Program Overview

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The UNMC/CUMC/Children's Hospital & Medical Center Pediatrics program has a very clear objective. It seeks to provide you, as a resident, with a comprehensive, excellent curriculum in general pediatrics and pediatric subspecialties. By selecting the items below, you can read about different aspects of the training program.

For additional questions, you can Ask the Chief.

Curriculum  
PGY 1:
  • Ambulatory Pediatrics/Newborn Nursery - 2 months
  • Emergency Medicine - 1 month
  • Developmental/Behavioral - 1 month
  • Elective - 2 months
  • Inpatient Pediatrics - 5 months
  • NICU - 1 month

Call during the inpatient pediatrics rotation is based on a rotating night float system. Residents will generally be on night float for 6 consecutive nights during the month and work days the rest of the month. There are generally 2-3 calls per month while on Ambulatory Pediatrics, Development, and electives.

PGY 2:

  • Surgery/Anesthesia - 1 month
  • Ambulatory and Rural Health - 1 month
  • Elective - 4 months
  • Emergency Medicine - 1 month
  • Inpatient Supervisor - 2 months
  • Inpatient Night Float - 1 month
  • NICU - 1 month
  • PICU - 1 month

Call during NICU Q4. The Inpatient Night Float resident works from 5:00 pm-7:00 am 5 nights a week. The inpatient supervisor months will generally have 2-3 call shifts per month. There are generally 2-4 calls during Ambulatory Pediatrics and electives. PICU call is based on a rotating night float system.

PGY 3:

  • Adolescent Medicine - 1 month
  • Community Pediatrics/Newborn Nursery - 1 month
  • Elective - 4 months
  • Emergency Medicine - 1 month
  • Senior Supervisor - 1 month
  • UNMC Night Float - 1 month
  • ICU Selective - 1 month
  • PICU - 1 month

Call during NICU is Q4. Night Float works from 5:00 pm-7:00 am 5 nights a week. There are generally 2-3 calls during Adolescent, Ambulatory Pediatrics and electives. Residents will also be required to complete an ICU selective in addition to their scheduled ICU months. This can be either a PICU or NICU month. PICU call is based on a rotating night float system.

Outpatient Clinical Rotations  

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Continuity Clinic
Residents are given multiple options for continuity clinic: Creighton University, University of Nebraska, Children’s Physicians, One World Community Health Center, or with another private community pediatrician. All clinics see a variety of health care maintenance and acute visits throughout the three years. Creighton University, UNMC, and One World have a large Hispanic and underserved patient population. Residents are given their own schedules at these clinics under attending supervision. Residents choosing to work with a private pediatrician are placed in clinics throughout the Omaha metropolitan area. They see patients on the attending physician’s schedule and are given more autonomy as they progress in their training.

Surgery/Anesthesia
Residents rotate on the Surgery/Anesthesia service during their second year. This rotation gives them the opportunity to become proficient with IV placement, airway management, and sedation techniques, as well as to gain exposure to a large number of common pediatric surgical procedures. They spend time on the wards rounding with the surgery team, in the pre-operative suite performing H&Ps, in the OR with the anesthesiologist, and in the clinic with outpatient follow-up. This rotation familiarizes residents with common procedures so they are better prepared to counsel families and patients later in their careers. During the rotation, residents also spend time in the Burn Clinic, learning about acute and chronic burn management.

Bergan Nursery/Creighton Clinic
Residents spend 1 month in the Bergan Newborn Nursery and Creighton Pediatrics Clinic during their intern year. In the mornings, residents cover the newborn nursery and round with community pediatricians. After rounds, residents see patients at Creighton’s Children’s Physicians clinic, where they have their own schedule.

UNMC Nursery/UNMC Clinic
Residents spend 1 month in the University of Nebraska Newborn Nursery and Pediatrics Clinic during their intern year. This time is divided between the Newborn Nursery in the morning and the clinic during the afternoon. The Newborn Nursery has around 2400 admissions yearly and interns get their normal newborn experience under the guidance of an attending physician. The University of Nebraska Clinic has over 20,000 visits annually.

Development/Behavioral Pediatrics
Residents rotate on Development during their intern year. During this month they participate in a number of clinics including psychology, neurodevelopment, autism, and NICU follow-up clinics. They interact with the families of medically complex children on an individual basis to get a better understanding of what those families’ lives are like on a daily basis.

