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, including major and minor trauma, acute medical illnesses, poisonings, obstetrical and gynecologic emergencies, and community referrals. Many of the general ward and PICU admissions originate in the ED. Pediatric residents play an indispensable role 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, residents see patients for same-day sick visit appointments. Most patients come from the resident continuity clinic or faculty practice clinic population 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 have the choice of having their continuity clinic experience at one of four sites. 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 chronic illnesses or disabling conditions. This experience takes priority over other assignments. Continuity clinic is also the site of a brief weekly didactic. Thirty minutes prior to the first scheduled appointment, a senior resident at each clinic site facilitates a discussion of a general pediatric topic. Every clinic covers the same topic. This is an 18-month-long curriculum that is repeated once during residency.
Resident Group Practice: The Glassrock Resident Group Practice is a continuity clinic two blocks from the hospital. Clinic patients consist of insured individuals and medically complex patients. Many patients are recruited from the UC Davis newborn nursery as infants, allowing the resident to develop a relationship with the family from birth. General pediatric faculty and volunteer clinical faculty from the community provide supervision in the clinic. Residents participate in the management of continuity clinic through the Resident Group Practice Committee, which undertakes continuous quality improvement projects related to clinic management and education.
Sacramento County Health Clinic: This is one of two federally qualified health centers our residents can choose for their continuity clinic, located a quarter mile from the main hospital. The focus of this clinic is to care for the underserved, Medi-Cal, and uninsured /underinsured patients. The County’s Refugee Clinic is housed in the same building; a third of the patients in our clinic are refugee children. Many patients seen at the UC Davis Emergency Department, inpatient services and Newborn Nursery are seen at this clinic, offering our residents an opportunity for continuity from the hospital to their own practice.
Sacramento Native American Health Center: 2.5 miles from UC Davis Medical Center is the Sacramento Native American Health Center, the other federally qualified health center our residents attend for their continuity clinic. This clinic is committed to providing culturally-competent, holistic, patient-centered care. The clinic does not have any tribal or ethnic requirements for patients to receive care. Services provided are pediatric, adult medical and behavioral care, dental services, and a laboratory is on site. UC Davis faculty are present four half days a week and serve as the continuity clinic attending.
Kaiser: In July 2011, we launched a new continuity clinic site for our residents at Kaiser. Kaiser is one of the largest Health Maintenance Organizations (HMO) on the west coast. We currently have Kaiser Davis, Kaiser Rancho Cordova, and Kaiser Folsom continuity clinic sites. Residents at these continuity clinic site 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 a HMO to request that their continuity clinic be at Kaiser.
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 Sacramento , Kaiser Point West, and Kaiser Roseville. This 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
In June 1997, Shriners Hospitals for Children, which focuses on crippling diseases 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.
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.