The clinical curriculum is designed to provide a balanced mix of inpatient and ambulatory experiences in general pediatrics and subspecialty care, with the goal of delivering comprehensive pediatric training. Individualized learning opportunities are available throughout all three years and are tailored to residents’ career goals. Recommended rotations are offered for those pursuing careers in primary care, pediatric subspecialties and acute care specialties, developed in collaboration with fellowship directors and faculty experts.
Although the schedule is structured in blocks, many rotations are hybrid experiences that combine inpatient and outpatient care (e.g., two weeks inpatient and two weeks ambulatory). Efforts are made to maintain balance between inpatient and outpatient months, and to avoid inpatient stretches longer than four consecutive weeks
| PGY-1 | PGY-2 | PGY-3 | |
|---|---|---|---|
| Inpatient general medicine (days) | 10 weeks | – | 4 weeks* |
| Inpatient general medicine (nights) | 4 weeks | 2-4 weeks* | 4 weeks* |
| Inpatient subspecialities | 4-6 weeks | 2-6 weeks | 2-4 weeks |
| Newborn nursery | 4 weeks | 2-4 weeks* | 2-4 weeks* |
| Neonatal intensive care unit | 4 weeks | 4 weeks | – |
| Pediatric intensive care unit | – | 4 weeks | 4 weeks |
| Outpatient general pediatrics | 4 weeks + 36 half days | 2-4 weeks + 36 half days | 2-4 weeks + 36 half days |
| Ambulatory subspecialities | 4-6 weeks | – | – |
| Emergency medicine | 4 weeks | 4 weeks | 4 weeks |
| Developmental and behavioral pediatrics | 4 weeks | – | – |
| Advocacy | – | 4 weeks | – |
| Adolescent | – | – | 4 weeks |
| Mental health | – | 4 weeks | – |
| Individualized curriculum and elective | 4 weeks | 12-16 weeks | 20-24 weeks |
| Vacation | 4 weeks | 4 weeks | 4 weeks |
Rotation details
Residents rotate through several general pediatric and subspecialty primary services (e.g., cardiology, neurology, hematology/oncology, pulmonology) throughout their residency. During these rotations, they encounter both common and rare pediatric diagnoses. Resident autonomy increases progressively over the three years of training.
Pediatric residents care for critically ill neonatal patients in our Level 4, 140-bed neonatal intensive care unit (NICU), which is connected by a walkway bridge to the BJC labor and delivery unit. The NICU encompasses a wide range of neonatal pathologies, including the management of extreme prematurity. Extracorporeal membrane oxygenation (ECMO) is available, and second-year residents interested in critical care have the opportunity to rotate with the ECMO specialty team.
The Pediatric Intensive Care Unit at St. Louis Children’s Hospital is a 40-bed unit that averages more than 2,000 admissions annually and provides comprehensive, multidisciplinary care to critically ill children of all ages. Services include pediatric trauma, neurocritical care, advanced mechanical ventilatory support, extracorporeal support (e.g., ECMO, RRT), and transplant care.
St. Louis Children’s Hospital is a Level 1 trauma center with a high patient volume. During their rotations in the emergency department, residents have the opportunity to practice hands-on procedural skills and manage a wide spectrum of diseases.
There is a wide array of subspecialty experiences available for residents—both inpatient (consult services) and ambulatory (outpatient clinics)—including allergy and immunology, antimicrobial stewardship, cardiac ICU, cardiology, child psychiatry, dentistry, dermatology, endocrinology, ENT, gastroenterology, genetics, hematology/oncology, hospitalist, immunology, infectious diseases, nephrology, neonatal neurology, neurology, ophthalmology, orthopedics, palliative care, PICU and NICU skills, pulmonology, radiology, rheumatology, sedation and toxicology.
While our residency offers several selective rotation experiences, residents also have the opportunity for dedicated career exploration through a one-month elective during the PGY-2 or PGY-3 years. This time may be used for subspecialty experiences, dedicated research, global health travel, additional primary care training, or a parenting elective for new parents. Elective months are call-free, and residents are not scheduled for cross-coverage during this time, ensuring a protected period for focused educational experiences.
Pediatric residents are welcome to participate in research, although it is not a program requirement. Information on available research opportunities is provided to interested individuals. Residents are encouraged and supported in submitting abstracts based on work conducted during residency and in traveling to present if an abstract is accepted. The program also supports resident representation at professional conferences, including the American Academy of Pediatrics, Pediatric Academic Societies and the Student National Medical Association.