Curriculum

The University of Florida Pediatric Residency Program at Orlando Health features a curriculum structured to provide residents with increasing levels of responsibility for patient care, clinical supervision, and teaching of junior residents and medical students. The curriculum is designed to help foster the development of skills and competencies set by the Accreditation Council of Graduate Medical Education (ACGME) for the training of excellent pediatricians prepared for contemporary practice. The program maintains a strong focus on primary care education while providing excellent exposure to the pediatric specialties and the care of medically complex children in a tertiary care setting. The program also provides experiences in inpatient, outpatient, and community settings and provides excellent exposure to a highly diverse patient population. Patient safety, evidence based medicine, and continuous quality improvement are additional areas of focus. Our curriculum is developed and continually improved through active participation and feedback from faculty and residents. The academic year consists of 13 blocks. Each block consists of 4 weeks.

Year 1

  1. Inpatient (General)
  2. Inpatient (General)
  3. Inpatient (Subspecialty)
  4. Inpatient Night Float
  5. PSCU
  6. NICU
  7. Nursery
  8. Emergency Medicine
  9. Hematology / Oncology
  10. Acute Clinic
  11. Adolescent Medicine
  12. Behavior and Development
  13. Advocacy/Procedures

Year 2

  1. Inpatient Night Float
  2. PICU
  3. PSCU
  4. PSCU Night Float
  5. NICU
  6. Nursery
  7. Emergency Medicine
  8. Hematology / Oncology
  9. Hospitalist Service
  10. Community Outpatient
  11. Child Protection Team/Behavior and Development
  12. ILC
  13. ILC

Year 3

  1. Inpatient (General)
  2. Inpatient (Subspecialty)
  3. PICU
  4. PICU Night Float
  5. Acute Clinic
  6. Acute Clinic
  7. Elective
  8. Elective
  9. Elective
  10. ILC
  11. ILC
  12. ILC
  13. ILC

NICU - Neonatal Intensive Care Unit
PSCU - Pediatric Special Care Unit
PICU - Pediatric Intensive Care Unit
ILC - Individualized Learning Curriculum

Inpatient Rotations

Inpatient Pediatrics

Residents gain skills in the care of acutely ill and hospitalized pediatric patients at Arnold Palmer Hospital for Children. Arnold Palmer Hospital for Children is the largest freestanding facility of its kind in the southeast and is a major referral center for subspecialty pediatric care. Residents work alongside fellows, physician assistants, nurse practitioners, clinical pharmacists, social workers, case managers, clinical staff nurses to deliver multidisciplinary, family-centered care. The inpatient pediatric service is divided between a general pediatrics service and a subspecialty service. An intern averages five to seven patients while on service.

Hematology / Oncology

Residents also rotate on the Hematology/Oncology service during both their intern and second year of residency. The Center for Children’s Cancer and Blood Disorders is housed within Arnold Palmer Hospital for Children and comprises a 20-bed inpatient unit, an outpatient clinic with a chemotherapy infusion center and a radiation oncology department. The senior resident is responsible for managing pediatric Hematology/Oncology consults. An intern averages five to eight patients.

Pediatric Intensive Care and Special Care

Residents participate in the care of critically ill children in the 17-bed Pediatric Intensive Care Unit (PICU). Board certified pediatric critical care attendings manage and oversee the care of all children admitted to the unit. The unit is staffed by dedicated nurses, respiratory therapists, pharmacists, social workers, chaplains, nutritionists, and child-life specialists. Current critical care technologies such as extracorporeal membrane oxygenation, hemodialysis, and high-frequency oscillatory ventilation are offered. The unit supports a dedicated pediatric critical transport service and serves as a major referral center for critically ill pediatric patients from all over Central Florida. The PICU provides residents with valuable experience in invasive cardiovascular monitoring, complex fluid management, mechanical ventilation, and postoperative management. Senior residents average five to eight patients while on service. The Pediatric Special Care Unit (PSCU) is a stepdown unit that cares for children that require monitoring and close observation. The PSCU has a capacity of 26 beds and averages near 2,000 admissions a year. Residents average eight to ten patients while on service.

