A med-peds residency is particularly challenging given the expectation for a resident to function at the same level as her peers in the single-track programs. Mindful of this challenge, we have found that our residents perform well on the wards, as they draw from their experiences on complementary rotations: their PICU experience informs their approach in the MICU. Geriatrics and newborn care often share similar issues of self-care and independence.
Tertiary inpatient training occurs primarily in two facilities: Yale-New Haven Hospital (Adult Medicine) and Yale-New Haven Children's Hospital (Pediatrics). Important to inpatient education is the community hospital experience which takes place at affiliated hospitals with dedicated Yale faculty, usually 1-2 months a year.
Yale-New Haven Hospital (YNHH) is a tertiary referral center as well as an urban community hospital. The hospital operates approximately 900 beds. In addition to serving the metropolitan New Haven area, YNHH is a regional referral center and has patients with less commonly seen medical problems as well as patients with undiagnosed and complicated problems. Residents care for patients being treated with a wide range of advanced medical technology, including bone marrow and cardiac transplantation and experimental oncology regimens. Since YNHH is part of the Yale University School of Medicine, residents learn from leading experts in a wide range of fields. The basic science and clinical research facilities provide an opportunity for residents to pursue questions that arise from patient care experiences into the laboratory or clinical research center.
The Medical Service of YNHH includes a 22-bed Coronary Care Unit, a 15 bed Medical Intensive Care Unit with adjacent “step down” unit, Oncology Service with a Bone Marrow Transplant Unit, a Cardiology Service, the Atkins Firm which manages patients with HIV-related diseases, and five general medicine teams.
The Yale-New Haven Children's Hospital is composed of 90 inpatient beds which include an 11 bed Pediatric Intensive Care Unit and a 10-bed Clinical Research Center. There is a 46 bed Newborn Special Care Unit which includes a Newborn Intensive Care Unit of 20 beds and a Continuing Care Nursery of 26 beds. In addition, the well baby service has 64 bassinets.
The Children's Hospital is completely integrated with respect to medical and surgical cases as well as private and staff patients. The patients are assigned to pediatric care units according to their age. Housestaff have the full and complete responsibility for the care of all children. The patients admitted by the pediatric surgical service or surgical subspecialties are cared for in coordination with surgical colleagues. The housestaff are supervised by members of the full time faculty as well as pediatricians of the greater New Haven area who constitute an active part-time faculty. The inpatient service is divided by age: an infant and toddler unit, a school age unit, and an adolescent unit. Full-time faculty is responsible for coordination of all teaching activities and for maintaining a high level of patient care for all patients. The Department of Pediatrics has available extensive and excellent support services including Diagnostic Imaging, Blood Bank, Laboratory Medicine and other contemporary diagnostic modalities.
The Department of Pediatrics maintains a close collaboration with the Yale Child Study center which is devoted to teaching and research in child development and child psychiatry. Also, the faculty of the Department of Genetics is involved in many aspects of patient care and teaching.