Pediatric Residency

Pediatric Residency

Elective Listing

2010-2011

(Updated: 06/16/2010)

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TABLE OF CONTENTS

GUIDELINES FOR ELECTIVES 3

ADOLESCENT MEDICINE 5

ALLERGY IMMUNOLOGY 5

AMBULATORY PEDIATRICS 6

ANESTHESIOLOGY 7

CARDIOLOGY 9

DERMATOLOGY 12

DEVELOPMENTAL PEDIATRICS 13

ENDOCRINOLOGY AND METABOLISM 13

GASTROENTEROLOGY, HEPATOLOGY, AND NUTRITION 14

GASTROENTEROLOGY AND NUTRITION – BOLIVIA 15

GENETICS 16

HEMATOLOGY-ONCOLOGY 18

HOSPITALIST 19

HOSPITALIST – AWAY (GUATEMALA) 21

INFECTIOUS DISEASE 22

HIV/RETROVIROLOGY AND GLOBAL HEALTH 22

NAVAJO ELECTIVE 24

NEPHROLOGY ELECTIVE 26

NEUROLOGY ELECTIVE 27

ORTHOPEDIC ELECTIVE 30

OTOLARYNGOLOGY ELECTIVE 31

PATHOLOGY ELECTIVE 32

PICU Elective 32

PEDIATRIC SLEEP MEDICINE 33

PHYSICAL MEDICINE AND REHABILITATION 34

PRIVATE PEDIATRICIAN OFFICE 35

PSYCHIATRY 35

PULMONARY AMBULATORY ELECTIVE 36

RADIOLOGY 37

RESEARCH 38

RHEUMATOLOGY 38

SIMULATION MEDICINE ELECTIVE 39

SPORTS MEDICINE ELECTIVE 39

PEDIATRIC SURGERY 40

SURGICAL SUBSPECIALTIES 41

UROLOGY 43

GUIDELINES FOR ELECTIVES

A resident's total elective program, as well as each individual elective, must be in keeping with the requirements of the American Board of Pediatrics and the Residency Review Committee of the ACGME.

In order to meet RRC guidelines regarding total amount of ambulatory time, residents may be limited regarding the number of predominantly inpatient electives that they can do. This issue primarily affects third year residents. Please consult with one of the chief residents if you have questions about your specific situation.

In order to meet RRC guidelines regarding subspecialty time, categorical pediatric residents must do seven subspecialty months, four from list A and three from either list A or B. Residents in the combined internal medicine-pediatrics program must do at least four subspecialty months, which must come from list A. These lists are dictated by the RRC and are not negotiable.

*Rising PL-2 residents received credit for 1 List A subspecialty by completing TCH 9. Rising PL-3 residents received credit for 3 subspecialities by completing TCH 9, TCH 15, and Blue Bird/Neuro Consult rotations. The remaining subspecialty months are completed by doing electives or additional subspecialty months from the lists below:

**BIPAI elective counts as Infectious Disease from List A.

Selective (List A) Subspecialties / Other (List B) Subspecialties
·  Allergy/Immunology
·  Cardiology*
·  Endocrinology
·  Genetics
·  Gastroenterology
·  Hematology/Oncology*
·  Infectious Diseases**
·  Nephrology
·  Neurology*
·  Pulmonary
·  Rheumatology / ·  Pediatric Anesthesiology
·  Child Psychiatry
·  Pediatric Dermatology
·  Pediatric Ophthalmology
·  Pediatric Orthopedics and Sports Medicine
·  Pediatric Otolaryngology
·  Pediatric Radiology
·  Pediatric Surgery
·  Pediatric Surgical Subspecialties
·  Pediatric Physical Medicine and Rehabilitation

Away Electives - Coordinating away electives, particularly the Navajo, BIPAI, and Guatemala electives, requires a great deal of effort on the part of the physicians and staff at those institutions. If you sign up for one of these electives, you are expected to go. Switching out of the elective should only be done under extreme circumstances. Pulling out residents that we committed to go reflects poorly on Baylor and may jeopardize the future availability of these electives.

During the PL II year, only one elective month may be taken away from the Baylor system. No more than a total of two months (PLII and PLIII years combined) may be taken outside of the Baylor Affiliated Hospitals. Exceptions will be permitted only for extenuating reasons, and must be approved by Dr.Ward or the Curriculum Committee. Dr. Ward must approve all outside electives (electives in the private practice offices in Houston of pediatricians on the voluntary faculty of TCH and with clinical appointments to the Baylor faculty do not count as outside electives). Any elective that includes 10 or more calendar days away shall be counted as an away elective.

Away electives are not permitted during the months of December and June as well as the month of the intern retreat - usually October.

Backup call is required during all electives except those outside Houston. The backup call schedule will be published in conjunction with the monthly call schedule.

