Overview

The Brigham and Women’s Hospital (BWH)/Children’s Hospital Boston (CHB) Medicine-Pediatrics curriculum is comprehensive and flexible.  The curriculum follows the guidelines outlined by the American Board of Internal Medicine and the American Board of Pediatrics and the requirements of the Accreditation Council for Graduate Medical Education.  The program is designed so that residents learn the skills necessary to become exceptional leaders in whatever field they choose, whether it be as a generalist clinician, hospitalist, or subspecialty physician.  The goal of the Med-Peds Residency leadership is to help residents achieve their long-term goals through personalized mentorship.  Over the four years, there are opportunities for residents to tailor the standard curriculum to their own interests and needs, particularly during research and elective time.  There is a wealth of mentors available for residents through these hospitals and the medical school. The program has an official mentoring program as well as individual meetings with the Program Directors to ensure that housestaff are connected to faculty who will support and guide them in their research and career paths.

As residents progress through the training program, they have a graduated increase in responsibility for the patient care, team leadership, and teaching with supervisory rotations beginning in their second year in both medicine and pediatrics. Interns and residents switch between the departments approximately every three months, the one exception being the first switch between departments, which occurs between July and August. This early first switch is designed to give interns the opportunity to experience pediatrics and medicine settings in the first few months of internship with their categorical counterparts.  This allows for better socialization and incorporation of Med-Peds residents with their colleagues.



The Med-Peds intern experience is 12 months. The first year provides the resident with the core experiences needed to assume supervisory responsibilities in both medicine and pediatrics.  Every intern rotates through essentially the same core experiences in preparation for more supervisory roles in the second, third and fourth years of residency. The curriculum is designed to be "front-loaded" so that interns gain important experience in direct patient care, performing invasive procedures, and becoming comfortable with intensive care, emergency room, and ward protocols. Second, third, and fourth year residents advance their leadership and clinical skills through supervisory rotations, ICU experiences, outpatient block rotations, and electives.

Residents spend most of their time at the home institutions of BWH and CHB, but also train at the affiliated institutions of Faulkner Hospital during medicine rotations and Boston Medical Center during pediatric rotations.  Faulkner Hospital offers exposure to academic, community-based internal medicine to complement the more tertiary/quaternary care of BWH hospital wards.  Boston Medical Center is a city hospital that has been a partner in the Boston Combined Residency Program in Pediatrics for more than 15 years and offers exposure to general pediatrics, emergency medicine, and pediatric and neonatal intensive care. This collaboration offers true educational excellence by combining the culture of a public city hospital with that of a private, sub specialty hospital.

Residents are fully supported and mentored in their individual interests and career development efforts. There are a host of electives available to residents at both institutions and at our sister program at MGH.  Additionally, residents have the opportunity to spend four months (2 from each department) focusing intensely on research activities in their third and/or fourth year.  Numerous structured domestic and international rotations are available through both residencies, ranging from Shiprock, NM to Lesotho, Haiti, Peru and South Africa.  Residents are also supported in their self-designed rotations abroad.  Residents are eligible to apply for the GHE-Residency available through the Brigham and Women’s Hospital Internal Medicine Residencyas well as the Harvard Humanitarian Initiative.  Residents have the opportunity to participate in the mentoring and lecture series associated with the Global Child Health Initiative through the BCRP.

Med Peds Core Curriculum

All Harvard CHB/BWH Med-Peds residents participate in a four-year Med-Peds Core Curriculum designed to prepare exceptional dual-trained physicians.  This core curriculum, organized by the Med-Peds faculty and chief resident, serves to supplement daily conferences sponsored by the categorical Internal Medicine and Pediatrics programs.  Currently, our core curriculum includes the following events that our residents attend together as a Med-Peds cohort: weekly Med-Peds Noon Conference, weekly Ambulatory Clinic Conferences, monthly Med-Peds Grand Rounds, monthly Med-Peds Mentoring Groups, quarterly Med-Peds Journal Club Dinners, and biannual Med-Peds Retreats. 

