Baylor San Antonio Pediatric Residency Curriculum By Year

Residents rotate through our pediatric hospital medicine (PHM) service in blocks of two to four weeks at a time. Residents care for a wide variety of both “bread-and-butter” pediatric illnesses and unusual or rare disease processes. Teams are typically composed of one attending, one senior resident, one to two interns, one to two medical students, and occasionally one PHM fellow. Interns typically care for six to nine patients and senior residents will lead the entire team. Around 5,000 patients are generally admitted to our PHM service per year.

Interns rotate through PHM night float in two-week blocks, whereas senior residents rotate on night float in one-week blocks. There is no 24-hour call. There are generally two interns and one senior resident on at a time, with 24/7 in-house supervision by attendings. A typical night consists of seeing eight to 10 new admissions, night rounding with our nursing colleagues, and responding to pages or calls about existing patients. When time allows, our residents will watch TV in the resident lounge, get late-night snacks from the coffee shop, catch some sleep in a call room, or enjoy some takeout from one of San Antonio’s many amazing local restaurants.

PGY-1s and PGY-3s spend four weeks in the emergency department at CHRISTUS Children's, a level three trauma center which sees an average of 87,000 patients per year. Residents work an average of fourteen 10-hour shifts per rotation, in addition to weekly didactics with emergency department faculty focused on common clinical presentations as well as simulation-based cases.

Residents spend four weeks in the 60-bed level four NICU at CHRISTUS Children's in both their first and second years. A typical day consists of pre-rounding on babies on the GME team, participating in multi-disciplinary teaching rounds, attending any high-risk deliveries, seeing new admits (whether from newly born babies or from the community), teaching sessions with our faculty, and performing any necessary procedures. Once per week, residents have a “late-stay” day where they are expected to attend night rounds, but there is no overnight call or night float. Nearly 500 newborns are admitted to our NICU each year.

In the intern year, residents rotate for 2 weeks through the newborn nursery at CHRISTUS Santa Rosa Hospital at Westover Hills, and then for 2 weeks through the newborn nursery at our main CHRISTUS Children's campus. Residents carry up to eight newborns per day, perform circumcisions as requested by families, and develop comfort with newborns in the first few days of life.

PGY-1s and PGY-3s will spend two weeks working with one of our CHRISTUS developmental pediatricians. Most of the time is spent working one-on-one with one of our two developmental pediatricians in the neurodevelopment clinic, participating in the multidisciplinary autism clinic, and attending the high-risk NICU follow-up clinic.

Residents spend four weeks in the 40-bed PICU at CHRISTUS Children's in both their second and third years. Our PICU sees around 400 admissions per year. A typical day consists of pre-rounding on the patients in the unit, participating in multidisciplinary teaching rounds, seeing new admissions, performing any necessary procedures, and attending teaching sessions with our faculty. Residents will participate in four to six days of night float throughout their rotation; there is no 24-hour call. In the second year, our residents additionally rotate with PICU faculty on our Intermediate Care Service, which includes medically complex inpatients who require a level of care between general and critical care. The PGY-2 resident runs this service under the supervision of a Critical Care attending physician.

Residents spend at least four weeks during their second year on the hematology/oncology service at CHRISTUS Children's, although many residents choose to spend more time with the service on elective rotations. Residents will spend two weeks covering the inpatient service and two weeks primarily in the hematology/oncology clinic seeing new consults and follow-up patients. Residents are expected to present a case at tumor board at the end of their rotation.

Residents have protected half-days throughout their three years of residency for longitudinal development and implementation of their required scholarly projects. These days are provided during the continuity clinic weeks. Previous residents have pursued projects in clinical research, quality improvement, medical education, and more. You can view a listing of selected publications of current and recently graduated residents.

Residents spend four weeks during their second year rotating in the adolescent medicine clinic at Brooke Army Medical Center (BAMC). Residents work alongside BAMC adolescent medicine fellows and faculty to gain additional comfort caring for teenagers and young adults.

Residents spend four weeks of dedicated time in their third year rotating with the clinical service in which they intend to practice after graduation from residency, whether that be in primary care or a subspecialty field. For residents interested in a career in private pediatrics, this is an opportunity to work with a local pediatrics office of your choosing. Residents interested in pursuing fellowship training will have additional exposure to their field of interest and will have the opportunity to take on additional responsibilities beyond those offered to residents on a typical elective rotation.

Residents in their PGY-3 year have the opportunity to rotate to an international site for four weeks. Opportunities include sites that are part of the CHRISTUS Health and Baylor College of Medicine international networks, or some residents identify other countries to create customized global health experiences. Residents may also choose to create a domestic underserved rotation locally in south-central Texas or rotate to one of San Antonio's underserved health sites.

We offer rotations in nearly all pediatric subspecialties. Residents use some elective time to choose subspecialty rotations of interest. We also offer distinctive, focused electives to help resident career development, including medical education, Healthy Beginnings (new parent elective), pediatric dialysis, transport medicine and vascular access, bone marrow transplant, and many others.

Starting in the 2022-2023 academic year, we transitioned to an X+Y model of continuity clinic, specifically 4+2+2, which will allow residents to have an uninterrupted focus on providing ambulatory care during their clinic time without having obligations to other services. See chart below for details. Residents will be divided into four cohorts spanning all class years. They will spend 4 weeks on a single rotation, then 2 weeks on another rotation, and then 2 weeks dedicated to their continuity experience.

During their continuity experience, residents will have patients assigned directly to their own schedule, and they will have the opportunity to follow the same group of children throughout their three years in the program. Other components of the continuity experience include Acute care/same-day clinic, Advocacy/Community engagement, Mental Health curriculum, and multidisciplinary education.

Residents have three weeks of vacation per year, one of which will be over a dedicated holiday period (Thanksgiving, Christmas, or New Year’s). Residents also have nine days of paid time off (PTO) per year, as well as seven professional advancement days per year.