Ambulatory/Rural Selective
This rotation occurs during the 2nd year. During this rotation residents spend three weeks in an outpatient clinic in the community working with a local pediatrician. They then spend 1 week in rural Nebraska where they experience all aspects of a rural practice; outpatient, inpatient, and newborn nursery. Rural sites include Scotts Bluff, North Platte, Grand Island, etc.

Community Pediatrics
This rotation is taken during the 3rd year. Residents spend mornings rounding at Bergan Newborn Nursery with community pediatricians. In the afternoons, they are involved with various community health organizations. The Douglas County Health Department teaches residents about lead, sanitation, and epidemiology in the community. Residents also visit One World Community Health Center for dentistry and pediatrics clinics. One World proved culturally respectful quality health care to the underserved. Lastly residents work with the home health agencies/visiting nurse associations to do home visits.

Adolescent Medicine
Residents take this rotation during their 3rd year. In order to get a full appreciation for the intricacies of adolescent medicine, they have a number of responsibilities during this month in addition to the weekly adolescent clinic. Additional activities include discussing teen pregnancy at a local high school, participating in an eating disorder partial hospitalization program, working with child/adolescent psychiatrists, and seeing patients in the STD clinic at the Douglas County Health Department.

Children's Hospital Emergency Department
The Children’s Hospital and Medical Center Emergency Department has >33,000 visits annually. It is staffed by Pediatric Emergency Medicine physicians. They see a wide range of acute and emergency conditions. Residents do one month of Emergency Medicine during each year of residency. During the third year Emergency Medicine month, residents have the opportunity to do Urgent Care at one of the local clinics.

Inpatient Clinical Rotations  

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Children's Hospital Inpatient
Children’s Hospital and Medical Center is a free-standing children’s hospital located just 3.4 miles west of the University of Nebraska Medical Center. It has over 200 beds and yearly admissions average over 7,000. Our new Hubbard Center for Children opened in August 2021, which added over 70 new beds in a 10-story tower. The original hospital tower, the Wiebe Tower, is an 9-story tower that contains our general med/surg wards. During their 3 years, residents spend 9 months on these wards. There are 4 inpatient teams. The residents routinely admit 10-20 patients in a 24 hour period and the resident service caps at 56 patients total. Children’s Hospital provides a good mix of bread-and-butter pediatric patients as well as more medically complex subspecialty patients, including cardiothoracic surgery patients.

Interns spend 5 months here, with at least one month on each floor. They are primarily responsible for 5-10 patients depending on the patient census. Interns arrive at the hospital at 6:00am, pre-round, and write notes on their patients. They then perform family-centered, multidisciplinary rounds with various services which include hospitalists, subspecialists, and private pediatricians from the community. Afternoons are generally used to follow-up on issues from morning rounds and admit new patients. Check-out occurs between 5 and 6pm. Call during these months is arranged based on a rotating night float system, with residents scheduled for 6 consecutive shifts from 5pm to 7am.

As a second year, residents spend 2 months on the wards supervising the interns, with a portion of that time spent as the night float supervisor. The daytime supervisors arrive between 6:00-7:00 am and spend the morning seeing the new and sick patients on their floor and supervising their 2-3 interns as well as medical students. The supervisor organizes and runs rounds. The afternoon is used to follow-up on issues from morning rounds, admit new patients and work on educational activities. Check-out occurs between 5pm and 6pm. The night float supervisor works 5 days per week from 5pm to 7am.

As a third year, residents spend two months at Children’s as a supervisor. One of these months is similar to their month as a second year (described above). The other month the resident is designated as the senior supervising resident. This is an educational month designed to assist the 3rd year in transitioning from resident to attending physician. The senior supervisor spends time participating in triage phone calls with the on-call hospitalist in which they help determine patient placement within the hospital.

UNMC Inpatient
As a second year, residents spend 1 month of days on the UNMC inpatient service. The pediatric resident service at UNMC admits approximately 1,000 patients yearly with an average daily census of 5-10 patients. The census is composed of general pediatric patients, as well as subspecialty patients including pulmonology, nephrology, and hematology/oncology (along with the bone marrow transplant team) patients. UNMC provides residents with more independence and autonomy. Smaller patient numbers also allow for more daily teaching than is often available with the busy pace at Children’s.

