Primary Care Track

Primary Care Track

Children’s National’s Primary Care Track has trained more than 100 pediatric residents since 1982. Our graduates choose a variety of careers after residency. Many practice primary care pediatrics in offices around the country, often in academic settings. Others have gone on to fellowships and pursue their primary care careers with a focus in an area such as allergy, adolescent and young adult medicine, health policy, or advocacy work. Still others have ultimately chosen subspecialty careers.

The Primary Care Track provides residents with a unique opportunity to apprentice in our busy downtown pediatric faculty practice at Children’s Pediatricians and Associates (CP&A) at Foggy Bottom. Our patients are all insured; 25 percent are insured through Medicaid. They come from across the metropolitan area and from a wide range of socioeconomic and cultural backgrounds. Our eight faculty members (most of whom have been with the program for more than 15 years) have a wide range of interests and expertise, including child advocacy, health policy, medical education, adolescent medicine, and health care systems.

Our teaching focus helps each resident hone critical thinking skills, become confident and independent as a practicing pediatrician, understand the value of being part of a team serving patients and their families, and to have fun along the way. Faculty and residents enjoy lively debate and discussion. Being in a smaller setting for concentrated periods of time during your second and third year allows you to develop collegial relationships with faculty and peers.

Our Residents

Our Residents

We accept five residents per year to the Primary Care Track.

What our residents are saying:

"I love the small program within a large program feel of the primary care track - you get all the benefits of a small program (lots of personal attention) within a larger program (large tertiary care center with all subspecialties)."

"Foggy Bottom has become a family of sorts for me--I love all of the attendings and really love learning all of their different styles. Also, everyone cares so much about you not only in a professional development sense, but also on a personal level."

Our Faculty

Our Faculty

Jeannie Chang Pitter, MD
Undergraduate: Stanford University Medical School: Stanford University
Residency: University of California, San Francisco
Primary Role within the Primary Care Track: Continuity Clinic Preceptor, Block Rotation Mentor
Interests: Health of underserved populations (domestic and global), HIV/AIDS, adolescent health, health education/promotion, medical education

Ellie Hamburger, MD
Undergraduate: University of Pennsylvania
Medical School: University of Pennsylvania
Residency: Children’s National Health System
Other Education: Master Teacher Leadership Development Program, George Washington University
Primary Role within the Primary Care Track: Clinic preceptor, Curriculum Planning and Development
Interests: Global Health, Prematurity, Complex Care

Jennifer Kaplan, MD
Undergraduate: Cornell University
Medical School: George Washington University
Residency: Children’s National Health System
Primary Role within the Primary Care Track: Clinic preceptor
Interests: Health Care Systems, Medical Practice Management, Billing and Coding, Adolescent Health

Judith Ratner, MD
Undergraduate: Wellesley College
Medical School: University of California, San Diego
Residency: University of North Carolina, Chapel Hill, PL-1 and 2 ; Children’s National Health System PL-3
Other Education: Fellowship Adolescent Medicine, Children’s National Health System
Primary Role within the Primary Care Track: Clinic preceptor, Adolescent clinic preceptor, Curriculum Planning and Development
Interests: Adolescent Medicine

Lynne Schoonover, MD
Undergraduate: Pennsylvania State University
Medical School: University of Virginia
Residency: Children’s National Health System
Other Education: Master of Science Pennsylvania State University ; Master of Arts University of California Berkeley
Primary Role within the Primary Care Track: Clinic preceptor
Interests: Adoption, School Health

Edward Sepe , MD
Undergraduate: University of California, San Diego
Medical School: University of California, San Francisco
Residency: Children’s National Health System
Other Education: Masters of Health Science, Joint Medical Program, University of California Berkeley ; Master Teacher Leadership Development Program, George Washington University
Primary Role within the Primary Care Track: Director, Primary Care Track ; Associate Program Director; Continuity Clinic Preceptor; Curriculum Planning and Development
Interests: Health Information Technology, Latino Health, Tobacco Control

Ellie Smith-Khuri, MD
Undergraduate: Tufts University
Medical School: Columbia University College of Physicians and Surgeons
Residency: Children’s National Health System
Primary Role within the Primary Care Track: Continuity Clinic Preceptor
Interests: Injury prevention, resident education, and pediatric environmental health

Teekie Wagner, MD
Undergraduate: DePaul University
Medical School: University of Louisville
Residency: University of Alabama
Primary Role within the Primary Care Track: Continuity Clinic Preceptor, Curriculum Planning and Development
Interests: Resident Education

Ellen O'Brien, MD
Undergraduate: Cornell University
Medical School: Georgetown University
Residency: Children's National Health System
Primary Role within the Primary Care Track: Curriculum Planning and Development
Interests: Resident Education, Hyperlipidemia,Patient Safety.

Rachel Shnider, MD
Undergraduate: Tufts University
Medical School: George Washington University
Residency: Children's National Health System
Primary Role within the Primary Care Track: Curriculum Planning and Development
Interests: Resident Education, SIDS, Global Health.

Track Projects

Track Projects

Many Primary Care Track residents will apply to have a half-day per week through the REACH program during their second and third years to work on a research project that will help to enhance their career development. Residents can also choose to use some of their elective time during their longitudinal elective experience to devote to the development and execution of their research project.

