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Yale Pediatric Residency Program

Welcome to Yale Pediatrics and the Yale-New Haven Children's Hospital. We are pleased that you have requested information about our residency program and we hope this information will be helpful to you. We hope that you will visit New Haven and learn more about who we are and how we go about ensuring that your post-graduate education in Pediatrics will be one of the best experiences of your life.

Our objective is to provide an outstanding education in pediatric medicine while delivering the highest caliber of patient care. This is accomplished with the combined commitment of the Department of Pediatrics and the Yale-New Haven Children's Hospital, which opened fifteen years ago and provides a state of the art facility in which to work and learn. Pediatricians from our faculty and community are committed to the housestaff and serve as teachers, role models and mentors. Our housestaff curriculum is dynamic, exciting and innovative. All of these factors make for a rich educational environment and make Yale an outstanding choice for pediatric housestaff education.

As a member of our housestaff, you will find yourself in a unique and special pediatric residency program to which you will contribute immensely and from which you will learn. The basics of contemporary pediatrics and the nuances and complexities of tertiary pediatric care are taught in both inpatient and ambulatory settings. These are specifically designed to ensure that families, their children and our housestaff are comfortable and can interact in a collegial, professional and effective manner. Your career opportunities will be unlimited and you will be prepared to pursue any aspects of pediatrics from primary care to subspecialty fellowships. It is our intent and commitment to meld both people and facilities in a manner that will benefit your education and result in the delivery of high quality care. We look forward to your visit.

Alan H. Friedman, M.D. Director, Pediatric Residency Program Associate Chair, Education	Rachel Chapman, M.D. Associate Director, Pediatric Residency Program	Annmarie Healy Coordinator, Residency Program

Past, Present and Future of Yale Pediatrics

Welcome to the Department of Pediatrics at Yale University School of Medicine and the Yale-New Haven Children's Hospital. The national stature of the Department and the Children's Hospital and our fruitful relationship with the primary care pediatricians in our community offer a unique opportunity for learning and practicing pediatrics in an exciting environment. Our scientific activities have consistently placed us among the top five pediatric departments receiving research support from the National Institutes of Health. Yale pediatricians are internationally recognized for their treatment of cystic fibrosis, diabetes, AIDS and other infectious diseases, congenital cardiac defects, dyslexia, and many other disorders.

Under the dynamic leadership of Alan Friedman and Rachel Chapman, the residency program is geared to provide exceptional preparation for primary care practice or for subspecialty fellowships, and our residents enter both pathways with equal frequency. The needs of inner-city children are addressed by programs such as "Adopt-a-Doc," which places residents in homes, schools, and churches of the New Haven inner ring communities. Sweeping renovations of in-patient wards illustrate the Hospital's vigorous partnership and our uncompromising dedication to family-centered care in a state-of-the-art environment. The Yale Child Health Research Center, the Pediatric Scientist Development program, and five training grants funded by the National Institutes of Health catalyze the training of the next generation of pediatric investigators and the development of novel therapies for pediatric conditions. Innovative elective opportunities include global child health, clinical epidemiology, and pediatric surgery. Expert teaching on bioethics, patient safety, and evidence-based medicine enlivens our curriculum. Our residents' energy and vivacity overflow, with impromptu parties in the "Smoothie Building" and undisputed championships on the softball diamond. The modest size of our collegial faculty fosters interactive learning and professional growth, while strong ties with dedicated community physicians ensure attractive practice opportunities for those graduates not pursuing fellowship.

Margaret K. Hostetter, M.D.

We invite you to investigate our program thoroughly. We're here to help you determine whether our combination of comprehensive patient care, excellence in research, and unwavering commitment to your educational development fits with your future as a pediatrician. Enjoy your visit with us. We look forward to meeting you.

Margaret K. Hostetter, M.D.
Jean McLean Wallace Professor and Chair
Department of Pediatrics
Yale University School of Medicine
Physician-in-Chief
Yale-New Haven Children's Hospital

The Yale Pediatric Resident Experience

Over the past years, Yale Pediatrics has been fortunate to attract a number of outstanding individuals to join our residency program. Often, we are asked the criteria used for the selection of prospective residents.

