Pediatrics

Clinical Environment

Training takes place at Helen DeVos Children’s Hospital (HDVCH):

 

hero-home

  • Magnificent free standing children’s hospital, opened 1/11/11
  • Referral center for 37 Michigan counties
  • More than 150 physicians in 40 pediatric specialties
  • More than 8,300 inpatient admissions annually
  • More than 190,000 outpatient visits annually
  • More than 41,000 pediatric emergency department visits annually and Level I trauma center with pediatric surgeons available 24/7
  • Nearly 9,000 surgeries a year
  • One of the largest children’s cancer and blood disorders programs in the nation with more than 750 patient visits monthly
  • West Michigan’s only bone marrow transplantation program
  • Only pediatric radiology department in West Michigan with nearly 75,000 visits a year
  • Expanded pediatric cardiology program including advanced interventional cardiology and electrophysiology
  • Cardiovascular surgery for infants and children as well as adults with congenital or childhood-onset heart disease
  • Comprehensive pediatric nephrology program including dialysis and kidney transplantation
  • Only pediatric sleep disorder laboratory in West Michigan managed by pediatric pulmonary specialists
  • Nation’s 10th largest neonatal center with more than 1200 babies admitted each year.
  • One of only 115 nationally accredited cystic fibrosis care centers in the United States
  • One of Michigan’s largest pediatric diabetes programs
  • A team of child life specialists focused on kids’ developmental needs and innovative ways of reducing the anxiety of hospitalization
  • Leader of Partners in Children’s Health, a network of hospitals throughout Michigan working together to improve the health of children and families
  • More than 40 specialty clinics in Grand Rapids and throughout the region
  • Lead agency for Safe Kids Greater Grand Rapids and Safe Kids Lakeshore Coalitions
  • Only Children’s Miracle Network hospital in the western and northern areas of the state
  • We have a Child Protection Team composed of 40 members from multiple disciplines which provides services for physically and sexually abused and neglected children on an inpatient and outpatient basis. This team has helped over 600 children annually since 1993

With this size and patient population, HDVCH ranks in the top half of children’s hospitals in terms of both inpatient admissions and outpatient care. However, with the involvement of community-based pediatricians and clinically-based specialists, Helen DeVos Children’s Hospital never loses its community-based atmosphere.

Program Focus

What does a typical floor week look like for a pediatric intern?

 

Daily Schedule For Floors

Typical Call Requirements
Call is now done as 14-16 hour shifts, either periodically, or as a “night float” responsibility, with up to 6 consecutive night shifts. Residents have 1-2 call-free months per year. PGY-1’s have no home call; PGY-2’s and PGY-3’s have 5-6 months of home call per year.

Elective Opportunities
We have a number of elective experiences, eg, Advanced Infectious Diseases, Critical Care Advanced Skills, Pediatric Cardiology, Pediatric Nephrology, Pediatric Endocrinology, Pediatric Neurology, Pediatric Pulmonology, Pediatric Gastroenterology, Pediatric Allergy & Immunology, Pediatric Genetics, Pediatric Dermatology, Pediatric Rheumatology, Child Psychology, Pediatric Radiology, Pediatric ENT, Pediatric Infectious Diseases, Pediatric Urology, Pediatric Anesthesiology, Pediatric Sedation, NICU Advanced Skills, Rural Pediatrics, Pediatric Psychiatry, Pediatric Orthopedics, Pediatric Ophthalmology, Senior Hospitalist elective, Toxicology, Advanced Nephrology, Cardiothoracic Surgery, and Chief Resident elective. In addition, we offer the following less common pediatric electives:

Child Protection
This rotation involves of working with the Child Protection Team, which is made up of physicians with special knowledge of child abuse/neglect, and social workers who all work together to evaluate possibly abused children. On this elective, you get a variety of experiences, including the Children’s Assessment Center (specifically for evaluating possible sexual abuse), St John’s Home (for children who have been abused and have failed foster care placement), and Kent County Prosecutor’s Office and Victim/Witness program (seeing the legal aspects, and actually getting to sit in on court cases).

Sports Medicine
Time on this rotation is spent in a clinic setting with orthopedic surgeons who specialize in sports medicine. The resident also has the opportunity to visit the operating room.

Quality & Safety
This rotation will give you a more in-depth look at patient safety and safety initiatives at HDVCH. You will take advantage of learning about the root cause analysis method of classifying medical errors, and you’ll have the opportunity to round with the safety team, learn about the safety culture transformation at HDVCH, complete a project in patient safety and quality, and educate your peers about what you’ve learned.

