Loma Linda University Children's Hospital - Pediatric Residency Program - Specialties

Specialty rotations

Adolescent Medicine

The adolescent division provides an excellent overview in the care of teenagers. The resident is intimately involved in patient evaluation in several clinics including a large local HMO, a county adolescent gynecology clinic, and the resident teaching clinic. These experiences develop diagnostic therapeutic skills for a wide spectrum of adolescent health problems.
  
Allergy/Pulmonary/ImmunologyThe allergy/immunology division, with close involvement from the allied field of pediatric pulmonary medicine, provides residents an excellent opportunity to become proficient in caring for patients in this area. The combination of dedicated faculty earnest about teaching, and the extensive clinical experience obtained in the large and busy outpatient clinic, active ICU, and ward inpatient services result in a well-balanced educational program.
  
Behavioral PediatricsThe section of behavioral pediatrics is involved in evaluating and treating children with many complaints including attention deficit disorders, sleep disorders, and discipline problems. During their one-month rotation, residents participate in providing care at the Loma Linda Faculty Medical Office and at the pediatric teaching office and also visit various schools and agencies that comprise the community supportive network. Some of the patients whom the resident evaluates may be followed by the resident in the weekly continuity clinic.
  
Cardiology

 

The cardiology division follows a diverse inpatient population, providing consultative support to the other pediatric services. Residents are encouraged to attend echocardiograms, diagnostic and therapeutic cardiac catheterizations, as well as cardiac surgeries. One of the most exciting aspects of the rotation is the opportunity to be part of the world's largest pediatric heart transplant program.

In the outpatient clinic experience, an interpretation of cardiac murmurs and follow-up of cardiac problems under the direct supervision of an attending cardiologist is especially valuable.

  
Endocrine
Inpatient duties during the endocrine elective include consultations for patients with newly discovered disorders and follow-up of established patients admitted with exacerbations of their disease. The majority of the resident's time, however, is spent in the outpatient setting. Weekly multidisciplinary diabetes team clinics are held in addition to daily clinics for initial evaluation and follow-up of patients with other endocrine disorders. During the summer months, residents may also participate in week-long camps for children of various ages with diabetes held in the nearby San Bernardino Mountains.
  
Forensic/Child Abuse
The evaluation of possible child abuse is one of the most difficult and stressful aspects of pediatric practice. During this required rotation the resident develops diagnostic expertise while attending multidisciplinary clinics for the evaluation of possible physical and sexual abuse. Exposure to the treatment of such children and the legal aspects of child abuse as they pertain to the child, family, and physician is also provided.
  
GastroenterlolgyThe gastroenterology rotation consists of both inpatient and outpatient services. Inpatients include those with failure to thrive and other nutritional disorders as well as those with intrinsic bowel or liver disease. House staff have the opportunity to assist with numerous procedures such as liver biopsies and endoscopy. They are also exposed to the intricacies of nutritional supplementation. Outpatient clinics, including the multidisciplinary cystic fibrosis and total parenteral nutrition clinics, as well as general gastroenterology clinics, provide an essential aspect of the learning experience.
  
GeneticsThe outpatient experience in genetics includes participation in both the newborn and maternal serum alpha fetoprotein screening program, genetic counseling, prenatal diagnosis, and evaluation of a wide variety of genetic diseases and dysmorphology in clinic patients. Inpatient consultations provide the opportunity to evaluate birth defects, heritable diseases, and metabolic disorders in newborns and children of all ages. Residents are also exposed to chromosome analysis in the cytogenetics laboratory.
  
Hematology/OncologyHematology/oncology experiences are available in both the inpatient and outpatient settings. The inpatient service includes daily care of the approximately 30 patients hospitalized for treatment of neoplasms or blood dyscrasias as well as consultations on ward and nursery patients. Pediatric nurse practitioners assist with these inpatient duties.

The outpatient service includes daily clinics for the evaluation of new patients and follow-up of established patients. Proficiency in performing bone marrow exams, in evaluating peripheral blood smears, and in administering chemotherapy are some of the skills that may be obtained during this rotation.
Infectious DiseasesMuch of the morbidity and mortality in pediatrics is still related to infectious diseases, so it is no surprise that this service has an active consulting role in many of our inpatients. Outpatient clinics and monthly infectious disease conferences augment the learning experience.
  
KaiserThird year residents serve as supervisory residents on the in-patient service at Kaiser Fontana. This is a general pediatric ward, with an interesting mix of patients, but concentrating on the usual diagnoses seen by a general pediatrician in the community. There is no overnight call during this rotation. The resident is responsible for helping in an urgent care pediatric clinic on an every fourth evening basis.
  
NephrologyLoma Linda offers a full range of services for children with renal disorders including peritoneal dialysis, hemodialysis, and renal transplantation. In addition to caring for chronic renal failure patients, the residents are also involved with inpatient and outpatient evaluation and follow-up of a wide variety of acute and chronic renal disorders.
  
NeurologyWe are fortunate to have excellent child neurologists and a world-class neuroradiology service. The resident benefits from a complete range of neurological problems in both the inpatient setting and in a busy outpatient clinic.
  
OK KidsStarted in July 2002, our newest rotation emphasizes those community outreach activities with which a general pediatrician is often involved. This rotation is required for all PL-3 residents and includes giving lectures, going to schools, involvement with homeless children, a visit to a WIC clinic, working in a clinic for incarcerated youth. More opportunities are being developed.
  
Pediatric Orthopedics
Two pediatric orthopedists train the resident in the evaluation and care of congenital hip dislocation, scoliosis, spina bifida, club foot, and a number of other areas pertinent to the pediatrician. The month-long elective includes participation in surgical procedures, daily rounds, lectures, conferences, and general as well as specialty clinics.
  
Child PsychiatryThe division of child psychiatry offers exposure to the various aspects of child and adolescent psychiatric and emotional disorders while working with a full staff of psychiatrists, psychologists, and counselors in both outpatient and inpatient settings. The resident participates in evaluation of the child, and often the family as well, in providing comprehensive outpatient service.
  
Pediatric SurgeryLLUCH is the pediatric surgery referral center for much of Southern California and performs approximately 1,000 surgeries per year. During this elective, the pediatric resident works directly with the pediatric surgery attendings and participates in surgical procedures, trauma care, pre- and post-operative evaluations, daily rounds, outpatient clinics, didactic lectures, and conferences. We are fortunate to have the support of surgeons with pediatric expertise in many surgical subspecialties including cardiothoracic, plastic, urology, and head and neck.