First and foremost, we feel that individuals entering a pediatric residency must have an intense commitment to child advocacy, to the well-being of children, and have a high level of sensitivity to the problems faced by sick children and their families. We want housestaff who will take joy in the continued growth and development of children and understand the importance of the application of the principles of preventive medicine and anticipatory guidance to maximize the potential of children. Yale residents are encouraged and expected to be curious, to question and to share in the challenge and excitement of learning, teaching and exploring new ideas. Our residents develop an extraordinary and enormously important cohesion, collegiality and a sense of mutual support. The Yale educational experience occurs in an atmosphere which allows one to emerge from the traditional student-teacher relationship to one of a colleague and peer. These aspects of your own growth and development as a physician are crucial. As a result, the experiences shared by housestaff during their residency have forged a sense of community that has resulted in life-long friendships both amongst the housestaff and with members of our faculty. Finally, we find that a sense of humor is an important and integral part of the process of training in Pediatrics. While our housestaff, postdoctoral fellows and faculty take their work seriously, the ability to laugh and to share happy moments while working together is essential.

We believe that the pediatric education at Yale provides an outstanding opportunity for career development for those who wish to practice the art and science of pediatrics.

A Few Words from the Chief Residents

People often ask us why we chose to be chief residents. Each of us has our own personal reasons, whether we hoped to spend time doing more research, teaching or administrative work. However, the unifying motivation for why we each applied for the job is that we love the Yale Pediatric residency program and our residents.

At Yale, we take our education very seriously. The faculty are as enthusiastic about teaching and caring for patients as they are about their research. Often, rather than being taught by an attending who is merely familiar with a diagnosis, you are taught by someone who has written about it. While teaching time is protected in scheduled conferences, opportunities for teaching are also seized at the bedside and among residents. You will be encouraged to be curious, to ask questions, and to seek out answers.

Of course, you will learn the most from your patients. You will see a wide variety of patients because we serve the surrounding urban community in addition to being a tertiary referral center. Your experiences will range from watching children grow up in your own continuity clinic to helping manage complex congenital heart disease patients in the ICU. You will learn to treat common diagnoses and see diagnostic dilemmas rarely seen outside of a tertiary center. You will be encouraged to formulate your own plan of care, supported by fellows and attendings whom you will quickly come to know on a first name basis. This balance will allow you to maximize your learning while still maintaining the highest level of patient care.

There is a distinct collegial atmosphere here — in our interaction with the faculty, our outstanding community pediatricians, and certainly among the housestaff. You will find that your co-residents become some of your closest friends. The formation of strong friendships will occur during late nights caring for a sick child, and through the Yale tradition of bringing the post-call intern breakfast and coffee in the morning.

The Immunizers Softball Team

Outside of the hospital, our residents and families spend time together. Our softball team, The Immunizers, plays weekly in the spring and summer and our games are well attended by both players and fans. Residents socialize frequently with potlucks, picnics and happy hours. One of the things we love the most about the group is that residents' families and significant others frequently attend these social functions, even when their Yale resident is on-call.

The three of us have chosen to pursue fellowships after our chief resident year. Kristin will be going into genetics, Mike will be going into cardiology, and Virginia will be going into infectious disease. Our residency training at Yale has prepared us well for the next stage in our clinical and academic training. We are also very excited to have this extra year to spend working closely with the pediatric residents and the Department of Pediatrics here at Yale. We look forward to meeting you on your interview day and showing you how great our program is! Feel free to contact us with any questions about the program or the interview process that you may have at pedichiefs@yale.edu.

Virginia Pierce, MD, Michael Monaco, MD, Kristin D'Aco, MD Yale Pediatric Chief Residents 2008-09

Rotation/Responsibilities/Nightcall

Special Considerations for the Yale Pediatric Resident

The Department of Pediatrics recognizes that residency is an educational process requiring individuals to have opportunities for adequate rest, outside endeavors and family commitments. For that reason, we have built several very special features into our pediatric residency program.

