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Pediatric Residency Program

Pediatric Residency Program

Clinical Experience

XYZ Curriculum

As of July 2025, CHAM has implemented an X+Y+Z curriculum, with each block lasting two weeks. This structure is designed to optimize resident learning, patient care continuity, and wellness by clearly separating inpatient and ambulatory rotations.

X Blocks (Inpatient Focus)

Residents participate in inpatient rotations, including general and subspecialty inpatient teams, the NICU, PICU, the Newborn Nursery, and Emergency Department. X blocks provide immersive experiences in high-acuity, hands-on clinical care.

Y Blocks (Ambulatory Focus)

Y blocks are devoted to ambulatory rotations, including subspecialty electives, Behavior & Development, Adolescent Medicine, and Full Time Clinic and other Primary Care rotations such as in our LINCS complex care clinic. Residents also attend their continuity clinics during Y blocks, allowing them to maintain ongoing relationships with their patients without disrupting inpatient responsibilities and educational objectives. Y blocks are structured with lighter hours to support resident wellness. 

Z Blocks (Flexible/Continuity Focus)

Z blocks can be either inpatient or ambulatory. By combining a Z block with an adjacent Y or X block, these flexible Z blocks can support rotations that benefit from continuity over a full month. Examples might include rotations with steeper learning curves such as ICU rotations, those that benefit from extended patient follow-up or longitudinal care, or electives of particular interest that residents want to fully engross themselves in for 4 weeks at a time. Residents also attend continuity clinics during Z blocks if on an ambulatory rotation. 

Benefits of the 2+2+2 XYZ Model 

Our new structured block system ensures residents gain comprehensive, high-quality clinical and educational experiences while maintaining wellness and continuity across inpatient and outpatient settings. As with traditional X+Y models, inpatient and intensive rotations are spaced out with predictable lighter rotations every 4-6 weeks. However, the flexibility of a Z block allows for longer 4-week rotations (Z+X or Y+Z) when beneficial to optimize educational experiences, patient care or resident preference which is often lacking in traditional X+Y models. 

Sample:

Postgraduate Year 1

The intern year at the Children’s Hospital at Montefiore Einstein (CHAM) emphasizes inpatient clinical experience to manage a wide range of common and complex pediatric conditions across different developmental stages. Under the guidance of senior residents and attending physicians, we feel it’s critical that interns serve as the primary clinicians for their patients and make substantive decisions in their patient’s care.

Interns also rotate through the Newborn Nursery (NBN) and Neonatal Intensive Care Unit (NICU) at the Jack D. Weiler Hospital on the Albert Einstein College of Medicine Campus. These rotations provide hands-on experience with neonatal resuscitation, deliveries, and management of both healthy newborns and common NICU conditions

In addition to inpatient responsibilities, interns participate in several outpatient experiences, including a month dedicated to Behavior & Development at The Children’s Evaluation and Rehabilitation Center (CERC) which is one of the largest academic centers dedicated to the care of children with or at risk for developmental disabilities. Each intern has 6-8 weeks of core electives as well as 4 weeks of our Multi-Subspecialty Elective that exposes interns to several core pediatric subspecialties early in their training. This unique experience helps interns develop foundational knowledge, identify potential specialties of interest, and meet potential mentors early in their training.

Each resident is assigned to one of three Continuity Clinic sites where they spend 1-2 half-days each week during ambulatory Y and Z blocks to build a foundation in primary care skills, outpatient advocacy and patient continuity.

Clinical Experiences Weeks
Newborn Nursery 4
NICU 4
Inpatient 16–18
Behavior and Development 4
Emergency Department 4 (Two 2-week rotations)
Elective 6–8 (2- & 4-week rotations)
Jeopardy/Sick Call 2
Mental Health (Ambulatory) 2
Multi Sub-Specialty Elective 4
Vacation 4 (One 2-week and two 1-week vacations)

Postgraduate Year 2

Building on the foundation from intern year, the PGY-2 year emphasizes the development of independent clinical decision-making, team leadership, and teaching skills. PGY-2 residents serve as supervising residents on inpatient units, leading rounds and guiding interns and medical students in patient care. Inpatient PGY-2 experiences include General Pediatrics, Hematology, Adolescent Medicine, Endocrinology, Cardiology, Gastroenterology, Neurology, Liver Transplant and our Surgical Subspecialties. PGY-2 residents also gain experience in our high volume, high acuity, Pediatric Intensive Care Unit (PICU). 

