Curriculum Overview

Residency training at CHKD combines formalized educational sessionsunique learning enhancementsresearch opportunities and exceptional clinical experiences with a diverse patient population spanning the breadth of pediatrics.

Based on direct resident input, rotations occur in four-week blocks with a total of 13 blocks per year.  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.

Our first-year residents learn while on rotations in the ED, NICU, nurseries and on inpatient teams (hospitalist, subspecialty) in addition to ambulatory pediatrics blocks, one of which is call-free.  One afternoon per week is dedicated to experiences in general pediatric continuity clinic.

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 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 residents are given half the year to pursue experiences tailored to their desired career paths while also returning to the ED, PICU, 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

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.  Click the headings below to learn more about each rotation.

Each resident spends one dedicated afternoon per week in 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.

 

Our pediatric residents have opportunities to choose from a variety of elective 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 

CHKD's Emergency Department receives over 50,000 annual visits and is home to the region's first and only Level 1 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

 

There are 4 resident ward teams:

  • Team C - Hematology/Oncology
  • Team H - Hospitalist
  • Team K - Cardiology, Neurology, Neurosurgery, Pulmonology & Rheumatology
  • Team D - Endocrinology, Gastro, ID, Nephrology  

CHKD inpatient statistics, June 2017 - July 2018:

  • Medical admissions: 5,144
  • Inpatient days: 47,218
  • Average daily census: 129

 

In addition to our 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

**During FY2017-2018, CHKD cared for more VLBW (very low birth weight) newborns than any other freestanding children's hospital in the nation.

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

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.

EVMS pediatric residents at CHKD participate in a number of different rotations throughout their training.