The Pediatric Residency’s three-year training program is composed of 13 four-week blocks per year. The program offers an innovative X+Y schedule: a three-week rotation followed by one week of ambulatory clinics, including continuity clinic, other ambulatory experiences and learning sessions. This schedule enhances the continuity clinic experience by minimizing disruptions from other rotations.
The curriculum also includes individualized tracks, additional programs and other educational opportunities.
Primary Care Training
The residency program strives to provide all residents with a solid foundation in primary care pediatrics and general pediatric knowledge, including preventive well-child care and acute outpatient care. The academic pediatric faculty in the Division of Ambulatory Pediatrics at Dell Medical School serve as educators, mentors and coaches for residents and provide them with comprehensive training in outpatient general pediatrics.
Throughout their training, residents have the opportunity to learn and deliver general pediatric care in a variety of settings and with diverse patient populations. The continuity clinic experience takes place at CommUnityCare Health Centers, a federally qualified health center that delivers medical care to the underserved population of Central Texas, including a large immigrant and refugee population. The continuity clinic training is enhanced through the X+Y schedule, which allows resident physicians to fully immerse themselves in the outpatient clinic experience for a week at a time. The program was among the first few in pediatrics to pilot this learning model in 2018, and the data since gathered has shown dramatic improvements in both the patient and trainee experiences. During continuity clinic time, residents have the opportunity to participate in immersive experiences such as the centering program and parent-child book club.
Additional primary care training takes place during the community advocacy rotation and ambulatory block rotations, when residents have the opportunity to rotate through different community-based experiences, as well as at the academic faculty practice, Dell Children’s Medical Group Pediatrics Mueller. At this site, residents care for patients coming from nearby neighborhoods and for patients with chronic diseases and/or medical complexities that receive subspecialty care at Dell Children’s Medical Center of Central Texas.
Residents also have the opportunity to pursue primary care experiences at Dell Children’s Comprehensive Care Clinic, which serves children with complex medical conditions; as well as with the school’s extensive network of affiliated private pediatricians. The program also provides additional professional development opportunities, including culinary medicine training and opportunity for certification in lactation counseling.
Residents interested in pursuing careers in primary care pediatrics are supported through mentorship; access to rich and diverse primary care pediatric experiences with academic general pediatric faculty and private pediatricians; research; quality improvement; medical education scholarship; and other opportunities.
Required Rotations
The pediatric emergency department at Dell Children’s Medical Center is the only designated Level 1 pediatric trauma center in Central Texas. Residents learn how to assess, evaluate and treat pediatric patients with acute medical and surgical conditions. Board-certified pediatric emergency medicine physicians and pediatric emergency medicine fellows directly supervise residents both day and night.
Four to five resident teams cover the inpatient wards. The day teams are composed of one junior or senior resident supervisor, two interns, one acting intern (depending on the time of year) and medical students from Dell Medical School.
Interns and senior residents cover the teams at night. Pediatric hospitalists supervise all teams both day and night. Ward teams function as the primary medical team with pediatric specialists serving in a consultative role. The rotation provides a robust inpatient medicine curriculum, and residents participate in educational conferences with minimal disruption to their daily workflow.
The mental health experience is divided between the first and second year. Residents learn from board-certified child and adolescent psychiatrists and multidisciplinary teams. Interns focus on the outpatient management of common and complex psychiatric conditions. Senior residents focus on the inpatient experience in the mental health unit.
Residents rotate in the newborn nursery at Ascension Seton Medical Center Austin during their first and second years. Newborn hospitalists supervise the rotation and residents have the opportunity to work with medical students.
Residents rotate in the neonatal intensive care unit during their first year at Ascension Seton Medical Center Austin, which has a large Level III NICU and a busy labor and delivery service. During their second year, residents rotate through Dell Children’s Level IV NICU, which is a part of the comprehensive care center and special delivery unit that provides specialized care to infants with complex congenital anomalies and other conditions.
At both NICUs, residents have the opportunity to work with multidisciplinary teams including specialized dietitians, social workers, therapists, child life specialists, pharmacists, nurse practitioners, fellows and attendings.
Residents rotate in the pediatric intensive care unit during their second and third year at Dell Children’s Medical Center, working alongside, fellows, mid-level providers and critical care attendings staff the pediatric intensive care unit. Day and night resident teams with 24/7 attending supervision provide coverage. Residents care for children who are critically ill with the benefits of a large support infrastructure and advanced technologies, including extracorporeal membrane oxygenation. Residents interested in intensive care management of patients with congenital heart disease and other cardiac anomalies can complete electives in the cardiac care unit.