Bone Marrow Transplant
This elective will give you experience in both the inpatient and outpatient settings, and the emphasis is on learning to care for children before, during and after their transplants. You will participate in journal clubs and conferences, as well as round with BMT attendings.

Rural Health
We are connected with multiple practices in rural areas, so residents with an interest in this area can live the professional life of a rural pediatrician for a month.

Global Health
We have a strong interest in global health in this residency program, and have 2 residency-run school-based clinics in Port au Prince, Haiti, and a community center in the rural countryside that you might want to visit and work in.  Alternatively, you can elect to rotate in virtually any country if you have an interest in global health.  Finally, our Global Health Clinical Scholars program for residents with a stronger interest in learning more about international and underserved health.

Pediatric Residency Clinic
Our pediatric residency clinic is an invaluable resource for providing health care for the underserved in the greater Grand Rapids area. It is staffed by 10 general pediatricians and 2 adolescent physicians. In addition we have two of the most outstanding full time social workers in the area. Though you may not believe it, Grand Rapids is an extremely diverse community with many ethnic groups. In our residency clinic it is possible to see families from Latin America, Iraq, Vietnam, Sudan or other parts of Africa in addition to numerous families of European heritage. Our interns spend one half day in clinic each week while our second and third year residents have one full day in clinic each week.  Third year residents may have the option of spending half of their continuity clinic day elsewhere, with a subspecialty group or in another type of primary care practice, depending on their career interest.

Research

Academic Project & Research Opportunities

Pediatric Research Residency Director

Pediatric residents at Helen DeVos Children’s Hospital complete an Academic Project during their three years here. The goal of this requirement is to learn more about the scholarly process of research or quality improvement, including development of a research question; development of a PDSA cycle; collection and analysis of data; performance of a literature search; and presentation of the results to a formal gathering of peers (eg, Pediatric Grand Rounds, Research Day here, or regional or national meetings). Our residents work closely with faculty mentors to accomplish this goal. Other resources, such as statisticians, are available at Grand Rapids Medical Education Partners located nearby. The nature of the project is not limited to a single type and may include clinical research, bench research, meta-analysis, or any unique research that satisfies the objectives. Data collection and processing, media production, and travel expenses for presentation at state or national meetings is supported, as needed, by the residency program. Residents are encouraged to submit their research for possible publication in pediatric journals.

Many of our faculty are very involved in clinical research, most notably those in the divisions of Hematology/Oncology, Genetics, Neonatology, Critical Care Medicine, Cardiology and General Pediatrics. In addition to working with our clinical pediatric faculty, you have the opportunity to explore the possibility of working with basic scientists at the Van Andel Institute.

Residents develop a research project during their training and have the opportunity to present it at numerous scientific meetings. Some have been submitted for publication.

The GRMEP Research Department has developed several tools and resources that will help residents and fellows develop ideas into manageable and realistic research projects. We have found that using these resources saves time and energy while avoiding typical pitfalls and dead ends. For example, the research project outline facilitates the translation of a good idea into a research project, provides the bulk of the narrative portion of IRB application, and serves as the guide for implementing the project.

The GRMEP Research Department provides support to residents and faculty in all areas of research and scholarly activity (e.g., quality, educational, surveys).  To access more details, including templates (e.g., study protocol, poster), help request forms and other contact information, visit GRMEP Research.

Unique Curriculum Features

Unique features to the Helen DeVos Children’s Hospital Curriculum:
Interest-Based Tracks:  As a resident you will receive guidance and mentorship in developing your career interests.  This will allow you to enter a track designed to help individualize your residency curriculum and take full advantage of your three years of learning.  Examples of tracks include primary care, underserved and global health, procedure-oriented specialties, subspecialty care and hospitalist medicine.

High Fidelity Simulation Program
Residents have monthly mock codes on all inpatient floor rotations, NICU, and newborn nursery rotations; a monthly simulation scenario as part of your didactic educational series; and several skills sessions per year, running scenarios in teams with our high fidelity Sim Baby. We also use simulation in the areas of patient safety, handoffs, and practicing routine procedures and skills. This is a very popular and important part of your residency curriculum here!  We have a brand new, state of the art simulation center in HDVCH that allows for videotaping, viewing colleagues working through scenarios, and great debriefing after the case is concluded.

