Pediatric Curriculum

Located at CRMC and VCH, these rotations provide residents with experience in caring for a wide variety of pediatric patients, including rare and complex disorders as well as bread-and-butter pediatric conditions, with access to needed subspecialists for consultations. Team structure varies by location, but usually there are 1-2 interns and a senior resident, frequently with a medical student as well. Ancillary services include pediatric case managers, medical social workers, child life specialists, pediatric therapy services, nurses and respiratory therapists. CRMC is also home to a Level 1 Trauma Center and Comprehensive Burn Center for the Central Valley.

At CRMC, we see a variety of normal well newborns as well as complex newborns including, but not limited to those with HIV exposure, congenital syphilis, hypoglycemia, neonatal abstinence syndrome, congenital anomalies, and late preterm infants.

Primarily an intern-run service with an NP and an Attending. Our interns are encouraged to take ownership of their patients and develop their clinical autonomy early on in their careers. Our residents also have the unique opportunity of following these infants from birth as their primary care provider in their continuity clinic at the Children’s Health Center.

We have a Level III NICU with over 60 beds and wonderful nursing staff providing around-the-clock care. CRMC serves as the high risk delivery center for the Central Valley. Our NICU provides transport services 24/7 and receives around 1,100 admissions per year. We also have a dedicated, state of-the-art stabilization room where critically ill infants are received and resuscitation efforts including necessary procedures are performed. Our residents are included in these encounters as well as daily care of the patients while on service.

Our resident NICU team is one of 4 NICU teams staffed by neonatologists. The NICU team regularly has multidisciplinary rounds with the bedside RN, RT, and pediatric dietitians. We also have a dedicated NICU pharmacist and RN discharge coordinator.

This service is covered by an intern, a senior resident and an in-house attending physician and includes coverage of the following services: 5C/Peds, NICU, Newborn, pediatric ED consults and admissions, and overnight mommy/daddy calls (via the pager) from our clinic patients. Our senior residents can further develop their clinical autonomy in a supportive environment during this experience before graduating and entering independent practice.

This is a Federally Qualified Health Center (FQHC) for our resident continuity clinics and other pediatric outpatient experiences. These consist of both acute care visits, well child exams, complex care patients, and newborn follow-up visits with the opportunity for formal teaching and management of the overall clinic workflow as a pediatric senior resident.

Primarily resident-run with attending supervision from faculty and experienced pediatric nurse practitioners. Our residents each have their own panel of continuity patients and quickly develop the skills and confidence needed to independently care for their patients. We see a wide breadth of medical and psychosocial issues in a highly underserved area with > 22,000 visits per year.

Senior residents (PGY-2/3) rotate at the CHO ED for 1 block in their PGY-2 training and allows our residents to rotate in an academic pediatric ED environment where they have exposure to peds ED, urgent care in the ED, and trauma shifts. Seniors also rotate to the PICU for their pediatric critical care training for 1 or 2 blocks total over their PGY-2/3 training. Our residency program provides housing in nearby Alameda for residents on these rotations

Some senior residents (PGY-2/3) rotate at MB for 1 block of PICU if they do not complete 2 PICU blocks at CHO. Seniors also may rotate in the Subspecialties. Our residency program provides housing across the street from the MB site for residents on these rotations

• Due to the absence of pediatric subspecialty fellows, our program allows a close working relationship between the attending subspecialists and residents. Most of these rotations occur on the local campus in the outpatient offices of North Medical Plaza and at the hospital (CRMC)
• Most will typically be a combination of inpatient consults and outpatient encounters depending on the service and individual interests of the resident. There are many opportunities available and residents are encouraged to individualize their educational experiences based on their career goals.
• Available pediatric subspecialities include: Cardiology, Endocrinology, Gastroenterology, Neurology, Nephrology, Pulmonology, Psychiatry, and others including opportunities at UCSF Benioff Children’s Hospitals.
• Other available electives include: Dermatology, Toxicology, Outpatient General Pediatrics in the local community, rural pediatrics, Breastfeeding Medicine, Public Health, Global Health Outreach, Research, etc.

• Continuity Clinic at CHC
  • Each resident is assigned to a continuity clinic team and sees a scheduled panel of their own patients 1 afternoon a week while on most local rotations.
  • Residents can often see their own or their teams’ patients when they present for urgent care visits.
• Community Pediatrics Division 

• Research 

   

• Primarily resident-run
• >22,000 patient encounters per year
• Staffed by General Pediatrics Faculty attendings and Pediatric Nurse Practitioners
• Separate pediatric urgent care (Station 3)
• Occasional pediatric specialty patients with select pediatric subspecialists
• Provides Regional Pediatric Special Services (HIV Care)
• Federally qualified health center that encounters a wide breadth of medical and psychosocial issues in a highly underserved area

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• Here our subspecialists provide care to pediatric patients in the fields of cardiology, endocrinology, gastroenterology, cystic fibrosis, nephrology, hematology, high risk infant care, pulmonology, neurology, rheumatology, and developmental pediatrics.
• Located next to both the FHCN clinic and CRMC, this enables access to our subspecialists

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• An alternative location for our subspecialists, based in Clovis near Clovis Community Medical Center

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• Home to the only Level 1 Trauma Center and Comprehensive Burn Center in the Central Valley
• Busy level 3 NICU and high-risk birthing center
• Located in the heart of Downtown Fresno

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• Tertiary care freestanding Children’s Hospital affiliated with Stanford located in Madera, about 20 minutes from downtown Fresno.

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