Categorical Track

Categorical Track Overview

Residency training at CHKD combines formalized educational sessions, curriculums, pathways, and exceptional clinical experiences with a diverse patient population spanning the breadth of pediatrics.

Since 2021-2022 academic year, our program has utilized the “X + Y” scheduling with the hypothesis that outpatient continuity could be maintained or improved while inpatient handoffs would be reduced. We use the “6 + 2” variation of this model with ‘X’ representing the number of inpatient and ‘Y’ representing the alternating and call free, ambulatory and continuity weeks. Annual paid vacations (15 workdays) are provided with efforts made for three full weeks. In addition, annual holiday vacations (5 days) are provided around Christmas or New Year's holidays.

First Year (PL1)

First Year (PL1)

Our first-year residents learn while on rotations in the emergency department, neonatal intensive care unit, nurseries and on inpatient teams (hospitalist, subspecialty) in addition to ambulatory pediatrics.

Roles of first-year residents:

• Enhance knowledge and develop skills necessary to understand, evaluate, and manage pediatric problems
• Supplement learning through conference attendance and engagement
• Differentiate between variations of illnesses and severity under senior resident and attending supervision
• Function as a primary care physician with guidance from attending advisors

Second Year (PL2)

Second Year (PL2)

Second-year residents continue their learning in outpatient, inpatient and acute-care settings while also assisting seniors in setting an example for and guiding junior residents and students.  Dedicated time is provided to our second years' choices of electives and scholarship.

Roles of second-year residents:

• Personalize curriculum in area(s) of interest guided by general peds/subspecialty physician mentors
• Acquire an increased level of responsibility for patient management
• Foster teaching and team leadership abilities alongside senior residents
• Mature as a primary care physician with advisement from faculty attendings

Third Year (PL3)

Third Year (PL3)

Third-year residents are given half the year to pursue experiences tailored to their desired career paths while also returning to the emergency department, pediatric intensive care unit, and wards with an emphasis on continual quality and process improvement, teaching, leadership, and the delivery of cost-effective care.

Roles of third-year residents:

• Acquire tools to effectively advocate for the health and wellness of diverse patient populations
• Provide evidence-based care for acute and chronic conditions in all clinical settings 
• Prioritize teaching, mentorship and supervision of junior residents and students
• Grow as a autonomous, proficient primary care physician in partnership with faculty attendings

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Educational Sessions

Residents receive 2 daily hours of dedicated protected learning time for scheduled conferences, typically between 8 -9 a .m. and Noon - 1 p.m.  Various educational sessions occur daily, weekly, and/or monthly.

Various educational sessions such as:

Academic Half-Days (Y-Block)
· Research Curriculum
· QI Workshop
· Career Development

Morning and noon conferences
· facilitated by attendings, chief residents, residents, ward teams and guest lecturers
· tailored using American Board of Pediatrics content specifications
· lunch provided daily
· Noon conferences are protected time with pagers covered

Weekly Pediatric Grand Rounds
· hospital-wide multi-disciplinary conference
· includes guest lecturers from around the world and in-house experts presenting the latest in their fields
· breakfast provided

Medical Code and Skills Workshop
· review PALS guidelines, code management and communication in a small group setting
· offers high fidelity simulation to reinforce proficient and confident actions during actual code situations
· strengthens multidisciplinary teamwork among nursing, pharmacy, respiratory therapy, chaplains and security
· common skills rehearsed:
o IO placement, intubation, umbilical line placement, lumbar puncture, suturing, code carts, medication administration, etc.

Rotations

Our program offers residents excellent learning experiences and clinical exposure spanning the breadth of pediatric medicine within a single facility dedicated solely to children.  

General Pediatrics

General Pediatrics

Each resident will spend time in their 'Y' block at the first floor General Academic Pediatrics continuity clinic. This opportunity allows residents to develop relationships with patients and families throughout their residency.  Residents participate in simulated patient/family scenarios with their attendings and hone their teaching skills through medical student instruction. 

Additional blocks of outpatient general pediatrics are scheduled to provide residents with a deeper understanding of the practice of general pediatrics.   There are ample opportunities to rotate in local practices where over 70% of community pediatricians are graduates of our program.

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Individualized Curriculum Experiences

Individualized Curriculum Experiences

Our pediatric residents have opportunities to choose from a variety of rotations, both local and global, including: 

• Adolescent Medicine
• Allergy and Immunology
• Anesthesia 
• Cardiology
• Child Abuse Pediatrics
• Community Pediatrics
• Critical Care Medicine
• Dermatology
• Developmental Pediatrics 
• Emergency Medicine 
• Endocrinology
• Gastroenterology 
• General Academic Pediatrics 
• Genetics
• Global Health and Medical Trips 
• Hematology and Oncology
• Hospital Medicine
• Infectious Diseases 
• Lactation
• Neonatal-Perinatal Medicine
• Nephrology
• Neurology/EEG
• Neurosurgery
• Otolaryngology
• Palliative Care
• Pathology
• Pediatric Surgery 
• Physical Medicine and Rehab
• Psychiatry 
• Psychology
• Procedural Skills
• Pulmonology 
• Radiology 
• Research QI
• Rheumatology
• Sports Medicine
• Simulation Lab
• Sleep Medicine
• Urgent Care
• Vascular Access 

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Ward Rotations

Nursery rotations

Nursery rotations

In addition to the in-house NICU, residents rotate through two nurseries within Sentara Norfolk General Hospital. This component of our program gives residents experience in supporting families with new infants. Residents participate in all aspects of routine newborn care in the Level 1 nursery and specialized care in the Level 2 nursery. 

Nursery statistics:

• Level 1 "well baby" beds: 25+
• Level 2 "special care" beds: 48
• Annual deliveries: ~5,000
  • >50% "high-risk" deliveries
  • Regional perinatal referral center

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Emergency Department Rotations

Emergency Department Rotations

CHKD's Emergency Department receives over 50,000 annual visits and is home to the region's first and only Level I Pediatric Trauma Center.  This affords residents quality learning and skill development opportunities in treating children with acute illnesses and injuries.

Common critical care, minor care, and procedural care interventions performed by our residents in the ED: 

• Resuscitations
• Ultrasound
• Pediatric trauma
• Lumbar punctures 
• Intubations
• Incisions and drainage
• Suturing
• IV access
• Splinting

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NICU

NICU

This resident-focused educational experience offers:

• The opportunity to do procedures starting as an intern, including:
  • Umbilical catheterization
  • Lumbar punctures
  • Intubations
  • Chest tubes
• Team rounding with a nutritionist, pharmacist and social worker to provide the best comprehensive care for patients
• Mentorship with attendings
• Close relationships with patients and families

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PICU

PICU

The Pediatric Intensive Care Unit educates residents from EVMS Pediatrics at CHKD, Portsmouth Naval Medical Center Pediatrics, EVMS Emergency Medicine and CHKD Pediatric Emergency Medicine program.

This rotation gives residents the chance to perform procedures including:

• Placing central lines and chest tubes
• Intubating with the 24/7 in-house intensivists 

Care for patients after complex surgeries including:

• Cardiothoracic surgery
• Extracorporeal membrane oxygenation (ECMO)
• Neurosurgery 
• Renal transplant patients 

Observe general and subspecialty surgical patients, treating intricate subspecialty patients, work alongside attendings, nurses and RTs, collaborate with a specialized PICU pharmacist and complete rounds as a team.

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