Resident Electives
The following electives are part of the curriculum for PL-2 and PL-3 residents, but these are not your only options.
Should you have an interest in unique or special fields of medicine that require elective rotations elsewhere − including outside the United States − individual rotations will be arranged. Several residents, for example, have chosen an international health elective.
Child advocacy is the work of pleading, defending, publicly recommending, or raising your voice on behalf of children and their families in order to improve their health and well-being. At the University of Virginia, advocating for patients − whether on an individual basis, within the community, or to the legislature − is an integral part of patient care and our residency training program. There are many opportunities available. For more information, see the Child Advocacy site.
The allergy elective includes evaluating patients in field clinics and will give you first-hand experience seeing children referred for:
- Asthma
- Allergic rhinitis, and recurrent ear and sinus infections
- Allergic conjunctivitis, chronic urticaria, and atopic dermatitis
- Food allergies, insect venom allergies and drug allergens
The immunology elective will help you to:
- Understand patients with primary and secondary immune deficiencies and rheumatologic problems
- Learn the basic concepts of the normal immune response and the mechanisms of autoimmunity
- Apply that knowledge to the care of children with immunodeficiency and autoimmune diseases
Working with pediatric anesthesiologists, this elective will allow you to:
- Gain experience in the preoperative, operative, and postoperative management of pediatric patients undergoing surgery
- Understand the needs and care of the pediatric surgical patient in the operating room setting.
By then end of the rotation, Residents will:
- Develop an understanding of the common education, support, and management needs of the newborn and maternal dyad.
- Develop an understanding of the needs and care specifically of the breastfeeding maternal and infant dyad.
- Develop an understanding of how health inequities and social determinants of health impact infant feeding, patient education, and health outcomes including mortality related to maternal and newborn care.
- Gain experience supervising R-1’s in caring for newborns and being a team leader.
- Review the physiology and recognition of physical findings of the normal perinatal transition and development of the breastfeeding relationship in preparation for completion of training.
- Review the pathophysiology, recognize physical findings, and learn appropriate management of common neonatal and breastfeeding medicine-related pathological conditions.
- Polish skills in interviewing and educating parents about transitional neonatal physiology and pathology, breastfeeding, and infant care.
- Review knowledge and skills of neonatal resuscitation.
- Develop supervisory, teaching, and leadership skills through overseeing activities of the Newborn PL-1 team under the supervision of the Newborn Attending
- Maintain familiarity with the most up-to-date literature and recommendations in newborn and breastfeeding medicine.
- Develop skills in newborn circumcision and newborn frenotomy as desired
Learning Objectives:
- Diagnose and manage acute illnesses or injuries that occur in a camp setting
- Manage chronic conditions, such as diabetes mellitus, asthma, cystic fibrosis, epilepsy, hemophilia, renal disease, sickle cell disease, post-transplant patients, and HIV infection in a rural camp setting
- Demonstrate ability to work with other medical team members, counselors, and other camp staff as an inter-professional team member to support the needs of the campers, volunteers and counselors
- Understand the impact and learn to interact with children with chronic illnesses in a non-clinical setting
Focusing on ambulatory care, the cardiology elective features daily outpatient clinics and several busy field clinics. You will learn to:
- Evaluate children with murmurs, syncope, chest pain, and pediatric ECGs
- Recognize and treat endocarditis, congestive heart failure, Kawasaki disease, and acute rheumatic fever
- Recognize common pediatric arrhythmias
- Develop an approach to cyanotic heart disease and operations associated with congenital heart disease
The Child Protection & Advocacy Elective is focused on providing a multidisciplinary experience surrounding the evaluation and management of children who are victims of child abuse, neglect, and/or sexual abuse. You will have the opportunity to:
- See inpatient and ED consults for suspected child maltreatment
- Participate in SAFE Clinic evaluations
- Observe forensic interviews and family advocacy at Foothills Child Advocacy Center
- Spend time with various community partners including CPS, Law Enforcement, Commonwealth’s Attorney, and others
The primary goal of this rotation is to provide a carefully supervised outpatient experience where the resident observes and participates with child psychiatry fellows in the evaluation and treatment of children and adolescents with psychiatric disorders. This will include experience with all treatment modalities including psychoactive medications. Residents will also participate in our telemedicine clinics which provide services to rural and underserved areas of Virginia. All work will be closely supervised by our faculty. While on the rotation, the resident will attend our formal fellowship educational activities.