• The On-call Schedule
  In all three years of our program, the on call schedule is every fourth night call or less frequent. The program is compliant with the regulations of the ACGME's work hour mandate. In recognition of the need to have periods of time free from hospital obligations, each year of our program has several weeks with limited overnight call. We believe that this schedule maximizes the opportunities for learning while recognizing the lifestyle issues inherent in a contemporary residency program. To allow you the maximal opportunities to plan for personal and family related activities, the on call schedule for the entire year is made available to the housestaff by the first day of each year of residency.
• Holiday Break
  In addition to the regularly scheduled vacation throughout the year, all members of the housestaff have an additional four days of vacation time provided either during the Jewish holidays, Thanksgiving, Christmas or New Year's. One-quarter to one-third of the housestaff are off duty at each of these traditional holiday periods. This allows for our housestaff to visit with family and friends, plan for travel or simply enjoy special times at home without the responsibilities of being on call.
• The Curriculum Committee
  Our Department has had a longstanding tradition of housestaff involvement in the planning, design and evaluation of the housestaff program. The Housestaff Curriculum Committee serves as the format for this process. This Committee consists of five to six faculty members, each representing an important area within the Department such as the Newborn Special Care Unit, Pediatric Intensive Care Unit, Primary Care Center, Hospital of St. Raphael and Bridgeport Hospital. Housestaff members of this Committee consist of at least three members of each year of the program as well as the Chief Residents. The Committee is chaired by the Director of the housestaff program. All discussions are informal and open to all members of the housestaff and faculty. In most circumstances, recommendations made by this Committee have been implemented after careful consideration by the members of the faculty and Chairman of the Department. A recent example of change is the implementation our new inpatient senior supervisor experience. An open format and a no-holds-barred approach allow for constructive and effective interchanges as well as ongoing assessments of the educational, patient care, and service components of our residency program. Our curriculum.
  
  Interns and families at the 2006 intern retreat
• Intern Retreat
  In the fall of each year, the intern class of the Pediatric, Med/Peds, and Psych/Peds programs retreat to the Hole In the Wall Gang Camp for a wonderful weekend of camaraderie, discussion and fun. All spouses, significant others and family members are invited to participate.

Salary & Benefits

A full range of benefits including medical, dental, vision, life, disability and malpractice insurance are provided to our Yale pediatric housestaff. The benefits office offers a matching 403b program. Specific details will be provided at the time of interview. The hospital also provides on call facilities for all residents.  Stipends effective July 1, 2007 were:

• PGY1 - $50,200
• PGY2 - $52,500
• PGY3 - $55,200

Summary of House Staff Benefits

Sample Residency Contract

Teaching Programs & Conferences for the Yale Pediatric Housestaff

The Yale Pediatric Residency Program is designed as a continuing and progressive educational experience. While bedside teaching and learning is of the essence, a core of didactic and interactive conferences form the basis to solidify your educational experience. Currently, emphasis is being placed on a case management approach. Our core teaching curriculum is evaluated on an annual basis and is closely coordinated and integrated among all three of the teaching hospitals. This year, computer teleconferencing links have been established between the Yale-New Haven Children's Hospital and the Bridgeport Hospital so that all of the Yale pediatric housestaff can observe and participate in the core lecture series.

In all of the patient care areas, the attending physician makes rounds with the housestaff on a daily basis, including weekends. The attending physician has the responsibility for coordination of patient care activities as well as teaching on all patients. This includes daily bedside examination and teaching for the housestaff. In addition, the attending physician for each ward team at the Children's Hospital are responsible for a didactic teaching conference weekly. An innovative conference series including Journal Club, daily inpatient as well as outpatient conference series, morning report, and mock codes are provided for the house staff. Pediatric subspecialists provide additional teaching conferences for the Yale pediatric housestaff two days per week as well as every morning as part of the Outpatient Conference Series. Finally, Pediatric Grand Rounds is the highlight of the weekly teaching schedule. All of these conferences are specifically directed to patient care problems and housestaff education. Daily conferences also occur in Radiology, Continuity Clinic, Newborn Special Care Unit, Pediatric Intensive Care Unit, and various subspecialty sections.

