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, Pulmonary, Cardiology, and a shared specialty team. Heme-Onc is staffed with interns and senior residents.  Pulmonary and Cardiology are 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 addmissions overnight . We do not have rotating night call. There are 2 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.

Outpatient Rotation:
The outpatient rotation includes three months as an intern. During this month the resident will work either in the acute General Pediatric Teaching Clinic or will work shifts in the Emergency Department.  Interns will also spend some educational time with our Team for Children at Risk (TCAR) to learn about evaluations of suspected medical neglect, physical and sexual abuse.  Didactics on the outpatient rotation include educational conferences twice a month in the Emergency Department and every Wednesday in the General Pediatric Teaching Clinic.  There are no true calls on the Outpatient Months as residents work shifts in the ER.

Behavior and Development:

Each intern will spend one month learning about child behavior and development with our developmental pediatricians.  This call-free month is a unique combination of clinic experiences evaluating children with suspected learning, developmental and behavioral abnormalities; exposure to the varied therapy services within the community, and lastly unique opportunities to work with families with chronic conditions in order to learn about the medical home model.

Newborn Nursery:
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.

Cardiology:

A 2nd 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.

Hematology-Oncology:

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.

Adolescent:  
The Adolescent clinic provides primary care to adolescent patients with the unique care needs for this population.  It is completed in two 2-week blocks; one in the intern year and one in the second year. Experiences include Sports Medicine and participating in the Eating Disorder Clinic, which is a multidisciplinary clinic evaluating teens with suspected eating disorders. Our adolescent section is staffed by adolescent trained physicians and has the support of Social work, Psychology, and Physical Therapy in clinic to provide comprehensive care.

Emergency Medicine:    
In addition to the ED experience as an intern, our upper level residents rotate in the ED for one month during each of their 2nd and 3rd years. The ER resident is able to manage more acutely ill patients with the ready assistance of ED fellows and attendings. Senior residents also assist in accepting outside physician calls about possible transfers to ACH for evaluation. Most shifts are eight hour shifts, with some 12 hour shifts.

General Pediatric Teaching Clinic: 
All 2nd and 3rd year residents will rotate through the General Pediatric Teaching Clinic, as well as satellite clinics, providing well child and acute care.  Residents have a goal to see approximately eight visits per half day clinic. Senior residents also supervise medical students including teaching as it warrants.   This is a no-call month.