Educational goals:
- Learn to describe cutaneous lesions morphologically with primary lesions,
secondary change, distribution and color. - Learn how presentation of skin disease can vary on skin of color (health equity
issue in dermatology is the lack of training on skin of color) - Learn to diagnose and counsel families regarding infantile hemangiomas, their
growth and involution cycle, and treatment options - Learn how to identify and manage basic infections disease on skin such as warts,
molluscum, tinea, impetigo. - Get visual experience with basic dermatology diagnoses seen in children and
young adults.
f. Reflect on how health inequities and social determinants of health affect
presentation, treatment and management in pediatric dermatology
The endocrinology elective is primarily outpatient focused, and there are a number of robust field clinics as well as clinics at the Primary Care Center and at in the Transgender Youth Health Services clinic.
You will see:
- Infants, children and adolescents with disorder of the endocrine glands (pituitary, thyroid, parathyroid, pancreas, adrenal, and gonads)
- Children with abnormal growth and/or sexual development
- Children with abnormalities of carbohydrate homeostasis (hypoglycemia and/or diabetes mellitus)
Objectives
- Residents are to develop an understanding of the needs and care of the pediatric otolaryngology in the outpatient setting (residents are welcome to attend surgical cases, but OR attendance not required)
- Residents are to develop an understanding of the otolaryngologist’s approach and treatments for children’s pathologies including:
- Otitis media/externa
- Snoring and sleep issues
- Nasal Congestion, both allergic/inflammatory and structural/anatomic
- Common causes of noisy breathing
- Neck masses
- How health inequities and social determinants of health may impact care access and presentation in the pediatric population with otolaryngologic pathology
Work as a gastroenterologist in outpatient and inpatient settings while you:
- Learn to evaluate and manage common gastrointestinal and nutritional complaints seen in general pediatric practice including constipation, encopresis, recurrent abdominal pain, recurrent vomiting, gastroesophageal reflux, and chronic diarrhea
- Assist during common endoscopic procedures including diagnostic upper and lower endoscopy
- Gain a good understanding of the evaluation and management of children suffering from inflammatory bowel disease, short bowel syndrome, acute and chronic liver disease, and a variety of feeding and nutritional disorders
Two nearby general practice clinics offer an opportunity for an additional general practice experience as an elective. The Northridge Clinic is located about three miles west of the University and serves about 13,000 patients each year. All pediatricians at Northridge are Department of Pediatrics faculty members.
The Orange Clinic, in the historic town of Orange, Virginia, about fifteen miles from the University, serves approximately 11,000 patients annually in a pleasant rural setting.
