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  • Clinical Curiculum

    The Department of Pediatrics draws from many sources to give its residents, interns and medical students a comprehensive understanding of childhood illness and injury. The diverse clinical experiences on the wards, in the nursery, intensive care units, clinics, and emergency room augments the new physician's basic knowledge of diagnosis and treatment, refines his or her clinical skills, sharpens insights and fosters the kind of sensitivity required of any good physician.
    Our Mission has three points:

    1. teach the art and science of medicine
    2. provide quality medical service to the children of Mississippi
    3. contribute to the knowledge of pediatrics through research and other academic pursuits

    As Mississippi's only academic health center we are uniquely placed to achieve these three goals. As the only tertiary care center for infants and children in the state, we provide service to patients with unusual and complex problems who are referred from other physicians and hospitals in addition to providing general pediatric care to children in the Jackson area. This mixture of patients allows the resident to see a sizable range of pathology. It also generates exceptional proficiency at recognizing and managing both the more complex and unusual disorders.

    Teaching is done both in the clinical setting and in a number of educational activities including various daily conferences. We have a complete complement of pediatric subspecialties, and residents will have an opportunity to rotate with any pediatric specialty.

    Specific rotations

    PGY-1

    Wards - General and subspecialty inpatients
    Night float
    NICU
    Newborn nursery
    Emergency Department
    Ambulatory - Outpatient clinics
    Elective

    4 months
    1 month
    2 months
    1 month
    2 months
    1 month
    1 month

    PGY-2

    Wards - General and subspecialty inpatients
    Hematology/Oncology
    Emergency Department
    NICU
    PICU
    Child Development Clinic
    Adolescent Medicine
    Elective

    3 months
    1 month
    3 months
    1 month
    1 month
    1 month
    1 month
    1 month

    PGY-3

    Wards - General and subspecialty inpatients
    Night float
    Hematology/Oncology
    Emergency Department
    NICU
    PICU
    Pediatric surgery inpatient
    Elective

    1 month
    1 month
    1 month
    3 months
    1 month
    1 month
    1 month
    3 months

    Call

    With the new ACGME duty hours, we have started a night float system for ward months. At least one intern and one PGY-3 (or 4th year Med-Peds) resident are on the night float team. They work from 6pm until 7am the following morning alternating from Sunday through Thursday or Monday through Thursday. Call on the weekend is taken by upper level residents on wards teams as well as by residents on electives. On weekend, interns stay from 7am until 10pm with their team if they are on call. In the NICU, interns stay until 10pm if they are on call.

    For Upper level residents (PGY-2's and above), residents take every fourth night call while they are in the NICU and PICU. While on ward months, they have an average of two overnight weekend calls for the month. During the week, call lasts until 6pm and is every fourth day.

    Residents on electives have "float call" either in the PICU or on the wards. They average 2-4 overnight calls per month.

    Inpatient training

    The inpatient ward services are divided into five teams: four general pediatric/subspecialty teams and a hematology/oncology team. During the winter months, a separate service exists for the Private Patients which also serves as "overflow" for General pediatrics. There is also a Surgical hospitalist service that PGY-3's rotate through that covers some of the surgical patients admitted to the hospital. Over the course of three years residents are rotated through all of these services to expose themselves to a diverse mix of both common and obscure pediatric problems. Teams take general pediatric admissions during the days that they are on call, and general pediatric admissions alternate amongst the teams at night. Teams also admit patients for their assigned subspecialties. As the only children's hospital in the state the inpatient service is often a mix of standard general pediatrics issues and more obscure diagnoses.

    First year residents act as direct care givers for the patients, learning the intricacies of pediatric care. Second and third year residents supervise the team, organize the efforts of the medical students, ensure that teaching of the first year residents and medical students is being done and take referral calls from community physicians. By the end of three years our residents have both excellent clinic skills with a broad range of pathology, experience as leaders and are recognized as sources of information by members of the community.

    Newborn medicine

    Solid background knowledge of fetal and newborn physiology and medicine provides an important foundation to understanding the general scope of pediatric medicine.

    During the three-year residency program, resident physicians will spend five months in newborn medicine. The experience is broad, ranging from well newborn care to neonatal intensive care to premature infant outpatient follow-up.

    The University's newborn center in the Winfred L. Wiser Hospital for Women and Infants is the tertiary center for newborn care in Mississippi. The only Level III newborn center in the state, it is the hub of a statewide regionalization program and provides care, research, teaching and data collection services.

    Intensive care

    The University has approximately 4000 deliveries per year. There are approximately 1000 admissions to the neonatal intensive care unit. Prematurity, sepsis, cardiac problems, inherited disorders and general surgical problems are a few of the many diagnoses faced by our residents. During residency a total of 4 months are required in the NICU. The residents are supported in the NICU by 24 hour attending coverage. At the end of three years, the resident will be prepared to care for the intermediate problems of newborns and also to provide the initial assessment and care for the sickest of infants. This includes extensive experience in the resuscitation of critical ill newborns and the completion of common procedures such as intubation and placement of umbilical catheters.

    The Pediatric Intensive Care Unit cares for critically ill children from the first few days of life through adolescents. The PICU at the University of Mississippi is the only dedicated pediatric unit in the state which means that every child in the state requiring critical care services comes to the University of Mississippi Medical Center. The PICU recently has undergone renovation creating private rooms that provide a more family centered approach. With the remodeling of our PICU, a Cardiac ICU was also created for the post-operative care of cardiothoracic surgery patients.

    Currently the unit has a total of 18 beds with 7 of those as CICU beds. As the final stages of renovation conclude, the PICU plans to expand to 24 beds in October 2011 with flexibility to expand that as needed. The unit has approximately 770 admissions a year. Some surgical services co-manage their patients but the pediatric residents are actively involved with every patient admitted to the PICU. Here the residents gain experience managing many complex conditions including sepsis, diabetic ketoacidosis, status epilepticus, status asthmaticus, trauma, and post-surgical issues such as congenital heart repair, airway reconstruction, craniotomy and spinal fusions. Two months are required during the residency and by the end of this time residents are experienced in the initial management of critical illness and assessing which patients can be managed by general pediatricians and which require transfer to tertiary care settings.

    Outpatient training

    Pediatric outpatient training involves rotations through a general pediatric clinic, continuity clinic and subspecialty clinics in the outpatient department as well as through the pediatric emergency room.

    Clinical experience is abundant, ranging from well-baby care to life-threatening emergencies. This kind of exposure is integral to developing the resident's level of competency in managing the many problems encountered in primary care pediatrics.

    Residents receive extensive emergency room and outpatient experience where they develop medical judgment skills, efficiency and the ability to manage multiple patients at the same time. Although the pediatric emergency room is staffed 24 hours a day by pediatric faculty, supervisory residents work closely with the senior resident on the floor teams to manage beds in the hospital and coordinate referrals from community physicians. Residents also learn skills to help facilitate movement of patients through the health care system.

    Participation in the continuity clinic is stressed at all levels of training to underscore the transition from inpatient care to follow-up treatment in the outpatient, child development and parental counseling areas. During each rotation, the resident is assigned one-half day each week in continuity clinic. Residents recruit patients from their other clinical experiences such as emergency department visits and inpatient service. In this, the resident acquires the skills necessary for patient interaction through a continuum of therapy, thus increasing his or her responsiveness to significant psychosocial issues in pediatric medicine.