A significant component of the PGY-2 year is expanded elective time, allowing residents to explore interests in pediatric subspecialties, general pediatrics, private practice, and research. All PGY-2s also complete rotations in Adolescent Medicine, LINCS (our complex care clinic) and further experiences in Mental Health. All PGY-2 residents also complete a two-week Full Time Clinic rotation, providing focused exposure to general pediatrics in the ambulatory setting and further strengthening outpatient primary care skills. This is in addition to the Continuity Clinic experience that continues during ambulatory Y and Z blocks. 

Clinical Experiences Cycles (4 weeks/cycle, Total 13 cycles)
PICU 4
NICU 2
Inpatient 8–10 (Including 2–4 weeks night float)
Emergency Department 4 (Two 2-week rotations)
Electives (Individualized and Career-focused) 12–14 (2- and 4-week rotations)
Adolescent Medicine 4
Mental Health (Inpatient/ED) 2
Full Time Clinic 2
LINCS Complex Care Clinic 2
Jeopardy/Sick Call 4–6
Vacation 4 (Two 2-week vacations)

Postgraduate Year 3

In their final year, residents focus on refining teaching and mentorship skills through supervisory roles on both the inpatient floors and in the intensive care units while building their independence and own clinical and professional identity. Dedicated inpatient rotations as Managing Senior and Admitting Senior provides third-year residents with additional opportunities to strengthen these skills while acting as the Senior in-house to support more junior senior residents and work closely with interns admitting new patients. PGY3s also oversee patient care teams for General Pediatric patients as well as Hematology, Oncology, Nephrology, Kidney Transplant, and Cardiology.

Third-year residents also participate in a hugely popular Community Health rotation, where they meet with national leaders in the field of community health to gaining insight into the social, economic, and environmental factors that influence patient health. They also spend this rotation providing confidential adolescent care and youth screening exams in the largest school-based health system in the country. The senior year continues to include elective time, including time for an advanced subspecialty elective to act as a junior fellow as well as a 4-week call-free elective, allowing residents to pursue diverse interests such as global health experiences, research, away rotations or preparation for careers in hospital-based or private practice medicine. 

Clinical Experiences Cycles (4 weeks/cycle, Total 13)
PICU 2
NICU 2
Inpatient 4–6 (including 2–4 weeks night float)
Managing Senior / Admitting Senior (Inpatient teaching and admitting) 2 weeks days
2 weeks night float
Emergency Department 4 (Two 2-week rotations)
Community Health 4
Elective (Individualized and Career-focused) 14–184–5 (2- and 4-week rotations)
Call Free Elective 4 (consecutive)
Full Time Clinic 2
Jeopardy 4
Vacation 4 (Two 2-week vacations)

Electives

At CHAM, we are fortunate to offer exposure to the full spectrum of pediatric subspecialties as well as unique and creative rotations. Residents with interests outside of the standard electives are encouraged to discuss their goals with us. We are open to creating individualized elective plans to accommodate your unique interests and career aspirations.

Core Electives None-core Electives
Allergy/Immunology Advanced Subspecialty Electives (after core)
Cardiology Anesthesiology
Endocrine Child Psychiatry
Gastroenterology Dermatology
Genetics Hospital Medicine
Hematology/Oncology Newborn Care
Infectious Disease Orthopedics
Neurology Outpatient Pediatric Surgery
Nephrology Palliative Care
Pulmonology Patient Safety and Quality Improvement
Rheumatology Private Practice
Radiology
Research
Sports Medicine
Teaching Elective
Urgent Care
Electives Under Development
Bone Marrow Transplant
Cardiovascular ICU
Transfusion Medicine
Child Abuse Pediatrics
Multi-Subspecialty Surgery Elective
Longitudinal Subspecialty Elective

Educational & Teaching Experiences

CHAM residents receive more teaching awards from the Albert Einstein College of Medicine than any other affiliated residency program. All residents, but particularly our interns, take a key role in educating and mentoring third- and fourth-year medical students. Senior residents additionally participate in medical student OSCE’s and small group sessions. For those with further interest in medical education, we offer a dedicated teaching elective for residents to explore adult learning theory, feedback skills, precepting techniques, incorporating technology into teaching, and the development of teaching products such as teaching scripts, simulations, podcasts and didactic lectures.

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