Senior Resident Orientation – Pediatrics
Welcome to Pediatrics: We look forward to working with you on Pediatrics this month. You
will be expected to take an active role in the leadership and teaching of the Pediatrics team.
You are to provide at least one 20-minute teaching session. You may assign learning issues to
the students and interns.
Rounds: Rounds begin at 8:00 am on weekday mornings in the 5th Floor Conference Room.
Weekend rounds begin at the discretion of the attending. You, as senior resident, are primarily
responsible for making sure rounds go smoothly.
1. Make sure the interns and students have seen all the patients, reviewed vital signs
and charts, and obtained lab results, x-ray reports, etc. before rounds. You are to
personally examine each patient prior to rounds.
2. Assign each patient to a specific intern and student for the duration of their hospital
stay, if possible.
3. In general, notes should be written before rounds. It is your responsibility to review
and discuss the notes with the interns and students before rounds.
4. Well babies should be seen before rounds. Each newborn should be examined by a
student and an intern. Relevant newborn information is presented and discussed
during rounds.
5. A student should present no more than one admission H&P. Any other admissions
will be presented by either you, the intern assigned to the care of the patient or by
the resident who was on call. People with morning clinic should present first.
6. You are to oversee completion of the treatment plans by the interns and students.
You are to be told about any notifications the interns receive from the floor about
patient issues.
Afternoon Rounds: The senior resident will lead bedside rounds with the in-house team at
3:30 each afternoon. Particular attention is to be paid to follow-up of issues from morning
rounds. You are to call the attending for checkout each afternoon around 4:30. You or the
intern should write a brief afternoon note. You are responsible for checking out the service to
the upper level resident on call each night.
Well-Baby Nursery: You are to oversee the team’s activity in the nursery. You are expected
to have gone to the nursery and answered any questions the team has and evaluated any
physical exam findings prior to rounds each morning. You are responsible for the paperwork
being completed correctly – admit orders signed, H&P form filled out, Ballard exam (estimation
of gestational age by maturity rating) done and charted, wt/ht/hc percentiles plotted, admit note
written, orders written. Every mother is to be seen by a resident every day, even if a student
has seen her. You are expected to be aware of what the mothers are being told. CMC mothers
should be given a copy of the yellow newborn book (or Spanish translated version when
appropriate).
Admissions: The senior resident on call is to perform a complete history and physical exam
on each patient admitted to the Pediatrics service, and write a concise H&P, assessment, and
treatment plan in the chart. The intern is to dictate a full H&P. Medical student H&P’s are not to
go on the patient’s chart. You do not accept any patient for admission. Physicians desiring to
admit patients to the service should be referred to the on call attending.
Senior Resident Orientation
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Emergency Department: We see our own patients, consults from the ED staff, transfers
from outlying hospitals, as well as unreferred patients (Mon, Wed, Thus, and Sat) after initial
evaluation by the ED staff. In certain circumstances, we may perform the initial evaluation as
well (if the patient was sent to the ED from clinic, for example). The upper level resident is to
have examined every patient and reviewed the treatment plan before the patient is checked out
to the attending by phone. No patient is to be sent out of the ED without having been
examined by the upper level resident! In the rare event that the upper level resident is not
able to physically see a patient due to other responsibilities, this fact is to be made clear to the
attending at the beginning of the checkout call. If a patient is to be followed up at UMC, you
must call the clinic (or voice-mail after hours) and let the clinic know to expect them. Call the
student for each ED patient – this is NOT optional.
Schedules: You are responsible for completing a clinic sheet for the month. Each intern has
FM clinic one half-day per week. Also, each intern is to be scheduled for Pediatrics clinic 3 halfdays per week. It is helpful if one intern is scheduled for Wed afternoon and one is scheduled
for Fri afternoon. Interns should not come to clinic on Tues am or Fri am because of lectures.
Attempts should be made to have at least one member from the team in house at all times. If
this is impossible, then an intern may go to clinic to be called back to inpatient duty if needed.
The interns and students are excused for Allergy Clinic (2nd Wed a.m.), Cardiology Clinic (2nd
Thursday (students and interns divided between am and pm), and Sickle Cell Clinic (3rd Friday
a.m. 2/3 months). Give a copy of the clinic schedule to the Pediatrics secretary. The schedules
of the medical students are not your responsibility.
Miscellaneous: Notify the attending of any problems with the team. As a rule, any
disciplinary action taken with the interns or the students should come from the attending. On
the other hand, you are encouraged to provide constructive criticism when appropriate.
Remember that you are a role model for the students and interns, whether you like it or not.
Use your discretion about the mechanics of the team. For example, you might want to meet
with the team before rounds and go over their presentations or notes. You are the leader of the
team and its smooth function is your responsibility.
The Pediatrics faculty appreciates your work in the care of our patients. It is our desire to
provide you with an excellent education in Pediatrics. Please make any suggestions that you
feel would improve the residents’ experience or patient care on the Pediatrics service.
Reading/Lectures: You are to attend lecture Friday morning. There is a collection of resident
articles that will be provided to you. This file is also located on the share drive under
“resident/student share” in the “pediatrics” folder. Please complete the articles under the “senior
resident” section in the table of contents before finishing the month.
Karen B. Burgess, M.D.
12/06/2005