Each Thursday afternoon, patients who have been discharged with diagnostic dilemmas or unusual diagnoses are discussed in a multidisciplinary literature-based conference which provides further opportunity for interaction between the housestaff and the faculty. This Discharge Conference provides opportunity for detailed discussion of intriguing and diagnostically difficult patients. Once monthly, the conference is devoted to a morbidity and mortality discussion to evaluate the issues of medical management, practitioner communication, and overal patient care. Discharge Conference also allows for both the housestaff and faculty to hear from world experts on various issues in pediatrics, as well as learn the latest clinical and basic laboratory information in the continuing effort to bring the bench to the bedside.

Primary Care Pediatrics

Residents learn to assess and manage common problems in ambulatory care in clinic under the supervision and guidance of their faculty preceptors. To enhance this clinical experience and supplement any gaps in their firsthand encounters, we developed a literature-based curriculum that covers a wide span of primary care topics in pediatrics.

The Yale Curriculum in Primary Care Pediatrics serves as the basis for the weekly pre-clinic conference that takes place in the half hour prior to resident continuity clinic. This conference is led by either a faculty preceptor or a resident under faculty supervision. Residents read the cases and key reference materials prior to coming to pre-clinic conference, which minimizes the amount of didactic information to be covered and enables vigorous discussion of the questions posed in the cases. The groups are small (including only residents, students, and faculty who have clinic that day), which facilitates active discussion and personalized education.

Our curriculum serves as a guide for organized, case-centered, evidence-based discussions of core topics in outpatient pediatrics as well as issues relating to the ethical, legal, and business aspects of healthcare. Through use of the curriculum, we ensure the quality, content, and accuracy of preclinic conference sessions from week to week. The curriculum is available to housestaff and faculty in both paper and online versions, both of which contain internet links to reference articles and useful resources.

There are two versions of the curriculum: one for moderators and one for learners. In both versions, each chapter is arranged in a standardized format: a case vignette followed by a series of questions. The moderator's version also contains suggested answers to the questions, teaching pearls, and suggestions for group exercises to reinforce key points.

This innovative curriculum was collaboratively developed by Yale housestaff and faculty to fortify evidence-based learning in our clinicl conferences. All original content was in fact written by Yale housestaff and faculty, and continues to be updated annually. It is currently used by more than 70 residents and 20 faculty in the Yale Pediatrics and Combined Medicine-Pediatrics Residency Programs. The curriculum has met with a high level of satisfaction based on surveys of residents and faculty.

For more information regarding The Yale Curriculum in Primary Care Pediatrics, please contact Jaideep Talwalkar, MD or Ada Fenick, MD.

Facilities

Yale-New Haven Children's Hospital

The Yale-New Haven Hospital system has served the greater New Haven area for over 150 years. It functions both as a community hospital for a population in excess of 400,000 and as a tertiary care center for the referral of patients from throughout Connecticut, New England and other states as well as foreign countries. This dual role assures a variety of clinical experiences including common pediatric disorders as well as a more complex, exotic and tertiary type of pediatric cases. Furthermore, in addition to this tremendous diversity of pediatric disease pathology, the Yale pediatric resident is exposed to a wide variety of patient diversity. Patients from every ethnic, social, cultural and economic background comprise both the inpatient and outpatient population in the Department of Pediatrics.

The Children's Hospital was recently renovated and is now composed of 94 inpatient beds which include an 19 bed pediatric intensive care unit and a ten bed clinical research center. In addition, there is a 46 bed newborn special care unit, and a well baby service which has 64 bassinets. The Children's Hospital is completely integrated with respect to medical and surgical cases as well as private and staff patients. The patients are assigned to pediatric care units according to their age. There are also dedicated units for Respiratory step-down, Hematology and Oncology, and patients on research protocols. The pediatric housestaff has the full and complete responsibility for the care of all children admitted to the hospital. The patients admitted by the pediatric surgical service or surgical subspecialties are cared for in coordination with our surgical colleagues.

The housestaff are supervised by members of the full-time faculty as well as pediatricians from the greater New Haven area who constitute an active part-time faculty. The Department of Pediatrics has available extensive and excellent support services including diagnostic imaging, blood bank, laboratory medicine and other contemporary diagnostic modalities.

