The Resident Group Practice: Continuity of Care
All house officers spend one half day per week participating in the Resident Group Practice where they follow a cohort of patients longitudinally through all aspects of sick and well patient care. In addition, residents spend block time in each year at their continuity site. There are three sites for continuity clinic; the main site is adjacent to the Hospital in the Helmsley Medical Tower, and there are satellite practices at NewYork-Presbyterian/Queens and the Long Island City Community Practice.
Every effort is made to ensure that patients see their own resident doctor at each visit, in order to forge strong physician-patient relationships. Residents in a group model see those same continuity patients for episodic illness and telephone triage. Residents often find their continuity clinic to be one of the most rewarding parts of their training.
The world's oldest and largest private cancer center, Memorial Sloan Kettering Cancer Center is a leader in patient care as well as innovative research. Pediatric residents at Weill Cornell have the opportunity to rotate through Memorial Sloan Kettering in both their intern and junior year on the oncology team. There is also an opportunity to do an elective in bone marrow transplant in junior or senior year.
The Hospital for Special Surgery is the top-ranked orthopedic hospital in the nation, as well as one of the top hospitals for rheumatology and neurology. It is a center of excellence in the care of children with orthopedic and rheumatologic disorders, providing care for patients with some of the most complex musculoskeletal disorders in the world. Pediatric residents rotate through the Hospital for Special Surgery in their second year of residency, providing them with the unique opportunity to attend not only the busy general orthopedic clinics, but specialty clinics including the sports medicine clinic, pediatric rheumatology clinic and skeletal dysplasia clinic.
Serving among the most culturally diverse populations in the United States, NYP/Queens is a 439-bed acute care hospital that last year admitted more than 34,000 patients, had more than 133,000 outpatient visits, and treated 80,000 people through the emergency department. Through their experiences at NYP/Queens, residents are provided with an opportunity to gain increasing autonomy in inpatient management and build collaborative relationships with community-based pediatricians throughout Queens. In addition to the inpatient experience, our residents complete a rotation in community pediatrics/pediatric advocacy at NewYork-Presbyterian/Queens.
The call schedule of the Pediatric Residency Program has been designed to comply with the New York State and ACGME restrictions on residents' working hours. The residency program supports the philosophy that cross coverage of inpatient units can be deleterious to patient care and resident education. For inpatient services, nights are covered for one week at a time via a night float system by two members of the team from that unit. Cross coverage is kept to a minimum with an emphasis on continuity of care. Thus, ambulatory selective and elective experiences can be carried out with no in-house call during the week, and occasional weekend calls.
In addition to weekly grand rounds and professors' rounds, there is a daily morning report and noon conference. Morning reports are attended by all residents on the pediatric inpatient service and those residents on ambulatory rotation as well as some of the faculty, the program director, and, when possible, the department chairman. It includes discussion of interesting cases in the inpatient and outpatient fields. Once per week for the first third of the year there is an intern morning report to focus on skills and topics specific for new interns. Noon conference is a daily one-hour didactic teaching session given by attending physicians and is designed to provide a comprehensive pediatric curriculum for residents. There are resident-led lectures on general pediatrics topics given prior to each session of the Resident Group Practice Clinics. In addition, as part of a major medical center that includes Memorial Sloan Kettering Cancer Center, Rockefeller University and the Hospital for Special Surgery, there are numerous day and evening lecture opportunities covering a broad range of medical topics at which all residents are welcome.