 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 and are supervised by Pediatric Emergency Medicine Fellows and Attendings.
An immersion experience for PL1 residents where they will learn about community resources for underserved 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. There is no call or inpatient coverage required of residents on Advocacy.
A clinical experience for all PL1 residents spent in one of three clinics within the Cincinnati Children’s primary care clinics. These three clinics primarily serve the Medicaid population of Cincinnati. In this 2 weeks residents will gain clinical knowledge in the care of underserved general pediatric patients. Residents will also gain experience in ancillary clinical experiences. There is no call or inpatient coverage required of residents on OPA.
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. There is no call or inpatient coverage required of residents on Private Practice.
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 serve the underserved patient population in the Cincinnati Children’s Primary Care Clinic, Hopple Street Clinic or Community Health Centers. They can also serve the general pediatrics populations of Cincinnati in various Private Practice locations in the greater Cincinnati area. Residents do not attend clinic post overnight shifts.
Experiences during the PL 2 / 3 years emphasize continued development of your clinical skills. Senior residents spend time on subspecialty 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.
A combination of general pediatrics teams and subspecialty services. PL2 residents serve as the direct supervisor of the inpatient team, coordinating rounds, educating PL1 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 CCHMC Emergency Department with 3 months of clinical time. They expand their care of emergent conditions including coverage of the Trauma Bay and the high acuity pod as well as rotating with overnight shifts. They will work alongside PL1 Residents, Nurse Practitioners and Clinical Staff and are supervised by Pediatric Emergency Medicine Fellows and Attendings. Each resident is scheduled for a procedure shift while on ED to gain experience with procedures.
Senior residents rotate at one of our 2 community NICU’s – University Hospital or Good Samaritan Hospital and in the CCHMC NICU – a tertiary care referral NICU. Residents in the community NICU’s work on the shift schedule model. In the CCHMC NICU PL2 residents care for neonates with more complex medical and surgical illnesses. In the CCHMC NICU residents take 28 hour overnight call on a q4-5 schedule. A NICU fellow and Neonatologist serve as leadership of all NICU teams.
In the PICU residents learn the care of critically ill pediatric patients, supervised by Pediatric Critical Care Fellows and Attendings. Residents care for critically ill patients with medical and surgical issues and have will be exposed to all of the modalities of critical care, including ECMO, trauma patients, and solid organ/bone marrow transplant patients. These patients expose our residents to a vast array of pathophysiology and provide amazing opportunities for learning and teaching. Residents are encouraged to maximize opportunities for conducting procedures and making independent decisions. The PICU rotation has its own set of didactics given monthly on topics such as mechanical ventilation, shock and inotropes, electrolyte abnormalities, renal failure, bioethical dilemmas, and more. Residents work in the PICU take 28 hour overnight calls on a q4 basis.
PL2 residents spend 1 month on the GI service caring for patients with gastrointestinal concerns – short bowel syndrome, liver transplant and small bowel transplants, feeding difficulties, IBD and IBS, constipation and diarrhea. They gain experience in the ambulatory experience by attending clinics throughout the month with various faculty. A PL2 only team, senior residents work independently and are supervised by Pediatric GI Fellows and Attendings. Residents on GI take 28 hour overnight call on a q4-5 basis.
PL2 residents spend 1 month on the Heme/Onc service. The team is split into Hematology and Oncology with residents being the primary resident on both teams rotating throughout the experience. They take 28 hour overnight call q4. Residents will work alongside Heme/Onc Nurse Practitioners and Hospitalists. BMT patients are not covered on this service. They gain experience in the ambulatory experience by attending clinics throughout the month with various faculty. A PL2 only team, senior residents work independently and are supervised by Pediatric Heme/Onc Fellows and Attendings.
Within the PL2 and PL3 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. In Developmental Pediatrics residents attend various clinics within the department of Developmental and Behavioral Pediatrics, learning the diagnosis and care of ADHD, behavioral disorders, developmental delay and autism spectrum disorders. During these months residents will take Jeopardy Call and Rounder Shifts.
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 senior 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.
During non-call months residents take “Jeopardy Call” to cover for illnesses and emergencies requiring coverage on the Inpatient Services and Emergency Department. There are typically 2-3 calls per month, a combination of weekdays and weekends. Rounder shifts are to assist in senior coverage for the inpatient services on weekend days. These are AM rounding shifts and occur 1-2 times per month. There is a pay-back system in the Jeopardy pool after 3 activations of Jeopardy.
As part of the Cincinnati Children’s team, you will have numerous opportunities to resuscitate our pediatric human patient simulator – a $230,000 blinking, talking, breathing, realistic mannequin approximately the size of a 7-year-old child weighing 20 kilograms. He simulates physiologic responses to critical injury and medical interventions. He has a realistic airway and realistic pulmonary, cardiovascular, metabolic and neurologic responses, and can be programmed to display a wide range of conditions and symptoms. The chief residents coordinate mock codes for inpatient teams, honing leadership skills in caring for critically ill children.
In addition to an available anesthesia elective, all residents will have the opportunity for an anesthesia experience. This offers residents an additional procedural experience and gives them focused training in airway management.
Senior residents may Moonlight in the CCHMC Emergency Department on 10-pm-6am shifts and Heme-Onc for census-dependent weekend rounding. There is also the ability to round in the University Hospital NICU for census-dependent rounding, though you must obtain a full Ohio Medical License prior to signing up for UCNICU Moonlighting.
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