Starting with the academic year of 2022-2023, we adopted an X+Y curriculum tailored to the needs of our program and its residents. As you will see below, each year consists of rotations that include inpatient floor/ICU months, subspecialty months, and ambulatory months. In our new X+Y curriculum, the inpatient rotations continue to remain one month in duration, whereas our subspecialty and ambulatory rotations now consist of 2 weeks of the rotation with 2 weeks of outpatient clinic experience. These outpatient clinic experiences include a mixture of continuity clinic and other subspecialty clinic opportunities tailored to the needs and interests of each individual resident. Residents also have a designated “admin half day” each week during the “Y weeks” for wellness and completion of other administrative tasks. As this is a new implementation we are piloting this year, we are continually seeking improvement and making changes based on resident feedback and are excited for the new changes to come!
First year (PGY-1)
The first year of residency or ‘intern year’ consists of establishing the understanding of both normal and pathologic pediatric physiology. Our year is broken down into monthly blocks that include working on the pediatric floor, subspecialties, well-baby nursery, intensive care neonatology and community advocacy.
On the pediatric floor, the intern is assigned to a team consisting of co-interns and senior residents. Their schedule alternates between day shifts & night shifts and consists of managing their pediatric patients from admission to discharge. On subspecialty rotations such as nephrology, infectious diseases, and genetics, interns rotate on a team with other residents of different levels learning from the faculty and fellows of that particular subspecialty. The workflow consists of day shifts with clinics intermixed into the schedule. In the nursery, the intern is responsible for the management of a healthy newborn from admission to discharge with a faculty attending. Finally, all interns go through a month of advocacy and community development to understand the resources available to all pediatric patients.
Typical Pediatric Resident Schedule for PGY-1
|Rotation||Inpatient Pediatric Floor at CMHH||Inpatient Pediatric Floor at CMHH||Inpatient Pediatric Floor at CMHH||LBJ Community Pediatrics||Well Baby Nursery at CMHH or LBJ||Neonatal Intensive Care at LBJ||Pedi Oncology Service at M.D. Anderson||Medical Genetics / Chronic Care||Infectious Disease||Neurology||Community Health & Advocacy / Individualized Curriculum||Nephrology|
Second year (PGY-2)
The second year of residency consists of reinforcing the objectives of the first year while also introducing higher complexity patients as well as the supervisory aspect of a resident-teacher.
On the pediatric floor, the upper level resident is responsible for the management of the team of residents including interns. Their schedule rotates from day shifts & night shifts and consist of the full management of a pediatric patient from admission to discharge while ensuring the objectives of interns are being met. Seniors have the option of taking a subspecialty elective of their choice such as GI, Cardiology, A&I, Rheumatology etc. On NICU and PICU, upper level residents have day and night shifts managing higher acuity patients in the context of a team with other senior residents, fellows and faculty. On ED, residents work on triaging and managing patients in the emergency department with rotating 8-12 hr shifts. Finally, all PGY-2 residents have a month of development and behavior to understand and recognize pathologic variants of pediatric milestones. Second years will also start taking 2-3 24hr call shifts on their reserve and jeopardy months, scattered between Children’s Memorial Hermann and LBJ Hospital.
Typical Pediatric Resident Schedule for PGY-2
|Rotation||Inpatient Pediatric Floor at CMHH||Inpatient Pediatric Floor at CMHH or LBJ||Neonatal Intensive Care at CMHH||Pedi Oncology Service at M.D. Anderson||Acute Care Outpatient Clinic||Neonatal Intensive Care at LBJ or CMHH||Adolescent Medicine||Emergency Medicine||Emergency Medicine||Development and Bahavior||Pediatric Intensive Care at CMHH||Cardiology or Individualized Curriculum Specialty Month|
Third year (PGY-3)
The third year of residency consists of ensuring residents are able to be comfortable in the career paths they’ve chosen for themselves after residency, whether it be general pediatrics or a subspecialty fellowship.
On the pediatric floor, the upper level resident is responsible for the management of the team of residents including interns. Their schedule rotates from day shifts & night shifts and consists of supporting their team in managing their roster of patients, ensuring the learning objectives of interns and medical students are being met. Multiple months are given to electives ranging from Advocacy, Global Health, outpatient clinics, Sports Medicine or subspecialties for residents going into fellowship. Senior residents also participate in a 2 week float stretch covering 12-18hr call shifts.
Typical Pediatric Resident Schedule for PGY-3
|Rotation||Inpatient Pediatric Floor at CMHH||Inpatient Pediatric Floor at CMHH||Pediatric Intensive Care at CMHH||Neonatal Intensive Care at LBJ or CMHH||Acute Care and Community Clinic Supervisor||Gastroenterology or Individualized Specialty Month||Night Float at LBJ and CMHH||Endocrinology or Individualized Curriculum / Elective||Pulmonary||Individualized Curriculum / Elective||Individualized Curriculum / Elective||Individualized Curriculum / Elective|