Advocacy Rotation 
Our program offers a unique rotation in child advocacy in the PGY-1 year.  This is a blended experience, where the resident spends equal time in a local public school, with the child protection team at HDVCH, and immersed in a patient safety introductory experience at HDVCH.  Each of these primary experiences is designed to help the resident better understand and become an effective advocate for patients and their safety.  In addition to the aforementioned activities the resident will have time to independently “shop” for common baby supplies, learn about community resources available to patients, and make contact with a local legislator about “hot” topics in medicine and health care financing.

Primary Care Experience
Each resident has the opportunity to work with a community-based pediatrician in the outpatient setting. This experience allows residents to feel the pace of pediatric practice as well as to learn the business side of medicine. Residents typically make morning rounds and attend meetings with their attendings, take home call for the practice, and have their own list of patients to see in the practice. Some residents have even gone to the Capitol to help with legislative work during this month.

Educational Conferences

The Grand Rapids Medical Education Partners Pediatric Residency at Helen DeVos Children’s Hospital strongly believes in teaching according to an adult learning model which emphasizes collegiality and the sharing of medical knowledge as well as an expectation to remain motivated in the pursuit of medical knowledge. To this end, we offer a wide array of teaching forums from which our residents can learn:

Inpatient Education

Morning Report – Senior residents present a patient who was recently admitted. A chief resident and several attendings are present to lead a focused discussion and help formulate a differential diagnosis and plan. The focus is on evidence-based evaluation and treatment.
Grand Rounds – A wide variety of topics are presented by MSU and visiting faculty. All house staff and faculty attend.
Multidisciplinary Case Conference – A more complex case is presented with discussion of differential diagnoses, evaluation, and management. Pediatric subspecialists provide added teaching and input. House Staff, community-based and hospital-based attendings, and subspecialists attend
Family Centered Rounds – On the general pediatric service, an inter-disciplinary team led by a hospitalist and senior resident, conduct table rounds where patients are presented by interns and medical students and diagnostic & therapeutic plans are formulated. Following this, the team moves to Family Centered Rounds, which occur at each patient’s bedside and include family members and the patient’s nurse.
Lecture Series – Interactive presentations are given on a variety of inpatient and outpatient topics by hospital and community based pediatricians. Curriculum is guided by Nelson’s Textbook of Pediatrics. This is completely protected time for all residents.
Attending Morning Report – Once a month one of our teaching faculty present a morning report where only attendings are allowed to ask questions and formulate a differential diagnosis and work-up. Residents watch and listen to learn from their thought processes. The case is followed by a short teaching session and updated literature regarding the diagnosis.
Professor Rounds – The MSU Department Chair of Pediatrics is presented an interesting case of which he has no prior knowledge, and then leads the group through a discussion of the differential diagnosis, diagnostic work-up, and current areas of research related to the case.
Rotation-Specific Opportunities

NICU Teaching Rounds – 10-15 NICU inpatients are presented by residents to NICU staff (neonatologists, nurses, respiratory therapists) during walking / beside rounds. Diagnoses and management are discussed in depth on each patient presented.
Newborn Lecture Series – Residents and attendings present newborn care topics in an interactive format
PICU Teaching Rounds – PICU inpatients are presented by residents to PICU staff (intensivists, nurses, pharmacists, respiratory therapists). Diagnoses and management are discussed in depth on each patient. Brief lectures on high yield topics directed by the attending intensivist frequently occur following rounds.
Radiology Rounds – Pediatric floor residents and interns review interesting imaging studies with the guidance of a radiology resident and/or pediatric radiologist. Discussion on interpreting radiographic studies as well as common clinical problems and the imaging modalities of choice.
Reading Club/Board Review – Each month residents receive a reading outline for Nelson’s Textbook of Pediatrics which corresponds with upcoming lectures. Nearly every week, an attending physician leads a one hour board review session, centered on interactive discussion of board style questions.
Specialty-focused conferences – Lectures including hematology conference, pediatric oncology tumor board, Child Protection Team meeting, pediatric cardiology/cardiac surgery conference, pediatric morbidity and mortality conference, and fetal ultrasound conference
Specialty Journal Clubs (rotation specific)

Primary Care Experience
Each resident has the opportunity to work with a community-based pediatrician in the outpatient setting. This experience allows residents to feel the pace of pediatric practice as well as to learn the business side of medicine. Residents typically make morning rounds and attend meetings with their attendings, take home call for the practice, and have their own list of patients to see in the practice. Some residents have even gone to the Capitol to help with legislative work during this month