Beginning in the academic year of 2022-2023, we adopted an X+Y curriculum tailored to our program and its residents’ needs. Our program currently has a 4+1 X+Y curriculum. As you will see below, each year consists of rotations that include inpatient floor/ICU months, subspecialty months, and ambulatory months. In our X+Y curriculum, all core rotations (inpatient and some subspeciality rotations) are 4 weeks in duration, with vacations during eligible rotations. 

In this model, each resident is placed in a scheduling cohort. Every 5th week is a “Y week” which is composed of continuity clinic time, a longitudinal rotation, and “professional development” time. Longitudinal rotations and professional development time are tailored to each year of training and allow for a longitudinal elective during all three years of residency. Residents also have a designated “admin half day” each week during the “Y weeks” during which time residents are free from clinical responsibilities and are free to use this time for wellness and completion of other administrative tasks. As this is a relatively new implementation, we are continually seeking improvement and making changes based on resident feedback and are excited for the new changes to come!

Continuity Clinic

During the Y weeks, residents attend a clinic where they see both well and sick patients on an outpatient patient. Our residents are assigned to a clinic during their intern year and the goal is to grow a panel of patients throughout residency.

Year-by-Year Preview

First year (PGY-1)

The first year of residency or “intern year” consists of establishing an understanding of both normal and pathologic pediatric physiology. Our year is broken down into 4 week rotations including the Inpatient Pediatric Unit (also called floor), Pediatric Subspecialties, Well-Baby Nursery, Intensive Care Neonatology, and Community Advocacy.In the inpatient Pediatric Floor, the intern is assigned to a team composed of co-interns and senior residents (PGY2-4 level residents). During the inpatient months, the team manages the care of their pediatric patients from admission to discharge. 

During intern year, residents also rotate on subspecialty rotations such as Nephrology, Infectious Diseases, and Genetics, where residents work on a team with other residents and learn from the subspecialty faculty and fellow. During these subspecialty rotations, residents see inpatient consults and attend subspecialty clinics. In the Newborn Nursery, the intern is responsible for the management of a healthy newborn from admission to discharge with a faculty attending. 

Finally, all interns will have a longitudinal Advocacy and Community Development rotation during their Y weeks to better understand the resources available to all pediatric patients.

Typical Pediatric Resident Schedule for PGY-1

Second year (PGY-2)

The second year of residency consists of reinforcing the objectives of the first year while simultaneously introducing higher complexity as well as the supervisory role of a resident-teacher.

On the Pediatric Floor, the upper-level resident is responsible for leading the team of residents and students and managing the care for their patients. A typical schedule includes day shifts & night shifts where residents oversee the management of their pediatric patients from admission to discharge while ensuring the objectives of interns are met. 

Upper level residents also work in NICU and PICU, where they manage higher acuity patients as part of a team with other senior residents, fellows, and faculty. PGY-2 residents also rotate in the ED, where they master triaging and managing patients in the CMHH Level I Emergency Department. 

During the PGY-2 year, residents have the option of taking a subspecialty elective of their choice such as GI, Cardiology, A&I, Rheumatology, etc. Finally, all PGY-2 residents complete a longitudinal Development and Behavioral Pediatrics (D&B) rotation during their Y week to understand and recognize pathologic variants of pediatric milestones. 

Typical Pediatric Resident Schedule for PGY-2

Third year (PGY-3)

The third (and final!) year of residency is designed to ensure residents are comfortable and confident in their chosen career paths after residency, whether it be general pediatrics or a subspecialty fellowship.

On the Pediatric Floor, the upper-level resident is responsible for overseeing the management of the team of residents including interns. Their schedule includes day shifts & night shifts and consists of supporting their team in managing their roster of patients, and ensuring the learning objectives of interns and medical students are being met. 

During this year, residents have multiple elective months that are unique to each resident. We have a variety of available electives ranging from Advocacy, Global Health, outpatient clinics, Sports Medicine, and Pediatric Subspecialties. 

Typical Pediatric Resident Schedule for PGY-3