ACHIA

Inpatient Pediatrics at the Children's of Alabama


INPATIENT PEDIATRICS AT THE CHILDREN'S OF ALABAMA

For inpatient services, interns and residents usually begin pre-rounding around 6:30-7 am. Vitals, labs, films, and radiology reports can be retrieved on any computer in the hospital or on the I-Pod Touch supplied to each resident.. All residents are expected to attend and participate in morning report from 8:00-8:30, and rounds with the attending begin at around 8:30.  Most teams walk round in the morning  with their attending, with the exception of on morning in each admitting cycle when they  sit down round with the overnight team.

Rounds are designed to be run by the upper level residents with attending supervision. The attending is present every day for rounds and plays a vital role in day-to-day education. Inpatient rounds are finished by 12pm so that residents are able to go to noon conference.

GENERAL INPATIENT SERVICES

-          General inpatient service is divided into 4 teams in the summer and 5 teams in the winter to account for natural variation in pediatric volume .

-          Each team consists of an attending, an upper level resident, an intern, and 1-2 medical students. 

-          Each team is also assigned a social worker  and case manager that help with  follow-up arrangements, patient teaching, working with DHR, and many
           other things. 

-          Each team has a cap of 16 patients with a limit of 12 patients admitted to a single team in a 24 hour admitting period.

-          While on general inpatient wards, each resident pair will admit every 4th (Apr-Sept) or 5th (Oct-Mar) day up to their cap of 16.  The resident services will 
           admit up to 16 patients total and the rest of the patients will be admitted to the Silver Team of hospitalists paired with an upper level resident.

-          A separate night float team will be in house at 6 pm and do cross cover and admissions, and round the next morning with the inpatient service.

-          Average intern patient load is 7-8.

AMBULATORY PEDIATRICS

The ambulatory curriculum is designed to offer a broad-based experience in several clinical settings. Experience in outpatient pediatrics is spread throughout the three years of residency and is centered at Children’s of Alabama and immediate surrounding area. This experience is spent in the Division of General Pediatrics and Adolescent Medicine, the Emergency Department at Children’s of Alabama, the Sparks Center at UAB, sub-specialty ambulatory clinics at Children’s of Alabama, at community care clinics managed by the Jefferson County Department of health, and with a number of community private pediatric offices.  There are also dedicated outpatient subspecialty months that focus on the outpatient aspects of specific subspecialties.

EMERGENCY DEPARTMENT

The Emergency Department rotation consists of shifts ranging from 4-12 hours in duration. Like most urban Children’s Hospitals, the emergency department cares for a wide array of ambulatory problems ranging from routine pediatric concerns to acute-life threatening trauma or illness. Approximately 50, 000 children are evaluated in the emergency department of Children’s of Alabama each year. During an emergency department rotation, resident provide initial contact and care with supervision from trained, emergency medicine specialists.

PRIMARY CARE CLINIC

- Residents spend ½ day a week in Continuity Clinic at the Primary Care Clinic adjacent to Children’s of Alabama. Located in Park Place, <1 block from the hospital (It will be connected when the new hospital opens in 2012), residents serve as the general pediatricians for children from the surrounding community. Residents are each assigned approximately 125 patients ages newborn to 18 years old with a variety of medical problems. Each clinic begins with a 30 minute talk on a relevant primary care topic.

ADOLESCENT

All residents complete a one month experience in Adolescent medicine. This rotation provides the basis for evaluation and care of this special pediatric population. Training locations include the inpatient and outpatient facilities of the Children’s of Alabama as well as special instruction in eating disorders clinic, juvenile detention centers, weight management clinics, adolescent HIV clinic, adolescent gynecology experiences, and a teen transition clinic.

BEHAVIOR AND DEVELOPMENT

An understanding of normal and abnormal behavior and development are key foundations of training in pediatrics. A one month experience in behavior and development is required for all residents. Multi-disciplinary clinics form this rotation including child development clinic, behavioral management clinic, newborn follow up clinic, autism clinic, Down syndrome clinic, spina bifida clinic, sleep disorders clinic, muscular dystrophy clinic, genetics clinic, neurology/movement disorders clinic and Rett syndrome clinic. In addition, community agency exposure with United Cerebral Palsy, the YMCA Day Care center and school based programs with the EPIC school round out the broad based educational opportunities. Educational modules and clinical case scenarios supplement the clinic rotations.

UAB Department of Pediatrics • 1600 7th Avenue South, ACC 604, Birmingham, AL 35233 • 205-638-9589

NURSERY EXPERIENCES AT Women and Infant's Center

One month is spent in the newborn nursery at UAB’s Women and Infant’s Center during a resident’s intern year. Residents will be responsible for the routine newborn care of around 10 babies each. Residents are taught normal and abnormal physical exam findings as well as the management and evaluation of common newborn problems such as jaundice, possible sepsis, feeding intolerance, and heart murmurs. Residents also gain expertise with circumcisions on this rotation. No call is taken during the newborn nursery rotation.

A total of 4 months during residency is spent in the 115 bed, level III+ Regional Neonatal Intensive Care Unit (RNICU) at UAB hospital. As one of the busiest NICU’s in the nation, residents can expect to see a wide range of patients ranging from 23 weeks gestational age to full term. Residents attend all high risk or otherwise complicated deliveries and thus become proficient at resuscitating newborns on this rotation. Additionally, residents have the opportunity to perform numerous procedures including intubation, umbilical line placement, and lumbar puncture. With the recent addition of a Cardiovascular NICU, residents are also exposed to the management and care of neonates with cardiac lesions. Call for 2nd and 3rd years is every 4th night. Interns are on a rotating night float system with one week of nights and three weeks of days every month.

PEDIATRIC INTENSIVE CARE AT CHILDREN'S OF ALABAMA

Second year pediatric residents spend two months in the Pediatric Intensive Care Unit (PICU) at Children’s of Alabama. This 19 bed unit provides state-of-the art critical care for the sickest of our patients. Residents gain in-depth experience in the identification and management of respiratory and cardiac failure, treatment of sepsis, management of severe trauma and a wide range of other disorders. This experience provides the confidence to manage sick patients the remainder of your career. Residents also hone their procedural skills with intubations, line placement and other diagnostic procedures during these rotations. Care is supervised by Pediatric Critical Care medicine-trained faculty.

PEDIATRIC SUB-SPECIALTY ROTATIONS (CHILDREN'S OF ALABAMA AND UNIVERSITY HOSPITAL)

The UAB Pediatric residency training program offers sub-specialty exposure to the full array of pediatric experiences. Sub-specialty rotations range from primarily inpatient experiences (Hematology-Oncology, Pulmonary and Renal) to primarily outpatient experiences (Allergy and Immunology, Cardiology and Rheumatology) or mixed inpatient/outpatient experiences (Endocrinology, Gastroenterology, Infectious disease, Neurology and Genetics). Subspecialty rotations are spread throughout the three years of training.