The genetics division supervises a full range of diagnostic genetics laboratories, and selects and evaluates appropriate genetic testing in patient evaluations and family counseling. The elective provides training in genetics appropriate for practice as a primary care pediatrician. It includes:
- Weekly genetics clinic at the Primary Care Center
- Seeing all genetics inpatient consultations
- Participation in six satellite genetics clinic held monthly throughout the western portion of Virginia
Each year many of our residents choose to do a month-long elective in global health. Through this elective you will:
- Identify current global health issues such as resource allocation, health systems management, and ethical standards for international development and research
- Gain an understanding of the epidemiology, diagnosis and management of common illnesses and tropical diseases affecting children in developing countries
- Learn to practice medicine with humility, professionalism and cultural sensitivity in a cultural context outside of your own
The outpatient hematology/oncology elective is focused on seeing patients in the ambulatory setting. You will:
- See patients with cancer, sickle cell anemia, and inherited bleeding disorders (of whom some are receiving scheduled therapies)
- Become the first referral physician of contact for ambulatory referrals
- Participate in evaluations of anemia, thrombocytopenia, neutropenia, lymphadenopathy, and some genetic disorders
During the infectious diseases elective, you will:
- Become conversant with the evidence which forms the basis for current practice of diagnosis and management of infectious disease in children
- Become familiar with procedures and interpretations in the microbiology laboratory
- Utilize this knowledge in the management of inpatients and outpatients with infectious diseases
Featuring a rigorous didactic component, the medical toxicology elective will give you the opportunity to:
- Evaluate patients with toxicology issues, including intentional and accidental overdoses, snake bites, unusual animal bites, industrial exposures, and potential chronic environmental exposures
- See patients with medical students, residents from other services, and with toxicology fellows and toxicology faculty who have faculty appointments in both Emergency Medicine and Pediatrics
- Review all Blue Ridge Poison Center calls with the attending physician
The pediatric renal elective provides an opportunity for you to become familiar with the evaluation and management of a variety of clinical nephrologic problems as they may be encountered by pediatricians. It is expected that you will be able to:
- Study, and learn to evaluate and manage basic fluid and electrolyte disorders, UTIs and vesicoureteral reflux, hypertension, congenital abnormalities in the newborn, acute renal failure, glomerular and tubular diseases, hematuria and proteinuria
- Be exposed to the intricacies of acute and chronic dialysis and transplantation as they relate to the practice of general pediatrics
During this elective, you will achieve a better understanding of the general methodological approach of the child neurologist and a keen sense of when a child neurologist should be consulted. Specifically, you will:
- Evaluate, classify and treat patients with childhood headache diatheses, cyclic vomiting, pseudotumor cerebri, status epilepticus, neonatal hypoxic-ischemia, cerebral palsy, Guillain-Barre syndrome, encephalomyelitis, cerebellar ataxias, epilepsy, common and complex childhood seizure, coma and brain death
- Become exposed to the general principles of the evaluation of ADHD, academic underachievement, metabolic, genetic and degenerative disorders, macrocephaly, microcephaly and hydrocephaly
As you participate in outpatient clinics and perhaps attend operative procedures, you will become familiar with the diagnosis and management of common ophthalmologic problems specific to pediatrics.
During this introduction to the evaluation, diagnosis, and initial treatment for the full spectrum of pediatric musculoskeletal conditions, you will learn about
- Cerebral palsy, myelomeningocele, and muscular dystrophy
- Fractures, including splinting, bracing and casting techniques
- Scoliosis and general orthopedic pathology (club feet, DDH, and intoeing)
The primary objective of this rotation is for you to shadow and immerse yourself in learning and getting the most out of your elective rotation. During this elective, you will see children and families with varying degrees of medical complexity and fragility throughout all phases of care (clinic visits, ICU admissions, hospital admissions; including end-of-life care in the hospital and community).
During this elective you will
- Learn to evaluate and manage infants and children with a variety of acute and chronic lung disease including asthma, bronchopulmonary dysplasia, pulmonary infections, cystic fibrosis, airway anomalies, congenital lung malformations, obstructive sleep apnea, restrictive lung diseases
- Understand the functions and use of a mechanical ventilator
- Become familiar with procedures relevant to the pulmonary subspecialty such as lung function testing and bronchoscopy
- Attend outpatient clinics at the University as well as at several satellite clinics in Roanoke, Lynchburg, Harrisonburg, Wytheville, and Winchester
The primary objective of this rotation is to familiarize yourself with different imaging modalities, their strengths and weaknesses, and appropriate imaging utilization.
To gain a greater understanding of the scientific method and acquire new knowledge through a mentored research experience, you may receive elective credit for up to eight weeks of research time. This may be augmented with an additional one-month rotation in a subspecialty rotation related to your area of research. It is anticipated that most research projects will take place over the course of several months to two years, with protected elective time allocated for periods of intensive work such as background literature reviews, data collection, or data analysis. More detailed information can be found at Pediatric Resident Research Elective