The Department of Pediatrics maintains a close collaboration with the Yale Child Study Center which is devoted to teaching and researchin child development and child psychiatry. Also, the faculty of the department of genetics are involved in many aspects of patient care and teaching.

The pediatric primary care center (PCC) is a major community resource for the care of children with approximately 15,000 visits per year. The PCC is oriented to continuity of care and dedicated to intensive houseofficer and medical student teaching. Weekly continuity clinics are held and are given the highest priority among resident responsibilities. In addition, senior level residents participate in an office practice rotation. This experience has been extremely well received by our housestaff, as it has afforded them the opportunity to observe firsthand how patient care is provided in the community setting as well as to learn how an office practice is conducted.

Hospital of St. Raphael

This hospital is conveniently located five blocks from the Yale-New Haven Children's Hospital. The pediatric experience at the Hospital of St. Raphael consists of 12 well newborn bassinets and a busy ambulatory clinic.

The Yale Pediatric resident rotations at the Hospital of St. Raphael provide a special opportunity for our housestaff to gain additional experience in the practice of community and ambulatory pediatrics. Housestaff rotations at the Hospital of St. Raphael include caring for patients in the well baby nursery and clinical experience in the ambulatory clinic. The Yale housestaff are supervised at the Hospital of St. Raphael by the Director of Pediatrics and the hospital based pediatricians there.

Bridgeport Hospital

The Pediatric Service at Bridgeport Hospital consists of 22 inpatient beds and a four bed pediatric special observation unit. In addition, there are fifty well baby bassinets and a neonatal intensive care unit. This large community hospital is located twenty minutes south of New Haven and provides the primary source of pediatric care for the largest city in Connecticut. There are approximately 1,500 admissions and 2,800 deliveries at Bridgeport Hospital each year. The Pediatric resident experience at Bridgeport Hospital offers a unique opportunity for the Yale pediatric resident to be involved in the care of patients with a wide variety of pathological conditions and to become experienced in the care of problems which would ordinarily be admitted to a community hospital. Specifically, the Yale resident rotations include the community pediatric in-patient service, the NICU and the ambulatory and subspecialty clinics. Bridgeport Hospital has a full-time supervisory staff of board certified pediatricians including generalists, 2 hospitalists and those with subspecialty certification in adolescent medicine, cardiology, critical care medicine, neonatology, nephrology and pulmonology. A Yale Pediatric Chief Resident is present at Bridgeport Hospital full time.

Big Apple Circus Clown Care Unit

The Big Apple Circus Clown Care Unit (CCU) is a community outreach program of the Big Apple Circus, a not-for-profit performing arts organization representing the finest classical circus in America.

Big Apple Circus Clowns

Using juggling, mime, magic, and music, the CCU's specially trained "doctors of delight" bring the joy and excitement of classical circus to the bedsides of hospitalized children three to five days each week, 50 weeks per year. The CCU makes "clown rounds" a parody of medical rounds where humor is the chief treatment. The clown doctors are professional performers who work one-on-one with hospitalized children, their parents, and hospital staff to ease the stress of serious illness by reintroducing laughter and fun as natural parts of life.

Through the generosity of the Garrett Smith Foundation, the Clown Care Unit is an integral part of the Yale-New Haven Children's Hospital.

Combined Residency Training in Internal Medicine & Pediatrics

The Yale Internal Medicine/Pediatrics Residency is designed to provide comprehensive training in the care of adults and children. The teaching faculty includes current faculty members from the Department of Internal Medicine and Pediatrics and Med/Peds trained faculty who supervise the continuity practice, participate in curriculum development and serve as mentors for the housestaff. Four residents are recruited each year for the four year training program. Inpatient pediatrics training occurs at Yale-New Haven Children's Hospital, inpatient internal medicine training occurs at Yale-New Haven Hospital, while outpatient training occurs at both sites as well as in community practices. There are 24 months of training in each specialty.

Graduates of the Yale Medicine/Pediatrics Training Program will have the skills and knowledge to provide comprehensive care to patients across the age span and to contribute as clinicians and scholars to issues that cross primary care internal medicine and pediatrics. The program was established in 1994, and recent graduates have entered academic primary care, private practice and subspecialty training. Graduates have also served as Chief Residents for both the departments of Pediatrics and Internal Medicine.

