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The goal of the first year of training in the LAUnCH Track is to become familiar with social determinants of health and how they affect the communities we serve. By the end of the first year, residents are expected to identify a community health topic that will be the basis of their longitudinal research project.
- Outpatient Acute Care (OAC): Residents spend one full 4-week block at their community-based continuity site, allowing them the opportunity to learn more in-depth about the community in which they practice, as well as how a community health center functions.
- Community Building Blocks: During this four-week rotation residents learn skills and techniques that will help them improve the health care of children in the community. Each week of the rotation is focused on a different social determinant of health with structured activities with community agencies or community leaders focused on that topic. Residents are also given ample opportunities to plan site visits or virtual experiences with other community organizations of interest. Examples of activities from the past include home visitation, speaking with a local pediatrician about threats to the health of the immigrant populations in our community, and visiting a local public school that has been adapted for children with complex medical needs. In addition, residents receive didactic sessions on the basic concepts of Community-Oriented Primary Care and begin to do a community needs assessment.
During their second year, residents have a half-day a week to work on their longitudinal projects as part of the Research, Education, Advocacy, and Child Health (REACH) Program. They spend this time working on a community health scholarly project, such as cultivating a relationship with a community-based organization that works on their identified health area of concentration and working with them to derive a plan for a healthcare intervention to address this need. Residents spend their outpatient block rotations learning the basics of advocacy and health policy.
- Child and Adolescent Protection Center: Residents spend two weeks working at the Freddie Mac Child and Adolescent Protection Center at Children’s National. During this time, residents have the opportunity to participate in the evaluation of various forms of child maltreatment for both inpatients and outpatients, and to learn what a child and family may experience when a report of abuse is made and how a multidisciplinary team works together to meet the needs of vulnerable children. By the end of the rotation, residents are expected to understand what history and physical exam findings are important to elicit, identify and document in cases of abused children and how the local legal system works in relation to abuse cases.
- Health Policy Fellowship (George Washington University School of Public Health): This three-week rotation held in conjunction with the GWU School of Public Health gives residents a broad overview of the background and context of health policy in the United States. Residents are introduced to key issues in health policy and to a sampling of key individuals and organizations in the field. The rotation culminates in a health policy analysis exercise where participants perform their own policy analysis and create recommendations related to a current issue being debated by Congress.
- Global Health Elective: During this one-week rotation, residents are exposed to global health issues such as the diagnosis and management of common illnesses and tropical diseases affecting children in developing countries, child and newborn survival in developing countries, and allocation of limited resources. Additionally, residents meet local healthcare professionals working in the fields of global health research, policy, and clinical care. This rotation also provides residents an opportunity to prepare for international elective experiences or future work in a developing country.
- The Child Health Advocacy Institute/Advocacy Selective: During this four-week block, residents will be introduced to legislative advocacy and have a hands-on legislative advocacy experience. Didactic sessions will provide an overview of the Child Health Advocacy Institute, the findings of the Community Health Needs Assessment and the priority areas of the Community Health Improvement Plan, the legislative priorities of Children’s National, and the steps to engage in legislative advocacy. Building on this foundation, residents will choose a pediatric health issue and create or adapt a legislative advocacy policy proposal to share with a legislator or member of their staff.
The main goals of this year are completion of the longitudinal project, continued development of community pediatrics knowledge and an understanding of the Advanced Medical Home.
- Outpatient Acute Care (OAC): Residents again spend a full block at their continuity site, not only seeing their own panel of continuity patients but serving as a teacher and mentor to more junior residents and medical students rotating through that clinical setting.
- Research Completion: In addition to the continued protected half-day a week to work on their longitudinal project, residents have additional time dedicated to finalizing their project and working on a publication or presentation at a regional or national meeting.
- Population Health and Leadership: Residents gain population health experience by collaborating with city-wide coalitions, community partnerships and a comprehensive medical home. Residents participate in innovative programs that are housed at the Town Hall Education, Arts and Recreation Campus (THEARC), a unique facility that serves as a community center for one of the most under-resourced areas of Washington, D.C. The facility houses a clinical site for a Children’s Health Center and it is the base for the Children’s Health Project, D.C. Mobile Health Program, which consists of medical and dental mobile units. Community partners within THEARC include the Boys and Girls Club, a middle school for girls, a ballet school, a music school and an art school. The rotation additionally teaches residents leadership skills by providing advocacy opportunities focused on how health policy and the legislative process impact child health.
Children's National LAUnCH Track residents attend continuity clinics in the community at sites affiliated with the Children's Goldberg Center for Community Pediatric Health in both Northwest and Southeast D.C. as well as Federally Qualified Community Health Centers in Northwest D.C. Education in continuity clinic sessions is focused on a blend of primary care and community pediatrics. The staff members are very familiar and active within the community they serve. Each site typically has one resident from each year of the LAUnCH track, so residents have the opportunity to interact with peers in the track as well as their community preceptors.
At the beginning of their first year, each LAUnCH resident is assigned a portfolio advisor who is committed to community pediatrics. As topics for longitudinal projects are identified, additional mentors are assigned to each resident. Additionally, faculty members of the Goldberg Center for Community Pediatric Health and in subspecialty divisions are available to offer career advice for our residents.
Semiannually, LAUnCH residents convene for symposia for informal discussions related to a resident's chosen community health topic. Residents, faculty, or community/policy leaders present the topic, followed by interactive activities or robust dialogue. These evening symposia afford residents and faculty the opportunity to engage in educational discussions on a wide variety of current issues in community health as well as a chance for residents in the track to catch up with one another.
Foggy Bottom Didactics
During certain outpatient rotations, LAUnCH residents have the opportunity to join colleagues in the Primary Care Track for a once-weekly morning of didactic sessions focused on general primary care pediatrics topics.