The emergency department rotation at The Cambridge Hospital offers MGH pediatric interns the opportunity to evaluate and treat a wide range of pediatric illness in the community setting. The department sees 32,000 patients per year which includes 15% of patients aged 18 years and younger. Interns work directly with on-site attending emergency physicians as the pediatric expert and primary caregiver to the pediatric patients. Rotators will have exposure to front-line community medicine including bedside procedures such as orthopedic splinting, abscess incision and drainage, and laceration repairs. The rotation provides a comprehensive community experience that will also educate interns about disposition planning and care coordination in a setting with more limited pediatric resources and sub-specialist availability than the tertiary care center, MGH, where they will also rotate.
The goal of the MGHfC Emergency Division rotation is to develop the ability of residents to triage, evaluate and manage children with a broad range of medical and surgical problems with varying levels of acuity. The rotation is based in an urban referral pediatric emergency department designated as a level I pediatric trauma center. Patients will include those aged birth to 19 years who live in the area, as well as those referred to this tertiary care hospital emergency department for higher levels of care. First, second and third year residents will all participate in this rotation. The residents will work closely with other team members, including other pediatric residents, emergency division attendings, subspecialists, nurses and support staff to triage and care for patients who present to the pediatric emergency room. The intern emergency medicine rotation combines shifts at both MGH, as well as shifts at Cambridge Hospital, a local community.
Newton-Wellesley Hospital is a community hospital in Newton, a suburb of Boston. It has a wide service area in the western suburbs. The spectrum of pediatrics at NWH includes the Pediatric Inpatient Unit, Newborn Nurseries, SCN, Pediatric Subspecialty Clinics and the Pediatric Emergency Department. Residents rotating at NWH manage a general pediatric inpatient unit under the supervision of attending hospitalists and community pediatricians. All house-staff operate under the supervision of the patient’s attending physician. Residents provide daytime coverage at NWH; overnight coverage is provided by NWH hospitalists and moonlighters. The team consists of one PGY-2 supervisory resident and one intern, joined by medical students from Tufts University and PA students from the Massachusetts College of Pharmacy and Health Sciences. Many of our own MGH graduates join the Newton-Wellesley community after residency.
NWH Intern Curriculum
The NWH intern rotation is designed to allow interns to learn how to manage common pediatric illnesses in a community inpatient setting. Skills in working with a variable patient/family population, including those that are highly educated and knowledgeable are necessary for this rotation. There is a strong emphasis on the teaching of medical and PA students on this rotation.
NWH Junior Curriculum
The NWH Supervisory Resident rotation is designed to allow junior and senior residents to supervise a team admitting patients to an inpatient pediatric ward in a community hospital. Leadership and supervision skills are paramount for the successful resident on this rotation. Communication and the management of transition to higher level of care when necessary are critical components.
The goal of the MGH pediatric surgery rotation is to develop the ability of first year residents to evaluate, stabilize and treat patients with a broad range of surgical problems of varying complexity and acuity. In addition to the operating suite, this rotation takes place in various settings within a tertiary care hospital including the pediatric emergency ward, inpatient pediatric floors, PICU and NICU. The team is led by a senior surgical resident working in conjunction with the pediatric surgical nurse practitioners under the leadership of attending pediatric surgeons. First year residents are both surgical and pediatric trainees who are the primary caregivers for the pediatric surgery patients.
Ward Teach Rotation
The Ward Teach rotation is a 2 to 4-week rotation in the PGY-3 year which combines medical student teaching with mentored large group teaching opportunities. During this rotation, the resident runs Morning Case Conference twice a week and one Wednesday noon conference every other week. Each Ward Teach resident is paired with a faculty mentor for 1:1 teaching and feedback on this large group teaching during the rotation. The conferences are designed to allow the residents to improve teaching skills while educating the residents about recent admissions to MGHfC. Residents of all three years, the hospitalist and teaching attendings, as well as medical students, attend the conferences. Additionally, the ward teach spends a significant amount of time with the medical students on their pediatric clerkship in their first clinical year. The ward teach observes medical students’ presentations on rounds, observes their initial histories and physicals when admitting new patients and reads their admission notes and gives them feedback verbally and in writing. The ward teach also leads 1-2 teaching sessions for the medical students, helps them with their physical exam skills in the newborn nursery, and leads 1-2 simulation sessions for the medical students. Additionally, the ward teach spends one evening at the Revere Crimson Care Collaborative, a pediatric student/faculty collaborative practice, assisting preclinical students in their history taking and physical exam skills. The overall goal of the senior resident ward teach rotation is to provide residents with the opportunity to teach in different settings to different levels of learner in a mentored setting in which they receive feedback through a structured “Resident as Educator” curriculum. Dr. Ariel Frey-Vogel is the rotation director.