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The Department of Pediatrics believes the best patient care is delivered when the major responsibilities rest with the intern and resident while having highly accessible attendings and consultants. Thus, pediatric residents take active roles in patient care and are the primary care physicians under faculty supervision on all inpatient services and in the Pediatric Ambulatory Clinic (PAC). We believe that interns must "learn by doing" in order to develop the confidence, skills, and clinical judgment necessary to succeed as a pediatrician. The large referral area of LSUHSC assures that experience is gained over a wide spectrum of common and uncommon illnesses. Supervision and teaching medical students is another important facet of Pediatric training at LSUHSC (see education). Training is divided into month long blocks spent on various clinical rotations (see schedule). The principal rotations are:
Inpatient Ward Rotations Patients admitted to the pediatric medicine service are cared for by one of the two pediatric medicine teams. Each team is comprised of a faculty attending, a pediatric resident, two interns, and a varying number of medical students. While the attendings have ultimate responsibility, residents serve as the primary physician, participate in all management decisions, and perform procedures as needed. In house call is every fourth night for interns. Daily activities include morning report, where new admissions and management are discussed, attending rounds, and evening checkout.
Critically ill pediatric patients are cared for in the PICU by a team consisting of PICU staff and residents. In addition to critical care pediatric medicine, residents gain experience in post op surgical care and management of trauma surgery patients. Residents become skilled in central venous catheter placement, arterial line placement, intubations, and ventilator management. In-house call is every fourth night.
Critically ill newborns are managed in the NICU by a neonatologist, neonatology fellow, and residents. Residents gain experience in the full scope of neonatology including resuscitation, ventilator management, fluids and electrolytes, and nutrition. A weekly case conference and teaching conference targeted at specific NICU problems further supplements the resident's educational experience. Rounds are made daily and in-house call is every fourth night.
University Hospital averages 2400 deliveries per year, and residents learn routine newborn care in our nursery. Residents perform initial and discharge physical exams as well as any procedures which are necessary including circumcision, if the resident desires. The Nursery staff has developed a curriculum which covers many aspects of newborn care which the resident studies independently and then discuss with the attending. Call frequency in the nursery is reduced and generally taken in the NICU/Ward (approximately 4/month).
Residents
see patients in the PAC with a wide range of illnesses from the common cold to complex
congenital heart disease. Residents obtain a strong foundation in pediatric ambulatory
care principals and practice, as well as a variety of emergencies in the urgent care area
of the pediatric clinic. Residents are the primary physicians performing initial
evaluations and workup but faculty backup is readily available twenty-four hours a day.
The Pediatric Emergency Room is located adjacent to the Adult Emergency Department. During the day, from 8am to 5pm, acutely ill pediatric patients are seen in the Pediatric Ambulatory Clinic, and only patients with trauma, patients actively seizing, patients in cardiopulmonary arrest, or patients arriving by ambulance are taken to the Main ER. The Pediatric ER then opens from 5pm to 8am on weekdays and 24 hours a day on the weekends and holidays with attending coverage by both pediatric and emergency medicine trained physicians. Residents and interns work a number of different shifts while on their PAC, PAC/ER, and ER rotations and therefore gain exposure to a wide variety of common pediatric problems, acute illnesses, and trauma.
In addition to the educational experiences already described, there are a number of daily morning and noon conferences to further your training such as weekly Grand Rounds, monthly case conference, pathology conference, radiology conference and journal club. Pediatric subspecialists and specialists from other divisions all participate in our educational curriculum.
First year residents will complete the following:
Second year residents complete the following:
Third year residents complete the following:
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