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Inpatient Training
The inpatient service is a 173-bed children's hospital providing a mixture of acute and chronic diagnostic and therapeutic challenges. Patients from the local area provide residents with good exposure to primary and secondary types of problems, and a large number of tertiary care patients are referred from the entire state. Full-time attending physicians are integral members of the teams providing care on both the infant and the children's acute disease services. Attending faculty make daily teaching rounds and are closely involved in the day-to-day operation of all units.
It is the policy of the department to delegate the primary responsibility of caring for all patients to the house staff. The inpatient service is conducted entirely within MUSC Children's Hospital; it is not necessary for house staff to rotate through affiliated hospitals for their inpatient experience.
Adolescent Medicine
Training in the care of adolescents is an important part of a pediatric residency. The pediatric residency program at MUSC includes a very strong and diverse training experience in adolescent medicine that is designed to provide a good foundation for general adolescent care in pediatric practice. Adolescent medicine clinical services include an adolescent clinic, the Young Mother-Baby Clinic, a school-based clinic at a nearby high school and an active inpatient consultation service. The pediatric resident may have experience in all these clinical settings while on the ambulatory rotation. In addition to this clinical training, didactic sessions in adolescent medicine are scheduled into the resident lecture series. Residents participate in a month-long adolescent medicine rotation. The rotation includes experience in all the adolescent clinics as well as participation in an adolescent substance abuse treatment program and adolescent medicine didactic seminars. Other specific areas such as sports medicine, private practice adolescent medicine or eating disorder group therapy sessions can be arranged at the request of the resident.
Cardiology
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Cardiothoracic Surgery
The division of cardiothoracic surgery has an active pediatric cardiac surgery section with two experienced congenital heart surgeons. Approximately 250 congenital heart operations are performed annually. The division of pediatric cardiology works very closely with the division of cardiothoracic Surgery in the care of infants and children with congenital heart defects. There is a special emphasis on correction of defects early in life. Residents care for patients after cardiothoracic surgery procedures once they reach the ward prior to their discharge from the inpatient service.
Continuity Clinic
The resident's Continuity Clinic is located on the Medical University campus. Each intern begins with a panel of 75 patients, which will grow to 150 patients over three years. Residents may add newborns and patients they encounter in the hospital, emergency room or outpatient clinics. Clinic patients receive all of their health care through this system. Patients see their own resident pediatrician for more than 50 percent of their visits, for all well checks, for school and behavior problems which can be scheduled in advance, for almost all rechecks for acute illness, for hospital follow-ups and for some of the initial visits for acute illnesses. In the Continuity Clinic, residents experience the fun of following patients long enough to get to know them and their families well. They help patients with illnesses learn how to safely stay out of hospitals and emergency rooms. They learn how to coordinate care for their patients with chronic health problems who need consultants. They see the myriad of relatively minor problems that concern parents, learn how to teach parents to recognize significant problems and encourage parents to practice good health maintenance with their children. Residents are available after hours to answer telephones calls, give telephone advice and, when needed, bring patients in to be seen. Health problems are discussed from an outpatient perspective at a mini-conference held at the beginning of each morning clinic. Approximately 4,500 patients, an average of 35 patients a day, are seen. The kept-appointment rate is over 75 percent, and patient satisfaction has been very good.
Critical Care
The critical care division coordinates the acute care of seriously ill children. The division directs patient care in the 11-bed Pediatric ICU. Coordination of care also extends to the Children's Hospital transport team, including emergency transports via MUSC's MEDUCARE emergency transport system. Residents learn to take care of critically ill patients with diagnoses with a wide spectrum of backgronds (eg., general pediatric, neurosurgery, pulmonology, neurology, urology, surgery, cardiology, hematology/oncology, etc.)
Developmental Pediatrics, Child Psychiatry and Genetics
The division of developmental pediatrics operates the Vince Moseley Developmental Evaluation Center which uses an interdisciplinary team approach in meeting the diagnostic and therapeutic needs of children with developmental disabilities. The team disciplines include developmental pediatrics, developmental psychology, occupational therapy, physical therapy, social work, speech/language pathology and schools. The team of professionals works together with children and their families through individual assessments, team staffing conferences with community professionals and follow-up parent conferences. From these interactions, a diagnosis and treatment plan is created to meet the specific needs of each child and his family. The types of developmental and learning problems evaluated include: learning disabilities, behavioral and emotional problems, developmental delay and mental retardation, cerebral palsy, autism, attention deficit hyperactivity disorder, spina bifida, high risk follow-up, and genetic defects, as well as a variety of other developmentally disabling neurological impairments. Fellowship training is available in this subspecialty.
