Core rotations are rotations that each resident will rotate through during his/her training at UAMS and ACH. They are the foundation of your general pediatric training and important for all physicians regardless of future career plans. Some rotations are primarily inpatient rotations, some primarily outpatient, and some are a combination of both.
Inpatient Ward Rotations
Three of our ward teams care for general pediatric patients. The team includes two to three interns, two to three medical students, one supervising senior resident, and one faculty attending. In addition, there are four specialties teams: Hematology-Oncology, Cardiology, and two mixed specialty teams that include Gastroenterology, Neurology, Nephrology, Pulmonary, and Endocrine. Cardiology is specifically a 2nd-year rotation combining clinic and inpatient experiences. While on service, residents attend morning report and team rounds in addition to noon conferences.
Another ward team is the night float team which provides cross-team coverage and admissions overnight. We do not have a rotating night call. There are two teams each night comprised of an upper level and an intern. We have in house attending coverage until midnight and phone coverage overnight.
Residents on daytime ward teams take short call up to 7:00 p.m. The night float team staffs the overnight admissions and cross-cover calls.
Behavior and Development
Each intern will spend one month learning about child behavior and development with our developmental pediatricians. This month is a unique combination of clinic experiences evaluating children with suspected learning, developmental and behavioral abnormalities, exposure to the varied therapy services, and lastly unique opportunities to work with families with chronic conditions in order to learn about the medical home model.
Each intern and several upper level residents will rotate through the Term nursery at UAMS. The nursery team consists of one newborn nursery hospitalist, one to two senior residents, and two to three interns. The nursery team attends all full term or near term C-section deliveries and any high risk vaginal delivery to learn resuscitation skills. They provide routine newborn care to babies greater than 34 weeks gestational age and care to the moderately complex newborn. There is a short call until 6:00 pm and a rotating night float system.
Neonatal Intensive Care Unit (NICU) and the Intensive Care Nursery (ICN)
Residents will rotate through the Neonatal Intensive Care Unit at ACH and the Intensive Care Nursery at UAMS. All interns rotate through the ICN, which supports continued learning in neonatal resuscitation after delivery to high risk newborn or premature neonate. Senior residents will rotate through the NICU and ICN. The ACH NICU is a referral-based, tertiary intensive care unit accepting transfers of any high risk newborn, including micro-preemies, critically ill newborns, and newborns requiring surgical or pediatric subspecialist care. Both the NICU and ICN are staffed 24 hours a day with neonatal fellows and/or attendings.
Pediatric Intensive Care Unit (PICU)
One month during each of the resident’s second and third year is spent rotating through the Pediatric Intensive Care Unit. This unit accepts the sickest, most acutely ill patients throughout the state and Southern region. Residents learn about the acute management of unstable patients, decompensating patients with chronic illnesses, and end of life care. Residents are supervised by Pediatric Intensive Care fellows and attendings, and these supervisors are available in-house 24 hours a day.
A second year rotation for all residents in order to learn about the accurate diagnosis of cardiac conditions, including normal variants and an introduction to the surgical management of complex congenital disorders. Residents work with board certified cardiologists in both the inpatient and outpatient clinic settings.
This team consists of an upper level resident and two interns. Residents on this service work with patients with different forms of cancer as well as blood disorders including anemias, sickle cell, disease and coagulophathies. Board Certified Hematologist-Oncologists serve as attendings.
All residents will rotate through the ACH ED throughout their three years of residency while working mostly eight-hour shifts. The ACH ED is the only pediatric Level I trauma center in the state and has 30 private exam rooms and four trauma/resuscitation bays. The facility treats nearly 60,000 children each year. During the ER rotations, residents have the opportunity to learn to manage more acutely ill patients and traumas while learning procedures including orthopedic splinting, intubations, suturing lacerations, lumbar punctures, and incisions and drainage of abscesses among others.
General Pediatric Teaching Clinic
All residents will rotate through the General Pediatric Teaching Clinic throughout their three years of residency providing well-child and acute care. This clinic provides opportunities to see well and sick children while learning common pediatric problems. Additionally, residents will rotate through the Adolescent Clinic and the Southwest Clinic. The Adolescent clinic provides primary care to adolescent patients with the unique care needs for this population. The Southwest clinic primarily provides care for Little Rock’s Hispanic population.
Over the course of a month, residents in their second year of training get to take time away from their typical clinical duties to focus on what it means to be an advocate for children. Through site visits to community organizations and meetings with community leaders, residents enjoy hands-on experiences and in-depth discussions about the challenges that impact the health of our patients and families.