Year Three

During the third year in Medicine, residents are exposed to inpatient and subspecialty electives, including geriatrics and intensive care. The first medicine block begins with inpatient medicine in which the PGY-3 again leads a team with responsibilities as outlined above. The block continues with a subspecialty month and ends with geriatric medicine. During this latter rotation, the resident is expected to participate in all the regular activities of UPMC Senior Care -- Shadyside. Goals include understanding the functional evaluation of older patients; recognizing the typical presentations of diseases in the elderly; managing common geriatric problems; learning the scope of social, community, and family resources; and learning to function as a member of a multidisciplinary team. Residents also round at one or more nursing homes.

The second medicine block includes inpatient medicine and two subspecialty electives. Combined med/peds electives are available. Med/peds electives are offered as two weeks of pediatric subspecialty combined with two weeks of the same adult subspecialty. These electives may include but are not limited to rheumatology, allergy/immunology and endocrinology. Residents have also created their own electives such as sports medicine .

This year contains a pediatric subspecialty month with the emphasis on the ambulatory part of the overall experience: outpatient referrals, consultations, and follow-up and communication with the primary care physician. Full participation-including subspecialty journal clubs, conferences, and morbidity/mortality reviews-allow in-depth learning.

There is a full month in the Pediatric Intensive Care Unit at Children's Hospital, one of the largest and most fully staffed in the country. Emphasis is on the pediatric role in critical illness, both medical and surgical, and on stabilizing the seriously ill child. Residents participate in a night float ICU system. In contrast to this rotation, the year also includes a practice rotation in one of a number of rural or urban group practices closely affiliated with the hospital. Practitioners in these groups are trained in student and resident education and serve as role models in primary care pediatrics. This rotation may also occur in the continuity clinic site if that location is in a community practice.

One month of pediatric training is split between NICU night float duties and independent research. In the NICU, our third-year residents share overnight responsibilities with fellows and neonatal nurse practitioners. Duties include responding to deliveries and assisting with the ongoing care of critically ill neonates. The nights provide a wealth of opportunities to hone procedural and management skills. Research weeks are focused on completing the requirement for a scholarly project. This project can take many forms, including retrospective analyses and topic reviews of any aspect of medicine or pediatrics.

Additional experience as a supervisory resident is available on the inpatient units, with two weeks of day and two weeks of night-team, and in the emergency room. Every attempt is made to provide exposure to different age groups and subspecialty wards from earlier inpatient months, so that the trainee receives well-rounded exposure to pediatric illness.

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