Curriculum, Didactics and Training
Morning Report
This core educational experience is an opportunity to thoughtfully analyze a case for discussion with peers and develop learning objectives with the support of our faculty. All residents, except those on night float or away rotations, attend morning report every Monday, Wednesday, and Friday from 7:30 to 8:15 a.m. (breakfast and coffee provided!). Each case is presented by a resident with a faculty mentor; these sessions provide a structured context for residents to develop their teaching skills using a variety of educational strategies and tools.
Academic Half-Day
Every Tuesday afternoon from 1 to 5 p.m., residents attend academic half-day. This protected educational time includes clinical lectures, simulation sessions and occasionally whole afternoon workshops with visiting expert facilitators. We integrate our QI curriculum into these half-days throughout the year and hold resident-led journal club every other month. We have monthly house staff meetings with our whole residency and program leadership to address any concerns and provide an opportunity for open communication.
Rotations
Residents on all rotations attend academic half-day on Tuesday afternoons and continuity clinic once per week except those on night float and away rotations.
Hospital Pediatrics
Residents rotate on the 19-bed inpatient ward with our pediatric hospitalists. We admit and care for a wide variety of clinical cases, ranging from pediatric “bread and butter,” such as respiratory infections and their complications, seizures, failure to thrive and neonatal fever, to more medically-complex patients and those with rare diagnoses.
Days start at 7 a.m. with sign-out from the night team. The central part of this rotation is family-centered rounds, during which residents present on their patients and work with a multidisciplinary team including the attending to develop a care plan for the day. The inpatient team also provides consultation as needed to our Emergency Department. On afternoons that residents are on the ward, they take new admissions, follow up on plans of care, and develop short presentations on pertinent clinical topics. The day finishes at 5 p.m. with sign-out to the night team.
Newborn Nursery
Residents rotate in the Newborn Nursery with our pediatric hospitalists. Our nursery provides couplet care in which newborns room in with the birthing parent. Residents round daily and gain expertise in the care of well newborns. This includes honing their newborn exam skills, providing anticipatory guidance for parents and collaborating with lactation specialists. Residents are expected to learn and implement evidence-based standards of care such as the Kaiser early-onset sepsis risk score and current bilirubin management guidelines.
Neonatal Intensive Care Unit (NICU)
Residents spend four weeks in the NICU in the second half of first year and again in the first half of second year, where they gain familiarity with caring for critically ill neonates and infants. Our NICU has 21 beds and routinely cares for patients born prematurely, requiring life support measures, requiring surgery and other diseases.
Residents start their day at 7 a.m. with sign-out and spend the morning in rounds with their attending and a multidisciplinary team including nursing, respiratory therapists, social work, nutrition and spiritual care. Residents attend all deliveries that the NICU team attends (C-sections and other high-risk deliveries) and can implement the skills they learned in NRP certification. Many residents also practice procedural skills including lumbar punctures and umbilical lines. The day finishes at 7 p.m. Residents work 6 days per week on this rotation.
Pediatric Intensive Care Unit (PICU)
Residents spend four weeks in the PICU in the second year where they gain familiarity with caring for critically ill infants and children. Our PICU has eight beds and routinely cares for patients with diagnoses such as sepsis, trauma, respiratory failure, critical post-surgical patients and other rapidly-evolving critical illnesses.
Residents work from about 7 a.m. to 5 p.m., Monday to Saturday. Our residents work closely with a multidisciplinary team, including critical care physicians, nurses, respiratory therapists, dietitians, pharmacists, therapists, social workers, consultants, interpreters and chaplains. Attending physicians will provide PICU-specific didactics regularly throughout the rotation, in addition to supplemental online material to be completed prior to and during the block.
Ambulatory Medicine
The ambulatory clinic experience runs through the first and second year of residency, with two blocks per year, plus an optional ambulatory rotation in third year. Residents work closely with supervising pediatricians to see patients from newborns to young adults with a wide variety of concerns. This experience exposes residents to normal and abnormal examinations, common pediatric complaints, typical childhood development and health promotion/disease prevention.
With every block, residents are expected to increase the number of patients they see in a half-day session. Ambulatory Clinic hours are 8:30 a.m. -5:30 p.m. or 9 a.m.- 6 p.m., Monday-Friday (with reading and admin time on Friday afternoons) and are based at Santa Barbara Neighborhood Clinics, our local FQHC partner.
Emergency Department
Residents will spend four weeks in each of their three academic years in our Emergency Departments at Santa Barbara Cottage Hospital and Goleta Valley Cottage Hospital. They will encounter a wide range of pediatric conditions from minor complaints to major trauma and need for resuscitation. There are approximately 15 shifts per rotation at varying times, each of which is eight to nine hours long.
Pediatric Residents are scheduled to work with our attending physicians who either have special training in Pediatric Emergency Medicine or who have a particular interest in supervising pediatric residents. Residents will perform the initial time sensitive evaluation of pediatric patients presenting to our emergency departments. They will have the opportunity to gain experience in key procedural skills including laceration repairs, lumbar punctures, intubations, splinting, and the stabilization of critically ill patients. During their rotation, they can also participate in simulation sessions, do an EMS ride-along, and participate in 911 call reviews with the Santa Barbara City Fire Department.
Adolescent Medicine
This four-week PGY-2 rotation includes a diverse array of clinical experiences. Cottage’s Adolescent Medicine Clinic anchors the rotation and is complemented by many community organizations and institutions that provide healthcare and support for young people. Residents rotate through several settings that include care focusing on eating disorders, mental and behavioral health, substance use, reproductive healthcare, sports medicine, as well as community health partners that work closely with youth. To supplement the clinical experiences, residents use a curriculum adapted from the Society for Adolescent Health and Medicine.
Electives
Core Subspecialty Electives at the Grotenhuis Pediatric Clinics:
- Gastroenterology
- Endocrinology
- Pulmonology
- Hematology/Oncology
- Infectious Disease
- Rheumatology
- Cardiology
- Neurology
Other Available Electives:
- Dermatology
- Sports Medicine
- Allergy/Immunology
- Breastfeeding Medicine and Lactation
- Radiology
- Anesthesiology
- Ophthalmology
- Palliative Care
- Primary Care
- Scholarly Activity/Research
- Procedures