Pediatric emergency department

Every resident completes several rotations in the Pediatric Emergency Department (ED). Residents, under pediatric emergency medicine faculty supervision, see approximately 1,100 patients each month with a wide range of emergency medical problems, includingmajor and minor trauma, acute medical illnesses, poisonings, obstetrical and gynecologic emergencies, and community referrals. Senior residents learn how to resuscitate patients brought in for injuries related to trauma. The ED rotation is often where most pediatric residents have opportunities to perform laceration repairs, proceduralsedation, lumbar puncture, and other common pediatric procedures. Many of the general ward and PICU admissions originate in the ED. Pediatric residents play an indispensablerole in providing high quality, prompt emergency care to the children of Sacramento and Northern California. The quality of this experience is outstanding, with residents having the opportunity to manage an extraordinary range of problems, perform many procedures and supervise medical students.

Urgent care clinics

While assigned to urgent care as part of their Ambulatory rotation, residents see patients for same-day sick visit appointments. Most patients come from the resident continuity clinic or faculty practice clinic populations and the problems encountered are similar to that seen in general pediatric practice. During this rotation residents also have an opportunity to participate in telephone triage, a vital component of pediatric training.

Resident practice clinics (continuity clinic)

Residents may choose to have their continuity clinic experience at Federally Qualified Health Centers (Sacramento County Health Center or Sacramento Native American Health Center), an academic health center (Resident Group Practice at Glassrock), or a Health Maintenance Organization (Kaiser). All residents spend one afternoon per week in their resident practice where they provide longitudinal primary care for their own panel of patients. In this role, residents develop the skills necessary to deliver well-child care including developmental screening and health promotion, as well as continuing care for children with complex chronic conditions.

Teaching Modules: Every week, thirty minutes prior to seeing patients, residents participate in the Yale Primary Care Pediatrics Curriculum. This is a case-based discussion facilitated by a senior resident with input from general pediatrics faculty. Residents complete this 18-month curriculum covering common general pediatrics topics twice during their residency.  

Residents also have the opportunity to learn from Behavior and Development Pediatricians, Child Psychologists and Child and Adolescent Psychiatrists during their continuity clinic at the Resident Group Practice and Sacramento County Health Center. Specialists are present in each clinic two weeks per month providing education regarding screening, identification, managing and referring patients with developmental, behavioral and mental health concerns in a general pediatrics clinical setting.

Resident Group Practice at Glassrock:

The Glassrock Resident Group Practice is a continuity clinic two blocks from the UC Davis Children’s Hospital. Clinic patients include 60% who are privately insured and 40% who have Medi-Cal, including patients insured through the foster care system. There is a higher degree of medically complex patients at Glassrock Resident Group Practice than other sites. General pediatric faculty and volunteer clinical faculty from the community provide supervision in the clinic. The clinic space is shared between General Pediatrics (resident and faculty practice) and pediatric subspecialties including Adolescent Medicine, Gastroenterology, Infectious Disease, Nephrology, Rheumatology, Cardiology, Dermatology, Pain Clinic, and Allergy/Immunology. In addition, social workers, dietitians, and nurses associated with subspecialists share the space. Residents participate in continuous quality improvement projects related to clinic management in a multi-specialty environment.

Sacramento County Health Clinic: This Federally Qualified Health Center is located a quarter mile from the UC Davis Children’s Hospital. The focus of the Sacramento County Health Center is to provide primary care and behavioral health services to the underserved, Medi-Cal, and uninsured /underinsured residents of Sacramento County. The County’s Refugee Clinic is housed in the same building; a third of the patients in Sacramento County Health Center are Dari or Pashto-speaking refugee children from Afghanistan and Pakistan. One of the aims of the clinic is to teach, support and promote interprofessional care. The healthcare team consists of medical and office assistants, nurses, medical students, physician assistant and nurse practitioner students from UC Davis’ School of Nursing, pediatric residents, and UC Davis pediatric faculty. Our goals for our residents in this clinic are to become familiar with leading an interprofessional health care team, learn general outpatient pediatrics, understand how social determinants of health impact a child’s overall health, develop skills in caring for the underserved, and deliver culturally and linguistically effective care to help our patients achieve their full potential. Residents and faculty participate in longitudinal quality improvement projects.   

