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 one 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 second year and one full day in your third 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 have 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 Early Intervention intake center in Washington, DC, 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.