Project Examples

  • Expansion of Health Policy and Advocacy Curriculum at Children’s National
  • An Analysis of “Off-label” medication use in the Pediatric Cardiac Patients: A Retrospective review using Electronic Health Records
  • Withdrawal of care at the end of life: Have the reasons for requesting ethics consults changed over time?
  • Total Therapy Study XV for Newly Diagnosed Patients with Acute Lymphoblastic Leukemia: Effects of Induction, Consolidation and Continuation Therapy for Pediatric Acute Lymphoblastic Leukemia on Health-Related Quality of Life (HRQOL)
  • Utilizing Guided Communication Boards to Facilitate Caregiver-Provider Communication During Pediatric Hospitalization
  • Implementation of a health policy and advocacy curriculum at Children’s National
  • Development and field testing of a protocol to assess the quality of community-based health care delivery in Malawi
  • The Blackboard Project: How do Children’s National Residents Utilize an Online Medical Education Home? An Analysis Using the Electronic Medical Record to Teach and Improve Patient Care: A Model to Make Your Learners Happier, Your Patients Healthier and Your Life Easier

Primary Care Track Resident Accomplishments 2008-2010

  • Grant Funding Received:
    • Children’s National Child Health Center Board Resident International Travel Grant
    • AAP DC Chapter Resident International Travel Grant
  • Projects Presented at:
    • American Thoracic Society 2010 International Conference
    • Pediatric Academic Societies Annual Meeting
    • American Society of Tropical Medicine and Hygiene Annual Meeting
  • Awards Received:
    • Student/Trainee Award in Education, Training, and Program Development. 2009 Children’s National Annual Research Poster Day
    • Frederick C. Green Pediatric Advocacy Award 2010
  • Articles Accepted for Publication in:
    • DNA and Cell Biology
    • JAMA
Curriculum

Curriculum

PL-1 Rotations

As a Primary Care Track resident, you will have almost the same PL-1 year as categorical residents, but your weekly continuity clinic site will be at CP&A. You will also spend your 1 month outpatient block at CP&A. During this month, you will be paired with a PL-3 resident to learn about both primary care and common acute care diagnoses.

PL-2 and PL-3 Rotations

During your PL2 and PL3 years, you will be at CP&A for a five-month block, seeing patients side-by-side with the attendings, working closely with the office staff, and gaining in-depth exposure to daily primary care pediatric practice. You will develop relationships with patients of all ages (birth through 21 years old) for well-child care, acute, and chronic illness. You also will get experience in referrals, coding and billing, and the business of primary care.

Your educational experiences during the PL2 and PL3 year include:

  • CP&A Peds Practice: During regular patient sessions, you will see up to eight patients per session as a PL-2 and up to 10 patients per session as a PL-3. Sessions include patients of all ages from newborn to 21 years old, and a mix of well-child care, follow-up, and acute care visits.
  • Continuity Clinic: During this patient session, you will start with a conference led by one of our faculty. Usually you have the same continuity clinic faculty preceptor for all three years of your residency.
  • Elective (REACH): One and a half days is given each week in your 2nd year and one full day in your 3rd year to structure as you choose to pursue advocacy, policy, global health, or research projects, or subspecialty clinic work. It can be part of a REACH project, or simply elective time. You hae the flexibility and independence to meet any individualized curriculum or pathway you choose from the Primary Care Track.
  • Psych/Behavioral Consult: During one of your clinical sessions each week, you have an hour set aside to have a longer visit with a patient who presents with psychological, psychiatric, behavioral, or learning issues.
  • Conferences: Primary Care Conference, Development, Behavior and Mental Health Conference, and Adolescent Conference
    • Primary Care Conference is held from 9 to 10:30 am every Wednesday and covers basic topics in primary care, often in our “journal club” format. Residents are often assigned to read the latest literature on an aspect of the topic, such as UTIs, and serve as “experts” on that aspect as cases are discussed. Each resident presents one of his/her own conferences during this time. These conferences can be based on cases they have seen in the Pediatric Intensive Care Unit or inpatient wards that hold particular relevance or lessons learned for the primary care setting. Resident conferences can also review or update a primary care case. We also use Wednesday mornings for field trips to the AAP legislative office, schools, and Toys R’ Us (to examine baby equipment, safety equipment, etc).
    • Development, Behavior and Mental Health Conference follows from 10:30 to 11:30 am, where we discuss cases and common topics encountered in infant development, behavior and child psychiatry.
    • Adolescent Conference, held after lunch on Wednesday, reviews topics such as interviewing and confidentiality, sexuality, contraception, and sexually transmitted disease.
  • Adolescent Medicine Patients: The Wednesday afternoon clinic session is mentored by our adolescent medicine specialist, Judy Ratner, MD, who runs the earlier conference and provides clinical supervision.
  • Community Health Experience: During the PL2 year, one clinical session per week can be devoted to a community health experience, to provide you with a broader understanding of the healthcare of children in an underserved population. Below are examples of current sites:
    • Upper Cardozo Clinic: This practice provides residents with an experience working in the system of care that serves the underserved population of the Columbia Heights neighborhood of DC. While the CP&A practice serves a very diverse population, 25 percent of whom are insured through Medicaid and SCHIP, the Upper Cardozo Clinic sees patients who may not have insurance and for whom access to care is more challenging. This experience is only available if a resident has working proficiency in medical Spanish.
    • DC Early Intervention: You visit DC's Early Intervention intake center and tour the facility where children from 3-5 years of age go to receive assessments. You will observe actual assessments of children for developmental delays and develop a deeper understanding of the concept of early intervention and the policies that influence how services are delivered to these children.
    • Cesar Chavez Elementary School: You will coordinate information sessions with elementary school children. This activity allows interaction with school children in the community outside of the clinical environment, giving residents a different perspective on child health. There is no language requirement for this experience.
    • Other experiences are available each year depending on local community needs and resources.
  • Mentor Meeting: Once a week, each resident meets with one of our faculty to review cases, discuss career plans, and do literature searches on clinical questions that arise from patients seen in the practice.