Ambulatory Rotations

	Ambulatory Rotations
	Curriculum Overview
	Ambulatory care is a key component of the curriculum. Over 50% of the experience is in an ambulatory setting including continuity clinic, urgent visit centers, ED, specialty clinics, behavioral pediatrics, adolescent medicine, and the Dyson community rotations.
	The Riley Outpatient Center (ROC) was designed to consolidate all of Riley’s outpatient services into a coordinated, multi-specialty, multidisciplinary care facility which meets the particular needs of children and their families. It accommodates the more than 128,000 outpatient visits/year made to Riley’s 50+ specialty care, as well as, general pediatric clinics. The Wishard Primary Care Center and Methodist Medical Tower each have a floor dedicated to general pediatric care including continuity clinics, as well as pediatric urgent visit centers.
	Pediatric residents learn to manage a wide variety of emergent and toxicological problems due to the broad diagnostic mix, high acuity and large patient volume afforded through rotations at all three hospitals. Methodist Hospital Emergency Medicine and Trauma Center provides care to over 115,000 patients each year, with 30% being pediatric/adolescent-aged patients. The LifeLine helicopter service, staffed by emergency medicine residents and flight nurses, is the only air transport service in central Indiana. Methodist houses the Indiana Poison Center lead by board-certified medical toxicologists.
	Pediatric patients are seen emergently in the Primary Care Center at Wishard Hospital which provides outpatient urgent care seven days and nights a week. The Wishard emergency department also serves as a trauma center. Pediatric faculty and residents are members of the team responsible for stabilization and initial evaluation of pediatric trauma victims.
	In the Riley Hospital Emergency Admitting area, evaluation is provided for children with emergent conditions related to complex problems who have been referred to subspecialists at Riley from physicians throughout the state.
	All residents complete a one-month rotation in Adolescent Medicine. Training sites include an adolescent inpatient service, as well as clinics at hospitals, schools and community health centers. Experience is gained in:
	adolescent growth development sexuality gynecology contraception sexually transmitted diseases substance abuse adjustment problems psychiatric conditions
	Additional experience with adolescents takes place during general pediatric subspecialty rotations.
	All residents receive training in the management of developmental and behavioral problems of children. PGY1 residents spend an outpatient month becoming familiar with developmental milestones and assessment and learning about community resources for both normal and developmentally delayed children. An inpatient month during the PGY1 year includes work as part of a multidisciplinary team caring for children with a variety of developmental disorders. Further education is achieved in the PGY2/3 years during a behavioral pediatrics rotation, involving clinics for children with school problems, developmental disabilities and behavior disorders. In the PGY3 year, residents gain experience in school health and community pediatrics. Community pediatrics deals with the role of pediatrician as a community leader, with community agencies, in public health and as an advocate for children.
	Comprehensive specialty services are available to meet the clinical needs of the children of Indiana. Interdisciplinary clinics are the cornerstone of highly specialized pediatric care. Opportunities exist in:
	ADHD/Disruptive Behaviors Amputee Apnea Autism Birth Defects Bronchopulmonary Dysplaisa Burn Cerebral Palsy Child Development Craniofacial Cystic Fibrosis Down Syndrome Growth Anomalies Home Ventilation International Adoption Learning Disabilities Medical Genetics Newborn Follow-up Rehabilitation Stem Cell Transplant Travel Medicine Sleep Disorders Clinics
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		Pediatrics Residency Programs