Throughout their three years of training, residents are exposed to graduated autonomy and will spend time on both JHACH wards and TGH wards. The JHACH wards team consists of interns, senior residents and medical students working together with the attending hospitalist. During the first year of training, interns spend 3 months on inpatient wards at JHACH and are responsible for 7-10 patients, with the senior serving in a supervisory position. The inpatient service is staffed by in-house hospitalists, who are available 24/7.

PL2 and PL3 residents spend two months each year on inpatient wards (1 month at JHACH and 1 month at TGH). The TGH wards team is composed of senior residents, who are responsible for the care of all patients admitted to the general pediatric and subspecialty service. Overnight, senior residents at TGH cover the Hematology/Oncology, Nephrology, Rehabilitation, and Newborn services, in-house, with the attendings available by phone.

PL2 residents have a 1-month subspecialty rotation at JHACH where they work with the Pulmonology and Nephrology services, directly managing patients with complex conditions. PL3 residents have a 1-month Hematology/Oncology rotation at TGH, where they manage complex patients and perform procedures, such as lumbar punctures for intrathecal chemotherapy. Residents receive daily teaching from the specialists during these rotations at both sites.

Residents have a 1-month newborn nursery rotation at TGH during their first year of training, with the option to complete an additional month during their PL3 year. The team consists of two interns, or 1 intern and 1 senior, along with 3 medical students. Under the supervision of general pediatric faculty and with certified nurse practitioners, residents provide care to healthy newbornsand those in the transition nursery within the Neonatal Intensive Care Unit (NICU).

The transition nursery provides care for infants requiring increased care such as cardio-respiratory monitoring and observation for neonatal withdrawal symptoms. Residents on the newborn service also attend deliveries of infants requiring a physician's attendance.

Overnight coverage is provided by senior residents on NICU and Wards. The nursery residents provide weekend day coverage in the NICU.

Interns spend two months in the NICU at TGH. TGH houses a Level IV NICU with 82 private beds.

Residents work with fellows and nurse practitioners in the NICU. Residents provide delivery room coverage and are exposed to a large number of term and premature neonates with medical problems. Interns receive an increasing number of patients and responsibility during the month. During their first year, interns do three overnight calls to augment their daytime experience. Attendings and fellows provide teaching during daily bedside rounds, organized didactics and are available in house 24/7. 

Senior residents have the option of doing additional NICU rotations as electives at either TGH or JHACH. The 97-bed Level IV NICU at JHACH further exposes residents to critically ill neonates, including those with complex congenital heart disease. Residents work closely with faculty and nurse practitioners in this unit.

Residents have two blocks of PICU during their second year of residency. They spend 1 month in the 28-bed JHACH PICU and 1 month in the 9-bed TGH PICU. JHACH is a Level 1 pediatric trauma center and TGH is a Level 1 trauma center as well as a burn center for both pediatrics and adults. Seniors take overnight call in the TGH PICU during night float rotations.  Having exposure to these two different units provides an extremely broad and robust educational experience.

During their rotations, residents perform a variety of procedures, including sedation, intubations, central and arterial line placement. At JHACH, residents will also work with fellows and APPs. Additionally, JHACH has a 22-bed Cardiovascular Intensive Care Unit (CVICU). Residents interested in Cardiology or Critical Care medicine can choose to do an elective in this unit.

Residents have two blocks of Emergency Medicine. Interns spend 1 month in the Emergency Department at JHACH and PL3s spend 1 month in the Emergency Department at TGH. Both are very busy free standing Emergency Rooms. 

 Core Electives

• Allergy and immunology
• Cardiology
• Child Abuse
• Dermatology
• Endocrinology
• Gastroenterology
• Genetics
• Hematology-Oncology (can include Bone Marrow unit at JHACH)
• Infectious diseases
• Mental Health (required)
• Nephrology
• Neurology
• Pulmonology
• Rheumatology

Individualized  Electives

• Hospice and Palliative medicine
• Neurodevelopmental disabilities and Rehab Medicine
• Pediatric Anesthesiology, Procedures & Transport (APT)
• Pediatric Radiology
• Pediatric Surgery
• Sports Medicine
• Maternal Fetal Medicine
• Research/Independent study
• DEENT (Dental, Ear, Eyes, Nose and Throat)
• Pediatric Pharmacy
• Hospitalist
• Cardiovascular Intensive Care Unit (CVICU)
• Pathology lab/Micro lab
• Patient Safety/Quality Improvement
• Complex care clinic
• Community Pediatrics
• Parenting