The program offers residents a wide variety of electives to meet their personal and professional goals. This includes medical specialties such as infectious diseases, palliative care, dermatology, nephrology, rheumatology, endocrinology, gastroenterology, sports medicine, cardiology, allergy/immunology, neurology, genetics and hematology/oncology. Surgical subspecialty electives include general pediatric surgery, urology, ENT, ophthalmology and orthopedic surgery. Residents have the opportunity to tailor their experience to meet their professional goals and interests with electives such as transport for critical care, point-of-care ultrasound for emergency medicine, breastfeeding/lactation for primary care, and dietitian-led experiences tailored to subspecialties and primary care. During the third year of training, residents can choose a longitudinal clinic experience during their Y-week in addition to their continuity clinic, often in a subspecialty clinic, complex care clinic or with a private practice pediatrics group. Research and career development electives can also be utilized to develop scholarly projects and prepare for and participate in job and fellowship interviews
Ambulatory Experiences
The adolescent medicine rotation is completed during the second year of residency. Residents participate in a monthly adolescent medicine didactic series with a board-certified adolescent medicine physician. Clinical rotations including sports medicine, concussion clinic and headache clinic take place at the Dell Children’s campus. Additional experiences with school-based sports medicine, adolescent primary care and care for patients with eating disorders occur offsite with our many community partners.
The community advocacy curriculum is completed during the first year of residency over two weeks and includes both asynchronous and experiential learning opportunities. The curriculum aims to provide pediatric residents with a deeper understanding of the role of the pediatrician working in their community in Central Texas. Pediatric residents learn about their ability to advocate for the health and well-being of all children by engaging with families, schools and community organizations to address the social, cultural and environmental factors impacting health. Through partnerships with local community-based organizations, schools and patient advocate groups, residents learn directly from many local organizations about resources and ways to improve the well-being of families in Central Texas.
All residents have their 3-year-long continuity clinic experience at CommUnityCare Pflugerville, a federally qualified health center. Residents provide primary care to a diverse and medically underserved patient population located in Pflugerville, TX. The clinic is located approximately 15 minutes from the main campus of Dell Children’s Medical Center. Board-certified general pediatricians supervise the continuity clinic experience and prioritize resident continuity with their patient panel. Residents participate in the primary care didactic curriculum and programs such as the Centering Program, an innovative group care model that delivers well-child care to a cohort of patients who stay together for years building a community of support for the patients and families.
The Developmental Behavioral Pediatrics Experience is completed during the first year as a longitudinal experience in the Y-week. Residents spend time with board-certified developmental and behavioral pediatricians in clinical and didactic sessions. Additionally, residents have exposure to applied behavior analysis therapy, speech and language pathology, occupational therapy, physical therapy, autism assessments, and parent-child interaction therapy with board certified clinical psychologists.
Sample Schedule
- Inpatient wards (9 weeks)
- Inpatient wards night shift (4 weeks)
- NICU (2 weeks)
- Nursery (3 weeks)
- Emergency medicine (3 weeks)
- Subspecialty outpatient elective (2 weeks)
- Community advocacy (2 weeks)
- General pediatrics ambulatory clinic (2 weeks)
- Complex care clinic (1 week)
- Mental health (2 weeks)
- Professional development (2 weeks)
- Elective/Individualized curricular experience (6 weeks)
- Y week (13 weeks, includes continuity clinic, developmental-behavioral pediatrics, QI/research and professional development)
- Vacation (3 weeks, can be a 1-week, 2-week, or 3-week block)
- Inpatient wards (5 weeks)
- Inpatient wards night shift (3 weeks)
- Inpatient triage officer (1-2 weeks)
- PICU (3 weeks: 2 weeks days and 1 week nights)
- NICU (2 weeks)
- Nursery senior (1 week)
- Emergency medicine (3 weeks)
- General pediatrics ambulatory clinic (4 weeks)
- Mental health (2 weeks)
- Adolescent medicine (3 weeks)
- Outpatient subspecialty elective (2 weeks)
- Electives/Individualized curricular experience (11 weeks)
- Y week (13 weeks, includes continuity clinic, adolescent didactics, residents as leaders and teachers, acute care, QI/research and professional development)
- Vacation (3 weeks, can be a 1-week, 2-week, or 3-week block)
- Inpatient wards (5 weeks)
- Inpatient wards night shift (2 weeks)
- PICU (3 weeks: 2 weeks days and 1 week nights)
- NICU (2 weeks)
- Emergency department (3 weeks)
- General pediatrics clinic (2 weeks)
- IDEA (1 week)
- Electives/Individualized curricular experience (18 weeks)
- Y week (13 weeks, includes continuity clinic, individualized longitudinal clinic, QI/research and professional development)
- Vacation (3 weeks, can be a 1-week, 2-week, or 3-week block)