SPECIAL ELECTIVES AND AWAY ELECTIVES Electives may be arranged in areas other than those listed on the following pages. Prior arrangements must be made and approval must be obtained by both the appropriate attending and Dr. Ward. Such electives must be educationally appropriate for a career in pediatrics and must meet all RRC and ABP requirements for credit.

Electives may be taken outside the Baylor program. Prior approval must be obtained from Dr. Ward. Please keep in mind that your institutional certificate from Baylor does not legally permit you to practice medicine outside of Texas. Therefore, you must either have a valid state medical license for the state in which the elective is to be done or obtain an appropriate institutional certificate when doing an elective outside of Texas. Failure to do so could place you in great professional jeopardy, since you would be practicing Medicine-pediatrics without a license. Your malpractice insurance through Baylor will cover you while on an official elective, even if outside Texas.

The Department of Pediatrics does not send residents on away electives. We permit residents to use time for valid educational activities outside of the Baylor Affiliated Hospitals. Therefore, the resident is responsible for all arrangements for away electives and also is responsible for his or her safety during travel to, from the elective, and at the elective itself. The Department bears no responsibility for any risk incurred as part of this elective. Specifically for residents who choose to go to under-served or under-developed areas, the resident is responsible for assessing any personal risks involved, including, but not limited to infectious diseases. In the case of travel outside the United States, it is the resident’s responsibility to ascertain whether or not special immunizations, chemoprophylaxis for malaria, or other health measures are required and to obtain these.

The Pediatric Department has informal contacts with several U.S. Public Health Service Indian Hospitals on the Navajo Reservation in Arizona, the Hospital Gustavo Castaneda-Palacios (pediatric community clinic), Zacapa, Guatemala, and Hospital Pedro de Bethancourt in Antigua, Guatemala. All of these are unique educational opportunities. Although individual arrangements will need to be made by the residents taking these electives, we can facilitate the process. For more information about these electives, see description below. If you are interested in doing BIPAI please see HIV/Retrovirology elective information.

Vacations, meetings, and holidays will need to be scheduled during away electives as during any other elective. Please keep this in mind as you submit your requests.

Residents planning to do special electives should obtain and complete a Special Elective Request Form from Dr. Ward's office. This is to be done after the year's schedule has been published and the month of assignment for the special elective determined.

ADOLESCENT MEDICINE

Director:Albert C. Hergenroeder, M.D.

Contact:Albert C. Hergenroeder, M.D. (832-822-3660)

Where to report first day: CCC, Suite 1710
Goals:
The resident will understand how to pursue further scholarly activity in a content area specific to adolescent medicine.
Objective:
By the end of the rotation, the resident will be able to perform/produce one or more of the following activities/products:
(1) an in-depth literature review of an adolescent medicine topic with subsequent presentation of the material to the adolescent medicine section faculty;
(2) with the guidance of a faculty member, perform a thorough literature review and write an UpToDate chapter in the Adolescent Medicine Section of UpToDate that will be subject to peer review and publication;
(3) provide research assistance for an existing research project in the section and be involved in the development of a research manuscript (if the resident were interested in continuing the work initiated during the elective) or a summary paper of 5 pages or more describing the research project and the research "lessons learned"
Description:
As there is a required PL-II Adolescent Medicine rotation, the goals of this special elective can be suited to the career goals of the resident, to include clinical and research work and can be discussed with Dr. Hergenroeder or any of the Adolescent Medicine faculty.
Restrictions on who is eligible for elective: None
Restrictions on time of year elective offered: None

ALLERGY IMMUNOLOGY

Director: William T. Shearer, M.D., Ph.D.
Contact: Program Coordinator, Teri McCumber, please contact prior to the start date of the elective (; 832-824-1319)

Where to report first day: Feigin Center,Suite 330

Goals & Objectives:

(1) To enhance the pediatric evaluation of allergic/immune deficient disorders by refinement/expansion of interview and physical examination skills.

(2) To provide insight into diagnosis and medical management of allergic/immunodeficient disorders in children.

(3) To stimulate interest in Allergy/Immunology and participation in better understanding of the immunopathogenesis of disorders such as asthma, primary immune deficiency, and pediatric HIV infection.

(4) To provide an opportunity for interested residents to participate in special projects including clinical research and introduction to immunology laboratory research.

Activities:

(1) Attend outpatient clinic when working with outpatient team and complete patient sign-out to clinic fellow.

(2) Attend inpatient rounds when working with inpatient team.

(3) Observe administration of diagnostic tests and maintain patient and procedure log.

(4) Attend all AI conferences and ImmunodeficiencyRounds.

(5) Give a presentation on an allergy/immunology topic duringone of the teaching conference sessions.

