Madigan Army Medical Center

1. Madigan Army Medical Center Robert J. Newman, MD COL MC Pediatric Endocrinology

3. Madigan - Pediatrics • Military and Civilian Staff • General Pediatrics – 9 (4 military & 5 civilian) • Adolescent Medicine – 1 • Cardiology – 2 • Developmental Pediatrics – 4 (2 military & 2 civilian) • Developmental Fellows – 5 • Endocrinology – 2 • Gastroenterology – 1 • Genetics & Dysmorphology – 1 (civilian) • Hematology-Oncology – 2 • Infectious Disease – 1 • Neonatology – 5 (4 military and 1 civilian) • Neurology – 2 (1 military and 1 civilian) • Pulmonology – 1 • Rheumatology – 1

4. Madigan - Other • Pediatric Surgery • Pediatric Orthopedics • Pediatric Ophthalmology • Pediatric Otolaryngology • Pediatric Urology • Pediatric Radiology

5. Pediatric Residency • 6 Residents per year group • Clerkship site for USUHS since 1999 • Clerkship site for WAMI (U of W) since 1982 • Currently 39% USUHS graduates (although USUHS accounts for only 15-25% of the annual applicants) • 3 PL-3’s • 2 PL-2’s • 2 PL-1’s • 2 of the 3 Army USUHS grads of 2003

6. The Rotation • 2 weeks Pediatric Ward / ICU • 2 weeks General Pediatric Clinic • 1 week Well Child Clinic • 1 week Mother-Baby Unit

7. General Pediatric Ward / ICU • Average census: 10-20 patients • Average length of stay: 2-4 days • Staff attending • Senior resident • Supervising resident • One or two interns (pediatric, family practice, transitional (elective)) • One to three students – MS-III & MS-IV

8. General Pediatric Ward / ICU • Each student responsible for one to three patients daily • Admission H&P; daily notes • Presents at rounds • Presentations at morning report • Case discussions with attending • On-call twice per week • Evaluated by attending and senior resident

9. Pediatric Clinic • Three to five patients per half-day • General pediatric or subspecialty clinic • Precepts with attending • Observed history and physical • Treatment room half-day • Evaluated by attending

10. Well Child Clinic • Birth to 24 months • Age-cohort half-days • Infant growth and development, newborn metabolic screening, infant nutrition and normal physical findings • Immunization room half-day • Required reading of selected articles • Works with single preceptor who evaluates every third year student

11. Mother-Baby Unit • Pregnancy and delivery history • Newborn physical examination • Attends normal deliveries • Assessment of risks for sepsis, hypoglycemia, hyperbilirubinemia, etc • On-call in NICU once or twice • Circumcisions • Works with single attending who evaluates every student – One student per week

12. Educational Opportunities • Morning report – case discussion • Morning Pearl • Morning lecture – 4 days per week • Multi-disciplinary conferences (Pediatric ER, Peds-OB, Peds Path) monthly • Noon lectures – general pediatrics • Continuity clubs – twice monthly • SIM center • Wilderness medicine / cardiology conf. • Combat pediatrics / Treatment guidelines • Physical diagnosis rounds

13. Educational Opportunities • Medical Library access • Ward and NICU libraries • Computer / Network access • Up to date • MD Consult • OVID / Pub Med • Courses available to students – (sporadic) MMHAC, PALS, NRP, Winter Conference