Pediatric Primary Care Residency

Curriculum and Rotations

Our Pediatric Primary Care Residency curriculum will offer residents a comprehensive, primary care-focused training program working alongside faculty at Moses Cone Hospital, the Tim and Carolynn Rice Center for Child and Adolescent Health, and the Cone Health Women and Children’s Center in a wide variety of clinical settings. Residents will also spend approximately half of each year rotating through North Carolina Children’s Hospital at the UNC Medical Center and its associated clinics.

Continuity Clinic

Residents will have continuity clinic at Tim and Carolynn Rice Center for Child and Adolescent Health at least one half-day per week, developing a longitudinal relationship with their patients and their primary care preceptors. Here, they get to manage medically and socially complex patients with the close supervision of faculty pediatricians. In addition to this continuity experience, residents will have an additional block month for intense exposure to community practitioner office environments in a rural health setting.

Integrated Primary Care Blocks

These longitudinal block experiences occur 3 to 4 times a year. Each day is divided into two half-days, with residents participating in a variety of experiences critical for primary care pediatricians: developmental pediatrics, outreach and advocacy, diabetes care, adolescent clinic, sports medicine, newborn care, and additional acute care. The advantage of this approach is that it allows for continuity across disciplines. A resident could see a newborn on Monday morning, then schedule that newborn in their own clinic on Wednesday. Because there is flexibility in the schedule, residents will also be able to see patients they have referred to a subspecialist. This level of continuity is a unique aspect of the Primary Care Track curriculum. For interns, these months include a week of night or day float on the inpatient ward. For upper-level residents, primary care months include longitudinal experiences in adolescent and behavior and development.

Inpatient Experiences

The inpatient experience for UNC Primary Care residents will occur primarily at Moses Cone Hospital. Moses Cone provides an outstanding opportunity to see a broad variety of diagnoses, take a leadership role on the inpatient team, and be a part of family centered care. Residents are encouraged to take the lead in making management decisions with close supervision by faculty. The PICU and ward are a single service, so hassles and paperwork associated with transfers are minimized and continuity is maximized. In addition, there is a close relationship with the Pediatric ED so that a resident could potentially see a patient in the emergency room, follow them to the PICU, and continue their care on the ward. This makes for a rewarding experience for residents and provides outstanding care for families and children. There is one week of night shifts during this month. Subspecialty ward teams at NC Children’s Hospital and intensive care experiences in the Neonatal and Pediatric Intensive Care units will occur at UNC and mirror those of the traditional categorical program.

On any given day, the inpatient service is staffed by UNC upper-level residents from any of the UNC Pediatrics residency programs (primary care, categorical, Med-Peds, etc.) and interns from both UNC Pediatrics residency programs and the Cone Health Family Medicine Residency. Upper-level pediatric residents supervise the interns and UNC medical students (on their third-year pediatric clerkship and fourth year acting internship) in the management of children admitted to the pediatric ward and seen in the Emergency Department. First-year residents have primary responsibility for the day-to-day management of children on the inpatient service and will also have opportunities to teach medical students; there is a week of night shifts on the intern rotation.

Newborn Nursery

During this rotation, learners will provide primary care for the infants admitted to the Moses Cone Pediatric Teaching Service in the Mother Baby Unit of the Women's and Children's Center . By the end of the rotation, residents master the newborn exam, get extensive experience managing hyperbilirubinemia and other common newborn conditions, and become comfortable with the care of the well newborn. For first year residents, this month will include a week of night or day float on the inpatient ward. Upper-level residents will return to the nursery during primary care months to maintain their nursery skills and to serve as a teaching resident for the UNC medical students. Senior residents will also attend high-risk deliveries with the neonatal team in order to practice resuscitation skills and attend low-risk deliveries and assign APGAR scores.

Emergency Department

Primary Care residents will spend one month during each year caring for and learning about acute care pediatrics in Moses Cone’s Pediatric Emergency Department . This 11-bed unit with dedicated resuscitation and behavioral health rooms is staffed by fellowship-trained Pediatric Emergency Physicians who care for more than 20,000 pediatric visits per year.

Additional Curricular Experiences

Our Primary Care residents will be supported by relevant curriculum outside of their clinical work including, a journal club concentrated on evidence-based medicine and cost-effective strategies for primary care pediatrics, and quality improvement initiatives focused on the medical home. Each residency class completes a team QI project by the completion of residency. UNC’s Gillings School of Global Public Health is internationally renowned, and the School of Medicine’s close relationship with Public Health is well illustrated by the Health Care and Prevention Program, the nation’s largest joint MD-MPH program, co-directed by one of our pediatrics faculty members. Our unusually strong medicine-public health cooperation means that residents in the Primary Care Residency will have an exceptional opportunity to expand their understanding of primary prevention and the population sciences. All Primary Care first years also get to participate in monthly support seminars. After lunch with their fellow residents, they join in innovative, interactive seminars on a variety of primary care topics and skills. Support seminars continue throughout the remainder of residency.

Schedule Overview