Third year residents spend 1 month of night float on the UNMC inpatient service. The resident will work 5 nights per week, arriving at 5:00pm and working until 7:00am. They cover the patients on the floor as well as the PICU service, including solid organ transplant patients.

UNMC NICU
The UNMC NICU is a level III, 36 bed unit with approximately 350 admissions annually. Roughly 15% of admissions are newborns weighing <1500g and over 70% of NICU patients require mechanical ventilation during their stay. The University of Nebraska Medical Center has 2600 deliveries annually and residents in the NICU are responsible for attending the delivery of all preterm and high-risk births.

During the intern year, residents spend 1 month in the NICU at UNMC. They are generally responsible for 7-10 patients. They work closely with the nurse practitioners who cover the NICU 24 hours/day. The NICU team is composed of an attending, 1-2 interns, 1 second year resident and a number of NNP’s, as well as many ancillary staff including RTs, dieticians, nurse case managers, social workers, and pediatric pharmacists. The interns arrive around 6am to see their patients, attend conference, and then round with the entire NICU team. The interns also do one week of nights while on the NICU. Call is q4 for the second year resident. The afternoon is spent with new admissions, simulations, and teaching. Check out generally occurs between 4:00-5:00 pm. There are no fellows, and attendings take call from home.

Children's PICU
The PICU at Children’s Hospital and Medical Center has 26 beds and over 950 admissions annually. There are 2-4 residents each month in the PICU as well as 2 nurse practitioners during the week. Residents are responsible for 2-6 patients depending on the census. The PICU has both medical and surgical patients, including post-operative neurosurgical patients. The Children’s PICU has an active ECMO team which on average is activated about one time per month. There is a new, separate Cardiac ICU (CICU) in the Hubbard Center for Children. Residents spend one week here during their PICU rotations. The rest of the PICU rotation is spent on two weeks of PICU days and one week of PICU night float.

Residents spend 1 month in the PICU during both their second and third years. (Additionally, residents have an additional ICU month during the third year.) The residents arrive between 6am and 7am to round on their patients. The residents round with the entire PICU team. The afternoon is spent with new admissions and teaching. The PICU attendings have developed an active curriculum that occurs every Wednesday afternoon. Residents usually check-out between 4:00-5:00 pm.

Bergan NICU (selective)
During their third year, residents do an ICU selective rotation .They may choose to do any extra month in the Children’s PICU (described above), or they may do a month at Bergan Mercy’s NICU. The NICU at Bergan is level III. It is staffed by neonatologists and neonatal nurse practitioners. The residents arrive between 6am and 7am to pre-round on their patients. Multidisciplinary rounds occur in throughout the morning. The afternoon is spent with new admissions and teaching. Residents usually check-out between 4:00-5:00pm. Call is Q4.

Electives  

The following electives are offered throughout the 3 years of residency. Residents have time to complete 10 of them. There are electives that the ACGME consider to be core electives and residents are required to take 4 of the 13 offered. In addition to the electives listed below, residents may choose to do an away rotation or design their own elective with permission from the Program Director. Further information on these electives can be found in the Rotation Descriptions.

ACGME Required Electives (4 of 13 required)

  • Allergy and Immunology
  • Cardiology
  • Child Abuse
  • Dermatology
  • Endocrinology
  • Gastroenterology
  • Genetics
  • Hematology-Oncology
  • Infectious Disease
  • Nephrology
  • Neurology
  • Pulmonology
  • Rheumatology

Additional Electives

  • Addiction Medicine
  • Administrative Elective
  • ENT
  • Designer Elective
  • Global Health
  • Hospital Medicine
  • Metabolism
  • Ophthalmology
  • Orthopedics
  • Pathology
  • Child Psychiatry
  • Public Health Leadership
  • Radiology
  • Research
  • Rheumatology
  • Spanish Immersion
  • Sports Medicine
  • Surgery
  • Transport Medicine
  • Many, many more! 
Conferences  

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Patient Management Conference
Patient Management Conference (PMC) is held on Tuesday mornings at Children’s Hospital & Medical Center and is televised to both Creighton University and the University of Nebraska. All residents present a case at this conference yearly and facilitate an in-depth discussion of management and evidence-based medicine with faculty, students, and other residents. Morbidity and Mortality is a part of this series and happens on a quarterly basis.

