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. Residents are on one of three teams – one of which cares for the more ill patients in our intermediate care unit which is directly adjacent to our pediatric intensive care unit. 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 10 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.

Our residents spend four weeks per year in the emergency department at the Children’s Hospital of San Antonio, 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. Our residents are accompanied by learners from across the city, including pediatric residents from San Antonio Uniformed Service Health Education Consortium (SAUSHEC), family medicine and emergency medicine residents from University of Texas Health Science Center – San Antonio (UTHSCA), and family medicine residents from CHRISTUS Santa Rosa.

Residents spend four weeks in the 60-bed level four NICU at the Children’s Hospital of San Antonio in both their first and second years. A typical day consists of rounding 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. Residents will stay into the early evening one day per week but there is no overnight call or night float expected. Nearly 500 newborns are admitted to our NICU each year.

Residents rotate through the healthy newborn nursery in their first year. Their time is split between the nursery at the Children’s Hospital of San Antonio and the nursery at CHRISTUS Santa Rosa Hospital at Westover Hills. Residents carry between four to eight newborns per day, perform circumcisions as requested by families, and develop comfort with newborns in the first few days of life.

Interns will spend four weeks working with our developmental pediatrics team at the Children’s Hospital of San Antonio. 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 the Children’s Hospital of San Antonio 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. Our residents rotate alongside pediatric and emergency medicine residents from San Antonio Uniformed Service Health Education Consortium (SAUSHEC).

Residents spend at least four weeks during their second year on the hematology/oncology service at the Children’s Hospital of San Antonio, 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 spend four dedicated weeks per year focused on developing a scholarly project. 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 third year have the opportunity to train at one of Baylor’s seven Pediatric AIDS Initiative Centers for Excellence in Africa, among other sites. Residents may also choose to work in one of San Antonio’s underserved health sites. This rotation has unfortunately been put on pause by the COVID-19 pandemic, but we are hopeful that it will be an opportunity for future residents.

We offer elective rotations in nearly all pediatric subspecialties. Residents have more than six months of elective time over the course of their three years. Some of the most popular elective rotations include nephrology, infectious diseases, genetics, and neurology.

Resident’s continuity clinic occurs wholly within the Pediatric Primary Care Clinic at the Children’s Hospital of San Antonio. Our patients come from all walks of life, but the clinic predominantly serves families of low socioeconomic status. Our continuity clinic faculty routinely win teaching awards and are near-constant sources of mentorship for our residents.

Starting in the 2022-2023 academic year, we will be transitioning 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 are currently under development, but we anticipate that residents will also spend time in the acute care/same-day clinic, participate in multidisciplinary education, and participate in advocacy/community engagement activities.

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.