National Capital Consortium (NCC)
Pediatric Residency Program
Walter Reed Army Medical Center National Naval Medical Center
6900 Georgia Avenue, NW 8901 Wisconsin Avenue
Washington, DC 20307 Bethesda, MD 20889
Malcolm Grow Medical Center Uniformed Services University
89th Medical Group 4301 Jones Bridge Road
1050 West Perimeter Road Bethesda, MD 20814
Andrews AFB, MD 20762
MEMORANDUM
Subject: HOUSE STAFF SUPERVISION POLICY
Section V.G.1 of the 1997 Residency Review Committee program requirements for pediatrics states, “The supervision of residents must be accomplished through explicit written descriptions of supervisory lines of responsibility.” This explicit written description must be distributed each year to the housestaff and faculty. This explicit written description must be available for review by the site visitor at the accreditation site visits. This memorandum constitutes that explicit written description per program requirement V.G.1.
Every pediatric patient seen by a pediatric trainee in the National Capital Area does so under the supervision of a staff pediatrician who assumes complete responsibility for those patients in whom he or she is the attending pediatrician of record. At the same time, since we are a teaching hospital, the staff pediatrician is also responsible for the education of pediatric interns and residents. Attending supervision may be direct or indirect. Indirect supervision occurs when the responsible staff is aware of the patient and is available to assist or provide direct supervision if needed but is not physically present. In these instances, the chief pediatric resident (PL-3) may provide direct supervision over junior residents and interns, depending on the complexity of the case. Procedures performed on pediatric patients vary in complexity. Therefore, a list of procedures and what level of pediatric trainee may perform them is also listed in this document.
Neonatal Intensive Care Unit (NICU)
Interns assigned to the Neonatal Intensive Care Unit are supervised by the senior residents (PL-2s and PL-3s) assigned to that area. Neonatologists and neonatalogy fellows supervise the senior resident and his/her attached intern. Overnight call staff consists of a 2 residents (2 senior residents, or 1 senior resident and 1 intern), in addition to a neonatal fellow.
Mother-Infant Care Center (MICC)
The intern assigned to the MICC is supervised by the third year resident assigned to that area. Pediatric faculty in the Department of Pediatrics supervises the third year resident and his/her attached intern.
Ward 51 (Bruton Inpatient Pediatric Unit)
The interns assigned to the Bruton Ward are supervised by the second year residents assigned to the ward as well as the PL-3 ward chief resident. The pediatric faculty in the Department of Pediatrics supervises the third year resident and his/her attached second year resident and interns. Overnight call staff consists of one senior resident and one intern. The ward attending takes home call and is readily available via phone or pager. The senior resident must notify their attending of any new admissions prior to arrival to the ward. The resident must also immediately notify the attending of any unexpected change in a patient’s condition. If the patient is post-procedure and has had an unexpected change in condition, then the fellow and attending performing the procedure should also be immediately notified.
Ambulatory Care
Faculty member of the Department of Pediatrics supervises interns and residents assigned to the Ambulatory Care rotation.
Subspecialty Rotations at WRAMC and NNMC
Subspecialty faculty of the Department of Pediatrics at WRAMC and NNMC supervises residents on subspecialty electives at WRAMC and NNMC.
Subspecialty Rotations at Children’s National Medical Center (CNMC)
Subspecialty faculty of the Department of Pediatrics at CNMC supervises residents on subspecialty electives at CNMC.
Behavior/Development
Interns and residents assigned to the Behavior/Development rotation are supervised by the faculty of the Behavior/Development Division who are members of the faculty of Department of Pediatrics.
Adolescent Medicine
Adolescent Medicine specialists who are members of the faculty of Department of Pediatrics supervise interns and residents assigned to the Adolescent Medicine rotation.
Pediatric Intensive Care Unit
Critical Care faculty of the Department of Pediatrics at WRAMC and CNMC supervises residents assigned to the Pediatric Intensive Care Unit.
Emergency Medicine
Physicians of the Walter Reed Army Medical Center Emergency Medicine Group supervise residents assigned to the Emergency Medicine service at Walter Reed Army Medical Center.
Pediatric Emergency Medicine
Physicians of the CNMC Emergency Medicine Group supervise residents assigned to the Pediatric Emergency Medicine service at Children’s National Medical Center.
Orthopedics
The pediatric chief of the orthopedics service at WRAMC and the orthopedic staff at Annapolis supervise interns assigned to the Orthopedics rotation.
Malcolm Grow Medical Center (MGMC)
Faculty of the Department of Pediatrics at MGMC supervises third year residents assigned to MGMC.
Community Pediatrics
A staff pediatrician assigned by the Program Director supervises the resident assigned to the community pediatrics rotation.