Weekly Med-Peds Noon Conference is the cornerstone of the Med-Peds Core Curriculum. Our Noon Conference, organized by the Med-Peds Chief Resident, covers core topics in both Internal Medicine and Pediatrics, and serves as a venue for exploring the field of transitional care. It also gives residents experience in teaching by leading and receiving feedback in a small group teaching session. In addition to learning the core topics,  residents also use this forum to discuss their personal research and outside clinical experiences with their peers, and to learn from others.  Of course, we are also very happy for the chance to see each other and catch up after a busy week on the wards! 

Med-Peds Grand Rounds features the opportunity to interact with invited expert faculty who are selected by a resident committee to present their perspective and experience with a specific Med-Peds topic.  Med-Peds Grand Rounds is teleconferenced between the Harvard BWH/CHB Med-Peds Program and our sister Med-Peds program at MGH, allowing us to taking advantage of the faculty at all Harvard institutions.  In addition, the Harvard BWH/CHB Med-Peds Program sponsors Med-Peds oriented Grand Rounds in both categorical programs.  

Ambulatory Clinic Conference: Residents discuss selected core outpatient Internal Medicine and Pediatrics topics standardized by both Med-Peds Clinic sites.  Both residents and preceptors participate in teaching these pre- or post- clinic sessions. 

Journal Club: On a quarterly basis, journal clubs in both departments are led by a Med-Peds resident, who focuses on a topic related to transitional care. 

Retreats: Biannual retreats allow time outside of the hospital to reflect, discuss program development, and play touch football!

For more information about the many Med-Peds gatherings and social activities, visit our "Life Outside Residency" link.
 

Harvard Brigham/Children’s Med-Peds Curriculum (Typical)

PGY-1
Medicine
4 weeks GMS (general medicine service)
4 weeks Oncology service
4 weeks Cardiology service
4 weeks AMB (outpatient block)
2 weeks Geriatrics
2 weeks CCU
2 weeks MICU
2 weeks ER
2 weeks vacation

Pediatrics
General Pediatrics 1 mo
BMC ward 1 mo (2 weeks nights)
Newborn 1 mo block
NICU 1 mo
Cardiology 1 mo block
ER 4 wks (2 wks of each)
Vacation 2wks

PGY-2
Medicine
4 weeks elective
4 weeks Cardiology or Oncology or General Medicine
4 weeks Faulkner
6 weeks AMB (outpatient block)
2 weeks CCU
2 weeks ER
2 weeks Sick Call
2 weeks vacation

Pediatrics
1 mo BMC Ward or SSU (short stay unit)
1 mo Child Development block
1 mo GI block
1 mo Oncology block
1 mo PICU
1 mo Delivery Room/NICU
2 weeks vacation

PGY-3
Medicine
4 weeks General Medicine Service
4 weeks Faulkner Ward, Cards or ONC
4 weeks AMB (outpatient)
8 weeks elective
2 weeks Night Team
2 weeks MICU
2 weeks vacation

Pediatrics
1 mo  ICP
1 mo selective in 4 wk block
1 mo adolescent block (NICU or DR call)
1 mo ER in 4 wk block
4 weeks elective (ELN, with night call)
2 wks elective call free
2 weeks NICU (BMC)
2 weeks vacation

PGY-4
Medicine
4 weeks Ward
4 weeks ICU
4 weeks AMB (outpatient)
8 weeks elective/research
2 weeks Night Team
2 weeks Senior Consult Resident/Geriatrics
2 weeks vacation

Pediatrics
8 weeks General Pediatrics (2-4 wks night team)
1 mo elective call free
6 wks elective ELN (total of 8 wks of ELN/ELC can be used as research time)
4 wks ER (BMC)
2 wk sick call
2wks vacation