Please click here to view our video about the Sacramento County Primary Care Center continuity clinic site

Sacramento Native American Health Center (SNAHC): This Federally Qualified Health Center is located 2.5 miles from UC Davis Children’s Hospital in Midtown Sacramento. As Sacramento’s first Federally Qualified Health Center, SNAHC has a long history of providing care under their mission: “Our commitment is to continue and share the legacy of a healthy American Indian / Alaska Native community based on cultural values delivered through a traditional, innovative, and accessible patient-centered health home.” While the clinic does not have any tribal or ethnic requirements to receive care and 30% of patients are Native, it exclusively serves patients and families covered by Medi-Cal. Full-scope wrap around services provided are pediatric and adult medical, dental, integrated behavioral health (including on-site crisis management), psychiatry, optometry, chiropractic, podiatry, and social support services, with a laboratory on site. Residents provide care in a multidisciplinary environment, serving as both primary pediatricians as well as pediatric consultants (directly and through quality improvement projects) to Family Medicine, Physician Assistant, and Nurse Practitioner providers in the clinic. UC Davis pediatric faculty are present three half-days a week and serve as our resident’s continuity clinic attendings. Residents have the opportunity to learn and conduct longitudinal quality improvement projects.

Pease click here to view our video about the Sacramento Native American Health Center continuity clinic site.

Kaiser:

Residents have the option to have their continuity clinic at Kaiser Permanente. Kaiser is one of the largest Health Maintenance Organizations (HMO) on the west coast, whose mission is to “provide high-quality, affordable health care services and to improve the health of our members and the communities we serve.” We currently have continuity clinic sites at Kaiser Davis, Kaiser Rancho Cordova, and Kaiser Folsom. Residents at these continuity clinic sites have their own panel of patients and learn how to practice pediatrics in a busy community HMO setting. We select one intern/year to have Kaiser for their continuity clinic experience. We request incoming interns with a strong interest in general outpatient pediatrics in an HMO setting to request Kaiser as their continuity clinic.

Kaiser Permanente Medical Center

Kaiser Permanente is one of the largest and most established Health Maintenance Organizations in the United States. During the last two years of residency, senior residents spend two 4-week rotations practicing general pediatrics in one of three Kaiser outpatient clinics in the Sacramento region: Kaiser South SacramentoKaiser Point West, and Kaiser Roseville. The Kaiser outpatient general pediatrics rotation provides a unique opportunity for residents to experience the "cutting-edge" of managed care and to function in an environment providing significant autonomy. It is among the most popular of all rotations with the residents.

Shriners Hospitals for Children

Shriners Hospitals for ChildrenIn June 1997, Shriners Hospitals for Children, which focuses on neuromuscular conditions, burn injuries and other special healthcare needs in children, opened the largest and most complete of its 22 hospitals next to the UC Davis Medical Center campus. All residents spend four weeks at Shriners during their second or third year, where they gain a unique exposure to pediatric orthopedics, genetics, rehabilitation medicine and outpatient burn management.

MIND Institute

UC Davis MIND Institute

During the second or third year of training residents spend four weeks on the Child Development and Behavior service, which is an integral part of the MIND (Medical Investigation of Neurodevelopmental Disorders) Institute. The MIND Institute brings together a broad range of UC Davis faculty with expertise in developmental-behavioral pediatrics, neurology, psychiatry, and basic science who all share a common interest in neurodevelopmental disorders. Residents are introduced to developmental screening tools and their use, as well as community resources available to families with children who have or are at risk for developmental and behavioral disorders.