Neonatal Intensive Care

Residents are exposed to the full range of medical and surgical disorders of premature and term newborns as well as to the latest technological modalities including extracorporeal membrane oxygenation (ECMO) at the Alexander Center for Neonatology.  The 142-bed NICU is the largest in the country under one roof, and cares for more than 1,600 babies every year.  Residents work alongside Neonatal ICU attendings, nurse practitioners, dedicated nurses, respiratory therapists, pharmacists, social workers, chaplains, nutritionists, and child-life specialists.  Residents attend high-risk deliveries daily and care for patients on a dedicated teaching service.  They average five to eight patients daily.

Nursery

Residents receive an invaluable Nursery experience at Winnie Palmer Hospital for Women and Babies, which is the second-busiest labor and delivery unit in the United States. The hospital typically has anywhere from 12,000-15,000 deliveries per year. Residents will be responsible for caring for newborns in the Well Baby Nursery, as well as a Transitional Nursery. Residents will be exposed to a wide variety of normal and abnormal newborn conditions. They will also perform procedures such as circumcisions and frenotomies. Residents average seven to ten patients per day.

Outpatient Rotations

Outpatient Pediatrics

Residents receive exposure to the acute health conditions most encountered in the office setting and the care of acutely ill children and adolescents during their Outpatient Pediatrics rotation. Clinical experiences are supplemented with lectures and small groups group discussions. The rotation takes place at the Orlando Health Primary Care Pediatrics facility located in the downtown campus within walking distance of Arnold Palmer Hospital. Residents are supervised by faculty from the Department of General Pediatrics.

Emergency Medicine

The Bert Martin's Champion for Children Pediatric Emergency Department & Trauma Center at Arnold Palmer Hospital is a 33-bed, 23,500-square-foot facility. The center is the only Level 1 Pediatric Trauma Center in Central Florida and provides care for over 20,000 patients each year. Residents do 8-12 hour shifts under the supervision of board-certified pediatric emergency medicine physicians during their rotation.

Behavior and Development

During this rotation residents learn the basic concepts of normal child development and screening; disorders of cognition/ language; and behavior and mental health issues. Residents spend time in various sites including the Howard Phillips Center for Children and Families, Prescribed Pediatric Extended Care and several special needs schools. They also work with specialists in Physical Therapy, Occupational Therapy, Speech Therapy, Physical Medicine and Rehabilitation, Neurology, Neuropsychology, Genetics and Adolescent Medicine. The resident’s continuity clinics during the rotation are focused on performing full developmental screens for patients scheduled for well-child checks. This experience is facilitated by our general pediatrics outpatient faculty.

Adolescent Medicine

Residents gain experience in delivering comprehensive, developmentally appropriate care to patients 11-21 years of age during their Adolescent Medicine rotation. The rotation provides residents with diverse experiences in the areas of sports medicine, pediatric and adolescent gynecology, sexual and reproductive health, and eating disorders. Residents also gain exposure to school-based health care through Teen Xpress, a mobile health program that delivers free medical, mental health, nutrition, and case management services to uninsured and underinsured adolescents in Orange County schools. Teen Xpress has been recognized nationally for its commitment to positive youth development and its strength-based approach to adolescent health promotion. Residents are supervised by multidisciplinary faculty.

Advocacy

The advocacy rotation includes a 2-week experience with Child Protection Team through which residents learn about child abuse prevention and intervention and the child protective services system in Central Florida. Co-located within the Orange and Osceola Children's Advocacy Centers, the multidisciplinary Child Protection Team assesses risk factors and provides recommendations for interventions to protect children. During the remainder of the advocacy rotation, residents are exposed to the In the Zone Community Pediatrics program. This program gives residents a chance to enter the community where they can see first-hand the many factors that impact a child's health. Residents also have the opportunity to spend time with local agencies, including the Ronald McDonald House, Second Harvest Food Bank, Coalition for the Homeless, and a nearby charter school. The program is designed to help prepare residents to act as effective leaders and agents of change within the community.

Individualized Learning Curriculum

The Individualized Learning Curriculum allows residents to tailor their elective rotations to their career goals. Possible ILCs include General Pediatrics, General Pediatrics with an Ambulatory focus, General Pediatrics with a Hospitalist focus, and Subspecialty Tracks. Examples of subspecialty tracks include Emergency Medicine, Gastroenterology, Adolescent Medicine, Pulmonology, Infectious Disease, Heme-Onc, Cardiology, Neonatology and Critical Care. To create their ILC, residents enlist the help of their faculty advisor to choose 2 Core Electives during their PL-2 year and a mix of 4 Core Electives and Selectives during their PL-3 year.

