Core rotations are rotations that each resident will rotate through during his/her training at UAMS and ACH. They are the foundation of your general pediatric training and important for all physicians regardless of future career plans. Some rotations are primarily inpatient rotations, some primarily outpatient, and some are a combination of both.
Inpatient Ward Rotations
There are currently six ward teams. Three of the six teams are a combination of general pediatric patients mixed with one to two subspecialty services like Nephrology and Neurology and based on the typical units of admission. This helps to provide a more focused learning experience for residents. The team includes three to four interns, two to three medical students, one supervising senior resident, and one faculty attending. In addition, there are 3 specialties teams: Hematology-Oncology, Pulmonary, and Cardiology. Heme-Onc and Pulmonary rotations are staffed with interns and senior residents. Cardiology is specifically a 2nd year rotation combining clinic and inpatient experiences. The senior residents on Heme-Onc are also attending clinic for a portion of their month’s rotation. While on service, residents attend morning report and team rounds in addition to noon conferences.
Residents take short call up to 7:30 p.m. on Sunday through Thursday evening. A team of night float residents staff the overnight admissions and cross-cover calls on these days. Overnight, or long call, is covered on Friday and Saturday evening per team.
Learn more about the Inpatient Wards
Outpatient Rotation:
The outpatient rotation includes the four months as an intern and the one month as a 2nd year resident. During this month the resident will work either in the acute General Pediatric Clinic or will work shifts in the Emergency Department. Interns will also spend some educational time with our Team for Children at Risk (TCAR) to learn about evaluations of suspected physical and sexual abuse. Didactics on the outpatient rotation include educational conferences every Tuesday in the Emergency Department and Wednesday-Friday in the General Pediatric Clinic. There are no true calls on the Outpatient Months as residents work night shifts in the ER.
Behavior and Development:
Each intern will spend one month learning about Child behavior and development with our specialists in this area. This call-free month is a unique combination of clinic experiences evaluating children with suspected learning, developmental and behavioral abnormalities; exposure to the varied therapy services within the community, and lastly unique opportunities to work with families with chronic conditions in order to learn about the medical home model.
Newborn Nursery:
Each intern and several third year residents will rotate through the Term nursery at UAMS. The nursery team consists of one senior resident and two to three interns. The nursery team attends all full term or near term deliveries to learn resuscitation skills. They also provide routine newborn care and care to the moderately complex newborn. There is a specific Newborn Nursery attending to help staff this team. Call on this service is every 4-6 days.
Neonatal Intensive Care Nursery:
Residents will rotate through either the Neonatal Intensive Care Unit at ACH or the Intensive Care Nursery at UAMS. All interns rotate through the ICN, which supports continued learning in neonatal resuscitation after delivery to include now the high risk newborn or premature neonate. Senior residents will rotate through either the NICU or ICN during their NICU months. The ACH NICU is a referral, tertiary intensive care unit accepting transfers of any high risk newborn, including micro-premies, critically ill newborns, and newborns requiring surgical care. Each NICU is staffed 24 hours a day with neonatal fellows or attendings.
Pediatric Intensive Care Unit (PICU):
One month during each in the resident’s second and third year is spent rotating through the Pediatric Intensive Care Unit. This unit accepts the sickest, most acutely ill patients throughout the state and Southern region. Residents learn about the acute management of unstable patients, decompensating patients with chronic illnesses, and end of life care. Residents are supervised by Intensive Care fellows and attendings and these supervisors are available in-house 24 hours a day.
Cardiology:
A 2nd year rotation for all residents in order to learn about the accurate diagnosis of cardiac conditions, including normal variants and an introduction to the surgical management of complex congenital disorders. Residents work with board certified cardiologist in both the inpatient and outpatient clinic settings. This month has no overnight call for the residents.
Hematology-Oncology:
This year, senior residents began rotating through both the inpatient Heme-Onc service as well as outpatient clinic in order to provide a more complete picture of this specialty. Senior residents on the inpatient service weeks will supervise the intern and work-up patients with different forms of cancer as well as blood disorders including sickle cell and coagulophathies. Board Certified Hematologist-Oncologists serve as valuable attendings.
Adolescent:
A required rotation that all 2nd year residents complete. The rotation includes experiences in the Adolescent clinic providing primary care to adolescent patients with their unique care needed for this population. Other unique experiences include rotating through a school-based clinic at JobCorp and participating in the Eating Disorder Clinic, which is a multidisciplinary clinic evaluating teens with suspected eating disorders. Our adolescent section is staffed by five adolescent trained physicians and has the support of Social work, Psychology, and Physical Therapy in clinic to provide comprehensive care.
Endocrinology:
All 2nd year residents complete an outpatient month in Endocrine. The resident will learn about the initial evaluation of children with short stature, abnormal pubertal development, as well as chronic management of diabetes and growth hormone deficiency
ER Admit:
Each 3rd year resident will complete one month working within the Emergency Department. The resident works 5-12 hour shifts weekly throughout the entire month, which is different from the outpatient month as an intern and second year, which includes shifts in both the GPC and Emergency Department. The ER Admit resident is able to manage more acutely ill patients with the ready assistance of ED attendings in addition to supervising junior residents. Senior residents also assist in accepting outside physician calls about possible transfers to ACH for evaluation.
General Pediatric Clinic:
All 3rd year residents will rotate through the General Pediatric Center for an entire month providing acute care on a daily basis. Residents have a goal to see approximately 10 visits per half day clinic. Senior residents also supervise interns and medical students including teaching as it warrants. This is a no-call month, but the resident will work 1-2 ER shifts on one of the weekends during the month.