For further information, please call (203) 785-7941.

New Haven

With a population of approximately 150,000, New Haven offers a rich cultural diversity. Though technically a medium sized city, New Haven feels more like a large town. It has a town's scale, with low buildings, tree-lined streets, and pockets of stores and restaurants to serve local residents. The downtown area, where Yale and the Medical Center are located, is small, inviting and easily traversed by foot. But New Haven has the resources and conveniences of a city. It has offices, banks, and stores that fill the streets with office workers, shoppers, and school children. Bordering the Yale campus are restaurants, music stores, cafes, coffee shops, bookstores, clothing boutiques, ice cream parlors and a variety of small retail shops.

Popular, folk and rock artists perform regularly at the Palace Theater, the New Haven Green, Toad's Place and other jazz clubs and dance clubs. The New Haven Symphony Orchestra performs at Woolsey Hall on the Yale campus and routinely attracts international talents such as Yo Yo Ma, Itzhak Perlman and Emmanuel Ax among others. Theater is an important component of the New Haven community and is performed at a variety of venues including the Yale Repertory Theater, which won a Tony for best regional theater, the Long Wharf Theater and the Schubert Theater. These cultural opportunities are both accessible and affordable here in New Haven.

Abundant opportunities for a wide variety of outdoor activities and sports exist in New Haven and the surrounding areas. The shoreline, one of the most beautiful and diverse on the East Coast, offers a variety of water sports including sailing, boating, kayaking, swimming, and hiking along the beach. Residents and faculty participate in local Ultimate, softball, soccer, and hockey leagues. Many people take advantage of the beautiful countryside to mountain bike, camp, hike, and play golf. In fact, the Yale Golf Course is ranked among the best and most challenging in the country. In August, Yale and New Haven jointly sponsor the Pilot Pen International Tennis Tournament which attracts some of the world's best players as they prepare for the U.S. Open. In the winter, skiing and snowboarding are popular activities locally. In addition, the famous resorts of Vermont and new Hampshire are just a few hours drive from New Haven. Cape Cod, Martha's Vineyard, Boston, and New York City are easily accessible.

These factors, along with the many wonderful, affordable neighborhoods in New Haven and the surrounding towns, make this a great place to live, work and raise a family. For those of us who live here, it's no wonder that the National Civic League, the oldest civic recognition program in the country, recently selected New Haven as one of the nation's 10 All-America Cities.

For more information on New Haven and what it has to offer, please visit:

• Info New Haven
• Visit New Haven

Faculty of the Department of Pediatrics,
Yale University School of Medicine

Margaret K. Hostetter, MD
Jean McLean Wallace Professor & Chair, Department of Pediatrics, Yale University School of Medicine
Physician-in-Chief, Yale-New Haven Children's Hospital

Alan Friedman, MD
Professor and Associate Chair for Education, Department of Pediatrics
Director, Pediatric Residency Program
Yale University School of Medicine

Scott Rivkees, MD
Professor and Associate Chair for Research, Department of Pediatrics
Yale University School of Medicine

Joseph Zelson, MD
Associate Chief, Yale-New Haven Children's Hospital

Pediatric Residents' Website

Yale Pediatric Graduates 2001-2008

Our graduates have been consistently recruited to top jobs in general pediatrics and earned prestigious subspecialty fellowships and faculty positions nationwide. Approximately half of our recent graduates have entered general pediatrics. Listed below are the fellowship appointments for our graduates from the past six years.

Minority Recruitment

The Yale University School of Medicine and the Yale-New Haven Children's Hospital are committed to increasing the representation of women and members of minority groups among its students, residents, postdoctoral trainees and faculty. We particularly encourage applications from such candidates.

Additional Information/Interview Schedule

We accept applications to our program through the Electronic Residency Application Service (ERAS) process only. Please feel free to visit the following site to gain additional information about New Haven: http://www.infonewhaven.com

We hope that these materials have provided you with a perspective of our pediatric residency program at Yale. If you feel that additional information would be helpful, please contact us at us at (203) 785-3898. Our interviews are conducted on Mondays and Thursdays from November through January. Interviews are by invitation only.