Conferences

Morning Report

Morning report occurs 2 to 3 times a week and allows residents to present cases and think critically to form differential diagnoses and management plans for patients in clinic, the newborn nursery, and the hospital.

Grand Rounds

Grand Rounds features a variety of state-of-the-art topics presented by our own expert faculty, visiting professors, national, and international speakers. The schedule will be available online shortly.

Didactic Conferences

These lectures are given by general pediatric attendings, sub-specialists and guest speakers on specific topics. The curriculum is based on the American Board of Pediatrics Content Specifications and is used as an adjunct to board preparation. Lectures also cover professionalism, residents as teachers, adult learning theory, ethics in pediatrics, billing and coding, and other interesting topics. The curriculum is structured around a carefully designed block schedule. Each 4-week period covers a specific subspecialty or organ system to help focus resident study. Many conferences promote resident participation using an audience response system.

Evidence-Based Medicine

Evidence-Based Medicine is a monthly conference that is facilitated by the program director, an expert in EBM. A pre-designated group of residents select a recent paper from the pediatric literature, present it, and encourage audience discussion. The conference promotes a critical review of pediatric medical literature. Faculty who are content experts are invited to participate and provide clinical context.

Clinical Pathology Conference (Professor’s Rounds)

A resident favorite. Facilitated by one of the critical care faculty, a general pediatrician is presented a case and works through his or her diagnostic thought process. Once the diagnosis is established, specialists from Pathology, Radiology, or special guests from the health department or medical examiner’s office present their perspectives.

Care of the Sick Child Conference

Residents are encouraged to attend this conference held annually in Orlando, FL and receive free registration. Emphasis is placed on the day-to-day issues and challenging diagnostic or management dilemmas the general pediatrician encounters. Topics are based on current trends and feature recognized leaders in their fields.

Quarterly PREP Exams

Quarterly PREP Exams provide a real-world ABP Boards exam experience to practice test-taking skills.  Exam content is correlated with topics from the previous 3 months of teaching conferences.  Each exam is followed by an exam review focused high-yield exam content and test taking skills.

Special Curricula

Mock Codes

To improve resident response, comfort level and competency with commonly encountered scenarios in the critical care setting, residents are involved in simulated codes while on the in-patient units. The multidisciplinary code team includes nursing, respiratory therapy, pharmacy, physician, and allied health staff members. Interns also participate in a separate Pediatric Advanced Life Support (PALS)-based curriculum utilizing simulated codes and mini-stations with simulators in scenarios developed by our residents and pediatric critical care specialists.

Communication Workshops

This curriculum helps residents build skills to effectively communicate with patients and families. It incorporates actors as standardized patients that enact scenarios frequently encountered in pediatric practice. The series also includes the Breaking Bad News (BBN) series that prepares residents to effectively engage in difficult conversations with patients and families.

Individualized Learning Curriculum

The Individualized Learning Curriculum allows residents to tailor their elective rotations to their career goals.  Possible ILCs include General Pediatrics, General Pediatrics with an Ambulatory focus, General Pediatrics with a Hospitalist focus, and Subspecialty Tracks.  Examples of subspecialty tracks include Emergency Medicine, Gastroenterology, Adolescent Medicine, Pulmonology, Infectious Disease, Heme-Onc, Cardiology, Neonatology and Critical Care.  To create their ILC, residents enlist the help of their faculty advisor and Program Directors.

TeamSTEPPS

Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) is an evidence-based set of teamwork tools aimed at optimizing patient outcomes by improving communication and teamwork skills among health care professionals. Residents participate in TeamSTEPPS sessions at least once during their training, where they learn to work as a multidisciplinary team with other physicians, nurses, respiratory therapists, pharmacists, nutrition, and child life.

Wellness Curriculum

The Wellness Curriculum addresses issues like resident fatigue, morale, work-life balance, and burnout. It is composed of class retreats, meetings with a physician coach, special didactic sessions, and group activities outside of the hospital. The goal is for residents to obtain the best balance possible so that they can realize their full potential.