Overarching Objectives for All Subspecialty Rotations


  1. Recognize the difficulties patients and their families encounter in dealing with complex illnesses that require subspecialty care.
  2. Demonstrate empathy and compassion in communicating with families during stressful times.
  3. Recognize the unique skill set of subspecialty nurses and support staff and the various strengths of numerous attending physicians within each subspecialty.

Interpersonal and Communication Skills:

  1. Effectively communicate to the precepting attending the history, exam, assessment, and plan regarding medically complex patients.
  2. Work effectively with inpatient care teams, communicating dynamic assessments and plans with nurses, other residents, fellows, medical students, and support staff.
  3. Communicate subspecialty opinions to the primary care physician when appropriate.

Practice-Based Learning and Improvement: 

  1. Use self-assessment and solicitation of feedback to identify areas of weakness within a subspecialty that may be improved within the short 4-week time frame of an elective.

Systems-Based Practice:

  1. Coordinate care plans involving multiple providers, including inpatient attendings, residents, and fellows, while keeping the primary care physician engaged in the patient’s care.

Patient Care and Medical Knowledge:

  1. Described in details for each rotation.


During three years of residency, you are expected to have completed 7 months of subspecialty training.  Four months are “core” subspecialties from the first column and three months are “additional” subspecialties which must come from either the core, or the expanded additional subspecialties listed below.  One of these is required, Pediatric Surgery, and so it does not count toward the 6 months of “individualized curriculum”.  The other two additional months, however, will count toward your individualized curriculum.  The remaining 4 “educational units” of individualized curriculum will be delivered during the longitudinal curriculum for interns and juniors (32 half days, 1 educational unit), and three months of PIC (Pediatric Individualized Curriculum) time in the senior year.  PIC months need to be well designed and mentored, as well as approved by your advisors, but they can be anything that helps develop you as a physician, working toward your long term learning and career goals. 

Four Core Subspecialty Months

The ACGME requires that you complete four educational units (4 week blocks) of four key subspecialties from those listed below.  These must be full one month experiences (e.g. NOT 2 weeks allergy, 2 weeks pulmonary):

  • child abuse
  • medical genetics
  • pediatric allergy and immunology
  • pediatric cardiology
  • pediatric dermatology
  • pediatric endocrinology
  • pediatric gastroenterology
  • pediatric hematology-oncology
  • pediatric infectious diseases
  • pediatric nephrology
  • pediatric neurology
  • pediatric pulmonology
  • pediatric rheumatology

Three Additional Subspecialty Months

The ACGME requires you to complete three additional educational units (4 week blocks) consisting of single subspecialties or combinations of subspecialties (e.g allergy and pulmonary CAN be combined).  Pediatric Surgery counts for one of these months.  Therefore, you will be selecting experiences from either the list above or from the following list.  These two months should be chosen based on your own learning and career needs.

  • child and adolescent psychiatry
  • hospice and palliative medicine
  • neurodevelopmental disabilities
  • pediatric anesthesiology
  • pediatric dentistry
  • pediatric ophthalmology
  • pediatric orthopaedic surgery
  • pediatric otolaryngology
  • pediatric rehabilitation medicine
  • pediatric radiology
  • pediatric surgery
  • sleep medicine
  • sports medicine

Three PIC (Pediatric Individualized Curriculum) Months

The ACGME requires you to complete a total of six months of “individualized curriculum” designed to meet your own learning and career needs.  You will have completed one month of this as part of the longitudinal curriculum in the PGY-1 and PGY-2 years.  The two months of subspecialty medicine that are chosen for these needs also count.  The remaining three additional educational units (4 week blocks) may be chosen from the lists below, or may be one of the program-sponsored PICs listed below.  In addition, a resident may design a PIC along with a faculty mentor(s) using the template on Wikidot.  We encourage residents to create research PIC rotations and the MGHfC Research Council is available to help set those up.  Global Health PICs must be designed with input from the MGHfC Division of Global Health.  All PIC rotations must have pre-defined goals and objectives that are approved by the Course Director and program advisors.

  • Cambridge Rotation in Newborn Medicine
  • MGH Delivery rotation
  • MGH Rotation in Acute Care
  • MGH Rotation in Pediatric Hospital Medicine
  • MGH Rotation in Transitional Care
  • NSCH Rotation in Community Hospital Pediatrics
  • NWH Rotation in Acute Care Pediatrics
  • NWH Rotation in Community Hospital Medicine
  • NWH Rotation in Newborn Medicine
  • Shriners Rotation in Pediatric Critical Care
  • Spaulding Rotation in Hospital and Rehabilitation Medicine

“Reading Electives” are prohibited unless express permission from one of the program directors  is obtained at least one month prior to the rotation. In rare instances, when you have a defined set of goals and objectives to accomplish under the mentorship of a faculty member, such rotations may be approved.. 

“Away Electives,” both domestic and international, require an application and approval process.  Please follow the instructions on Wikidot to apply for an away elective.  This process needs to be started several months in advance.

To schedule a subspecialty or PIC rotation at MGH/Affiliated sites, you must take the following steps:

  1. At least one month before the rotation, contact the course director or contact person listed in the elective guide. Many of these electives can accommodate only one resident at a time, so it is important to call as early as possible before your elective rotation begins.
  2. As soon as you have permission to take the rotation, you must email the Program Coordinators with the following information:
       a. The rotation you will be taking
       b. The dates of the rotation
  3. Read the orientation and curriculum information, available on Wikidot several days before the start of the rotation
  4. Contact the course director a few days ahead of time to arrange when and where to meet on the first day of the rotation.
  5. At the end of your rotation: 
       a. Please remind your faculty preceptors to complete an evaluation for you.
       b. You must complete evaluations of both the rotation and faculty members through New Innovations.