The child psychiatry program is designed to stimulate and encourage the pediatrician's awareness of the psychological aspects involved in the optimal practice of pediatrics. Consultations are available for all patients with follow-up plans for treatment as indicated. Individualized electives are available to learn psychiatric assessment, behavioral management, and psychopharmacology. The two areas work together closely and operate a developmental/behavioral clinic to address mental health needs in developmentally disabled children and adolescents.
Genetics is part of the required one-month rotation in the first year of residency through developmental and behavioral pediatrics. During the third year of training, the pediatric resident is given the opportunity of taking an additional one-month elective rotation in genetics.
Fellowship Application (pdf)
Emergency Medicine
The division of pediatric emergency medicine provides a wide range of pediatric emergency experiences with supervision by attending physicians. A combination of direct patient care, teaching sessions, mock codes and resident directed conferences covers all aspects of pediatric emergency medicine. The development of evaluation management and technical skills is integrated with teaching the team approach needed to deal with an emergently ill or injured child. The pediatric ED has an attending in-house 24/7.
Endocrinology
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Gastroenterology and Nutrition
The gastroenterology/nutrition division diagnoses and manages children with diseases of the gastrointestinal tract, liver and pancreas and children with nutritional problems, including failure to thrive, malabsorption, tube feedings and parenteral nutrition. Close collaboration with the pediatric radiologists, psychologist and surgeons as well as the pathologist and pulmonologist is maintained on both the inpatient and outpatient services. Residents are welcome to elect a month rotation with the division where one-on-one didactic sessions are designed to meet the specific needs of the resident, who is participating in the GI and nutrition clinics and managing in-house patients. During this rotation, residents are encouraged to participate in a full range of GI procedures.
General Pediatrics
The general pediatrics division provides a wide range of experiences for the pediatric resident. The division provides comprehensive care to children in the community and to children with a wide variety of problems presenting for acute episodic visits. In addition, general cases referred to MUSC Children's Hospital are cared for by the general pediatric service. Faculty members are available and present during all patient contacts to teach residents and students. A pediatric attending covers the general clinic while another pediatric attending simultaneously covers the continuity clinic to maximize resident teaching. Regular conferences are held to discuss issues and topics of importance to general pediatricians in their practices. The division has a very active research program, and residents frequently conduct research projects under the guidance of division members.
Health Services Research/Academic Generalist Fellowship Program
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Hematology/Oncology
The hematology/oncology division is responsible for the evaluation, treatment and follow-up care of all patients with hematologic disorders, coagulation defects and malignant diseases. It is also responsible, in collaboration with the adult oncology transplantation team, for pediatric patients undergoing bone marrow transplantation and it is an integral part of the university wide Hollings Cancer Center. In coordination with the attending hematology/oncology physicians, the house officer assigned to this service is responsible for consultations, evaluations and treatments of both hospitalized patients and those seen in the outpatient facility. The house officer is provided with support from the Department of Pathology and Laboratory Medicine, twice-daily rounds, informal didactic teaching and frequent contact with all members of the division. Upon completion of a rotation on this service, the pediatric house officer will have achieved familiarity with evaluation of hematologic problems, will have the ability to recognize and manage common problems associated with pediatric malignancies and will have acquired the technical and psychological skills to perform these in practice. Additionally, exposure to multi-institutional therapeutic protocols will help the house officer become knowledgeable about the most recent advances in the care and treatment of pediatric patients with malignancies.
Infectious Diseases and Clinical Immunology
The pediatric infectious diseases division provides consultation on a wide variety of infectious problems. Patients with common pediatric infections are admitted from the local population while the statewide referral population provides exposure to unusual or severe infections. The pediatric residents interact with the division through formal or informal consultations and in topic-oriented teaching sessions. The elective in pediatric infectious diseases gives the resident an opportunity to see inpatient and outpatient consultations and to review the telephone consultations received by the division. Participation in clinical research projects by interested residents is encouraged.