(6) Discuss educational and scholarly activity experiences with one or more of the following: AI Faculty Member, Associate Program Director, Program Director.

Description:

The elective is offered at Texas Children's Hospital. Residents will participate in the outpatient evaluation of children with hypersensitivity diseases and primary and acquired immune deficiencies. Inpatient activities will be limited to participation in rounds and consultations will occupy not more than 25% of the resident's time. Allergy/Immunology Outpatient Clinics are held Monday through Friday at Texas Children's Hospital. Patients are also seen at Ben Taub General Hospital on Wednesday mornings at the outpatient allergy clinic. These clinics provide residents an opportunity to evaluate a spectrum of diseases including: allergic rhinitis, asthma, urticaria (acute and chronic), drug hypersensitivity, eczema, primary immune deficiencies, pediatric HIV infection, and other secondary immune deficiencies. Teaching conferences includea weeklysectionconference and CPC,sectionimmunodeficiencyrounds,section Hypersensitivity Course conference, sectionFellow-BasedClinics conference, and Pediatric Grand Rounds. During the elective, residents are requested to present a topic of their choice inallergy/immunology at one of the teaching conference timeslots. Additional learning opportunities include participation inAllergy/ImmunologyBoardReview sessions, laboratory observations in our Allergy/Immunology Clinical Laboratory (ie. flow cytometry) among otherAllergy/Immunology educational experiences.

Restrictions on who is eligible for elective: None
Restrictions on time of year elective offered: None

AMBULATORY PEDIATRICS

Director: D’Juanna White-Satcher, M.D
Contact: Ida Hernandez, 832-822-3441

Where to report first day: Clinical Care Center 15th floor Suite 1540.00- 9 AM

Goals:
To better preparethe residentforindependent practice in primary care pediatrics.

Objectives:
To expand the residents exposure to a variety of clinical subspecialties, support services and community resources in order to better prepare themselves for pediatric practice.

Description:

The elective is fairly flexible in that it can be organized and planned according to the individual's needs and objectives. The resident will devise a schedule for the entire month of activities chosen from a list of 15 different activities. The experiences includesome subspecialty clinics such as ophthalmology, urology, sports medicine, and otolaryngology. In addition, the resident can observe how children with specific needs such as the developmentally or mentally retarded child or handicapped child are evaluated and managed in the community. This is accomplished by visiting such agencies as theAvondale House( community program for children with Autism or PDD)orMHMRAInfantParent Training Program. There is also a session with a billing specialist. If the resident wishes to do something not listed, this activity may be done but must be discussed with Dr.White-Satcher prior to finalizing the schedule. At the completion of the elective the resident will complete a project based on their learning experiences. This elective is an excellent choice for the resident interested in general pediatrics or private practice. The elective is limited to two house officers per month.

Restrictions on who is eligible for elective: None

Restrictions on time of year elective offered: None

ANESTHESIOLOGY

Director: Nancy Glass, M.D. and Carlos Rodriquez, M.D.

Contact: Nancy Glass, M.D. Email: Carlos Rodriguez, M.D. email:

Where to report first day: Main OR Control desk at 7AM, dressed in scrub attire, and request assignment from the Anesthesia GOAT (Anesthesiologist running the schedule)

Please see Pediatrics website via the TCH Intranet (under DocumentsàElectives) for Patient Log, Procedure Checklist, and further information regarding the elective. Bring the Patient Log and Checklist with you on the first day of the rotation.

Goals:
(1) Acquire a basic understanding of Pediatric Anesthesiology, including the special considerations imposed by pediatric anatomy and physiology.
(2) Understand the rationale for when an artificial airway is necessary, and develop competence in the placement of common airway devices.
(3) Develop an understanding of acute postoperative pain management

Objectives:
Patient care

·  Assist the anesthesiologist with all aspects of anesthetic care, including the preoperative assessment, and in the recovery room. This will include procedures such as IV placement, bag mask ventilation, and endotracheal intubation.

·  Develop an appropriate post operative pain management plan with the Anesthesiology attending

Medical Knowledge

·  Discuss pertinent topics with assigned attendings relating to pediatric anesthesia and common co-existing pediatric diseases

·  Attending morning teaching conferences, held Mondays, Tuesdays, Thursdays and Fridays at 6:15am. Attendance at Wednesday conferences is not required.

Practice Based Learning and Improvement

·  Attend departmental Quality Improvement meetings

·  Actively seek and accept feedback from attendings regarding all aspects of performance

·  Maintain a case log

Professionalism

·  At all times, conduct him/herself in a manner befitting the medical profession. This includes, but is not limited to, appropriate attire, personal grooming, demonstrating courtesy and empathy with patients and family, and collegial behavior towards other medical and nursing staff

Interpersonal and Communication skills