The Residency Years

The second and third residency years consist of 13 four-week block rotations each.

Second Year

  • Ward Seniorship - 1 block
  • Emergency Department, Children's Hospital Los Angeles - 1.5 blocks
  • Hematology/Oncology - 1 block
  • Pediatric Intensive Care Unit - 1 block
  • Neonatal Intensive Care Unit, Children's Hospital Los Angeles - 1 block
  • Cardiovascular Acute Unit - 1/2 block
  • Ambulatory General Pediatrics - 1 block
  • Night Shift - 2 blocks
  • Elective With Q4 Call - 1 block
  • Free Elective No Call - 3 blocks (includes 4 weeks vacation)

Third Year

  • Ward Seniorship - 1 block
  • Emergency Department, Children's Hospital Los Angeles - 1.5 blocks
  • Hematology/Oncology - 1 block
  • Pediatric Intensive Care Unit - 1 block
  • Neonatal Intensive Care Unit, Hollywood Presbyterian Medical Center - 1 block
  • Jeopardy Call - 1/2 block
  • Night Shift - 2 blocks
  • Elective With Q4 Call - 1 block
  • Free Elective No Call - 4 blocks (includes 4 weeks vacation)
  • Ward Seniorship
  • Hematology-Oncology Rotation
  • Emergency Department Rotation
  • Pediatric Intensive Care Unit Rotation
  • Neonatal Intensive Care Unit Rotation
  • Cardiovascular Acute Unit
  • Ambulatory General Pediatrics Rotation
  • Night Shift Rotation
  • Elective Rotations
  • "Free" Elective Rotations
  • Jeopardy Call

This month is one of the most challenging months but is also considered the most interesting and rewarding. Residents are assigned to a medical ward where they supervise and teach the five interns, as well as the medical students on the team. There is no overnight call on this rotation.

This rotation consists of inpatient and outpatient management of hematology and oncology patients.  The call is every fourth night. The acuity of patients on this floor is usually higher than patients on the other floors and residents improve their ability to manage acutely ill children during this rotation. 

The ED rotation during the 2nd and 3rd year includes many shifts caring for trauma patients (lacerations, fractures, MVAs, etc.) as well as shifts in the walk-in urgent care clinic. There is increasing autonomy in the ED during the 2nd and 3rd years of residency.

The Pediatric Intensive Care Unit rotation involves working exclusively in the PICU taking care of critically ill infants and children. Residents are on call every fourth night with a PICU fellow. Our hospital is a multi-disciplinary pediatric center providing extensive exposure to critically ill children.

Second and third year residents rotate through the Hollywood Presbyterian-Queen of Angels Medical Center (HPMC) and through the Children's Hospital's NICU. With about 3,500 deliveries annually, the HPMC NICU provides many opportunities to strengthen neonatal resuscitation skills and manage common neonatal medical problems. The Children's Hospital NICU is a level III tertiary referral center. Residents learn to manage more complex neonatal disorders under the supervision of fellows and attendings.

Two weeks in the second year are spent in our Cardiovascular Acute Unit learning medical and potential surgical management of these patients. Rounds occur with both the cardiologists and hospitalists, as well as the cardiovascular surgeons when necessary. Both weeks are call-free and without weekend responsibilities.

Second year residents spend one dedicated four-week rotation enhancing their outpatient general pediatric skills and knowledge.  Residents spend time in the Children's Hospital Los Angeles Urgent Care clinic where they see patients from the surrounding community.  They also spend time in the General Pediatric continuity clinic where they see their own panel of patients as well as same day sick visits for other patients in the practice.  Several sessions during the block are dedicated to didactic learning.  Residents meet individually with our general pediatric faculty and discuss a variety of general pediatric topics (e.g. immunizations, infant feeding, hypertension, orthopedic issues, health care plans, etc.).   

During these rotations, two residents on each of the wards alternate consecutive nights of call.  The other days/nights are free of clinical responsibilities other than occasional continuity clinics. Night Shift residents supervise interns on the general wards or cover Oncology patients during these rotations.

“E4” rotations are elective blocks with call. Residents choose their daytime elective, but cover one of the wards every 4th night. All medical and surgical subspecialties are represented and provide electives for residents. Residents can also choose to do elective rotations at a nearby hospital or office, including a variety of managed care settings.

Second and third year residents also get 3-4 "free" electives ("Free E's") per year, which are call-free and can be taken at any hospital/clinic/private office. Many of our residents use this opportunity for national/international pediatric experience. Residents take their vacation (four weeks each year) during these electives, which can be used all at once or split between the 3-4 blocks.

Interns are assigned to two weeks of jeopardy call during the year (during their call-free months).  PL-2 residents are assigned to jeopardy call during a call-free elective with jeopardy call every fourth night (a total of seven call nights).  PL-3 residents have jeopardy call during a two-week block that is free of any other clinical responsibilities (alternating nights).  All residents are relieved of any clinical duties if they are post-call from a jeopardy call overnight shift.