Internal Medicine & Pediatrics (Med/Peds)
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Neonatal-Perinatal Medicine
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Nephrology
The pediatric nephrology division provides statewide tertiary diagnostic and therapeutic services for children with kidney and urinary tract diseases. A maintenance peritoneal dialysis program performs more than 500 dialyses per year. A home peritoneal dialysis training program is also provided. More than 1,500 visits are handled in the weekly pediatric nephrology clinic each year. Weekly seminars deal with renal pathology, nephrology, urology, and patient-care problems. The house officer is exposed to a variety of renal problems and participates in the care of chronic dialysis patients. The nephrology elective offers an in-depth exposure, wherein the house officer is given the chance to review the current literature and to participate in clinical research.
Neurology
During the second training year, the pediatric resident is offered a rotation in child neurology with supervision by child neurologists. Experience includes basic information in pediatric neurological diseases, electroencephalography, neuroanatomy and neurophysiology. The uses and limitations of special diagnostic studies, including cerebrospinal fluid examination, video-EEG, and both CT and MRI scanning are considered. A clinical approach stressing acquisition of knowledge and skills in neurological diagnosis in the outpatient department as well as at the bedside and clinical pathological correlation is stressed.
Ophthalmology
The Albert Florens Storm Eye Institute has four pediatric ophthalmology faculty members who are available both for inpatient and outpatient service consultations. The staff manages a large variety of ophthalmic disorders in children and assists in the diagnosis of neurological and general systemic diseases. Lectures and seminars are available periodically throughout the year. Pediatric residents are encouraged to spend elective time on the service where they will become familiar with the in office diagnosis and management of common pediatric ophthalmic disorders.
Pulmonology, Allergy and Immunology
The division of pediatric pulmonology, allergy and immunology (PPAI) came into existence in July 2000. It is committed to providing effective and innovative patient care, education about common and rare pulmonary, allergic and immunologic disorders, and research. It is growing in faculty, patient numbers and research projects.
Division faculty admit their patients to Team 2, so attendings make daily management/teaching rounds with members of that team. Faculty perform consults whenever requested. Residents on the elective and the requesting team benefit from the consult. Faculty do case-based teaching in small groups two to four times per month. Mid- and upper-level residents who take the PPAI elective will attend the division's four main clinics: multi-disciplinary, cystic fibrosis (CF), allergy, and pulmonary. Division faculty regularly attend and contribute to morning report and provide lectures whenever requested.
The general patient groups seen in this division include asthma, apnea, BPD, CF, congenital abnormalities, lung infections, neurologic disorders, respiratory failure, restrictive lung diseases, sleep disorders and other miscellaneous conditions. The division utilizes and teaches the concept of healthcare provision by a multi-disciplinary team. Residents also learn a great deal about the indications for and information to be obtained from various types of testing, including bronchoscopy, exercise testing, pulmonary function testing and sleep studies.
When taking the PPAI elective, residents are strongly encouraged to do a literature review of a topic of relevance to their future career goal. Residents interested in doing research are encouraged to do a project with division faculty. Resident teaching is intended to provide whatever the trainee needs. The faculty and team recognize the varying career goals of each trainee and try to provide an experience of maximal benefit to the individual.
Radiology
The division of pediatric radiology in the department of radiology is staffed by three fully trained full-time pediatric radiologists who have dual appointments in pediatrics and radiology. In addition to working with the entire spectrum of pediatric radiologic investigative procedures, they are intimately involved in resident teaching and research. Daily conferences are held with the pediatric clinical subspecialist and house staff. A pediatric radiology elective is offered.
Transport Service
The Children's Hospital has an established transport team especially designed for the neonatal and pediatric patient up to age 16. This team consists of a transport nurse and a respiratory therapist with medical control provided by the divisions of critical care and neonatology. A fully staffed medical transport service comprised of a helicopter, airplane, and mobile intensive care ground ambulance greatly enhance the Children's Hospital transport capabilities.
Child Life
The child life department focuses on the psychosocial needs of pediatric inpatients. Child life specialists provide diverse services to address the social, emotional and developmental needs of infants, children and adolescents. Programming includes assessment and a psychosocial care plan including therapeutic play and developmental support. Intervention strategies foster continued growth and development, minimize adverse reactions to the health care experience and reduce stress and anxiety.
Goals for children include mastery, control, opportunity for choices, self-expression and increased understanding and cooperation with medical treatments and procedures. The department supports family-centered care initiatives and developmentally appropriate care throughout the Medical Center. Child life staff members manage and staff Medical Center playrooms and may be assigned to pediatric clinics, the department of emergency services and hospital units. Child life provides in-service classes and lectures within health care settings and throughout the community. Topics include child development and psychosocial issues concerning children and health care experiences. Consults are accepted from all services. |
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