Friday Block Didactics
This is a three year didactic series based on the American Board of Pediatrics content specifications that is held weekly on Friday afternoons. These sessions are level specific. They combine active learning through seminars and simulated experiences. Board review sessions are also included. Residents have 1-2 block didactic sessions per month.

Journal Club
Once a month, a second year resident chooses a recently published article to present and discuss with faculty and residents. They prepare the discussion with help from a mentor and epidemiologist. This conference is televised to all sites.

Teaching Rounds
Teaching Rounds are conducted at each site on Mondays and Thursdays from 12:00-12:45 PM at Children’s Hospital & Medical Center and from 8:00-8:45 AM at University of Nebraska Medical Center. These sessions consist of a patient presentation and discussion on evaluation and treatment. Residents present these cases to other residents, medical students, and faculty to facilitate discussion and emphasize teaching points.

Pediatric Grand Rounds
On Friday mornings, the Pediatric Department hosts Grand Rounds which is open to all physicians and students. Speakers come from within the University of Nebraska and Creighton University systems, as well as from other well-known institutions throughout the country. Each year, the residents are asked to select a Distinguished Lecturer to include in this series. All 3rd year residents have the option of presenting a Grand Rounds to fulfill their scholarly activity requirement. These presentations are televised to all 3 sites.

Annual Research Forum
The Annual Research Forum is held in May and includes poster presentations from faculty, fellows, residents, and students who were involved in research during the past year. One or two research projects are selected for a presentation that is televised to all 3 sites. Annual teaching awards are given out at the conclusion.

Retreats  

Intern Year
Each year in September, the interns are given a weekend free from all clinical responsibilities and retreat to Nebraska City for the annual Apple Jack Festival. Friday night is spent with a relaxing dinner, followed by team building activities and the annual talent show. Past talents have included cooking, knitting, Chinese writing, Guitar Hero, and a fashion show. Saturday morning is also spent doing team building activities after which families and spouses are invited to join the interns for lunch and an afternoon of their choosing. Everyone returns to the lodge for a picnic Saturday evening after which they are on their own for the rest of the weekend.

Several years ago, recognizing the winter slump, the chief residents started the tradition of giving interns an afternoon off in late February or early March for some fun and relaxation. Past activities have included an afternoon of board games, bowling, and laser tag.

2nd Year
The 2nd year retreat is used for professional development and preparation. It takes place the weekend of the AAP Regional Meeting, that takes place in the Fall at Mahoney State Park. The residents hear from a number of professionals on issues of malpractice, contracts, investments, etc. That evening, spouses and families join the residents for a nice dinner and the following day the residents take part in the Regional AAP Meeting.

3rd Year
The 3rd year retreat is solely for fun and one last chance to bond as a class. They are given a weekend free of clinical responsibilities.

FAQs  

What is the call schedule like?
Interns have 5 months of inpatient pediatrics during which a rotating night float system is used. They will generally work 6 consecutive night float shifts one week, and return to days for the rest of the month, covering weekends as well. The same format applies to the NICU during the intern year. There are generally 2-4 calls per month while on Ambulatory Pediatrics, Development, and electives. The Emergency Medicine month is call free.

2nd years have 1 month with Q4 call – NICU. They spend one month as the night float supervising resident at Children’s working from 5:00 pm-7:00 am 5 nights a week. They spend one month as a daytime supervising resident at Children’s taking 24 hour calls on weekends. There are generally 2-4 calls during Ambulatory Pediatrics, Surgery/Anesthesia, and electives. The Emergency Medicine month is call free. They spend one month at UNMC as the daytime hospitalist working 6 days per week.

The UNMC Night Float works from 5:00 pm-7:00 am 5 nights a week. They spend one month as a daytime supervising resident at Children’s taking 24 hour calls on weekends. There are generally 2-4 calls during Adolescent, Community Health, and electives. The Emergency medicine month is call free.

Do you have a back-up system?
Yes. Residents take back-up call as supervisors. They are assigned 2-3 days on back-up during which they must carry their pager at all times. In the event that a resident cannot take their scheduled call, the back-up is called if there is less than 24 hours notice. If there is enough notice, residents are expected to arrange a switch.

How many call free months do you have?
There are no call free months per se. The Emergency Medicine rotation contains night and weekend shifts, but you do not cross cover for other services during this month. We also try to give residents at least one call free month during their residency if possible.