Pediatric Residency Program

Saint Louis University’s Pediatric Residency Program dates back to 1933. Since 1956, its primary site has been SSM Health Cardinal Glennon Children's Hospital which has continuously offered exceptional clinical and educational experience to house staff and medical students as a fully accredited program credentialed by the Accreditation Council for Graduate Medical Education (ACGME)

About Our Pediatric Training

We pride ourselves on providing the best educational and clinical experiences to meet the ever growing, changing and complex needs of children and those who care for them. Our program provides the basics in pediatric education in your first year of training, allowing you to customize your residency training in your third year with six months of individualized curriculum, as well as  a wide range of experiences and exposures to fully prepare you for the next step in your pediatric career.

The idea that trainee responsibility for the initial patient assessment, plan development and management is central to all rotations in our residency program. Core didactic sessions, formal and informal conferences, bedside/classroom teaching, faculty/paramedical support, and program flexibility allow our residents to tailor the experience to meet their individual career goals. We routinely re-evaluate our program and make changes as necessary to improve the educational experience for our residents.

About Our Graduates

Pediatricians who trained at Saint Louis University's Pediatric Residency Program represent every major pediatric subspecialty in the United States, with many of our graduates receiving prestigious awards for their contributions to pediatric research. Our residents who pursue careers in subspecialty medicine routinely match in top tier subspecialty fellowship programs and go on to contribute significantly to the subspecialty care of children.

Our graduates are employed across the world in general and subspecialty pediatric practices and are found in academic medicine, private practice, community health centers and international practice. In the area of primary care, our graduates contribute to maintaining good health care for the pediatric population, which often includes actively participating in and organizing programs to improve the safety and health care accessibility for all children.

The Application Process

The Saint Louis University Pediatrics Residency Program accepts applications solely through the Electronic Residency Application Service (ERAS). To be considered complete, your application must have a dean's letter as well as at least two letters of recommendation (preferably one from your chairperson or director of pediatric student education or residency).

Passing scores for the USMLE Step 2 and USMLE CS exams must be uploaded to ERAS by January 31, 2018, for our program to consider you for ranking.

Osteopathic Students

COMLEX Level 1 and level 2 scores are accepted in place of USMLE Step 1 and Step 2 scores. Passing scores on the COMLEX 2 CE and COMLEX 2 PE must be uploaded to ERAS by January 31, 2018, for our program to consider you for ranking. We encourage applicants to also take USMLE examinations to facilitate fair comparisons in our ranking process.

International Graduates

You must have a certificate from Educational Commission for Foreign Medical Graduates (ECFMG) to apply. Foreign nationals are required to obtain a permanent resident or J-1 visa sponsored through the ECFMG. J-1 visas require the successful completion of USMLE Steps 1 and 2. Contact the ECFMG for information about visa sponsorship applications and current immigration regulations for postgraduate training.

Deadlines and Interviews

All applications need to be submitted by November 4 to be considered for an interview.  

We  begin offering interview dates late September into early October and interviews are conducted from mid-October to late January. Every effort will be made to accommodate your schedule. We interview on Mondays and Thursdays, avoiding the Thanksgiving, Christmas and New Year's weeks. Please let us know if there is a particular area of interest that you would like to explore during your visit with us.

Explore SLU's Resident Benefits

Curriculum 

PGY-1 PGY-2 PGY-3
 

Inpatient (Hem/Onc and Endo)

Inpatient Team Leader(H/O and Endo or Cards/Pulm)  Individualized Curriculum: Inpatient
Inpatient (Cards & Pulm) Inpatient Team Leader (GI & Clin Med or Renal & Clin Med)  Individualized Curriculum: Inpatient
Inpatient (GI & Clin Med) Night Team Individualized Curriculum: Outpatient
Inpatient (Renal & Clin Med) PICU Individualized Curriculum: Outpatient
Night Team PICU Individualized Curriculum:Subspecialty Elective
NICU Neurology Individualized Curriculum:Subspecialty Elective
Newborn Nursery St. Mary's NICU Floor Supervisor
Ambulatory/Community and Advocacy Ambulatory/Quality Improvement Floor Supervisor
Adolescent Medicine Subspecialty Elective Inpatient
Developmental Pediatrics Subspecialty Elective St. Mary’s NICU
Subspecialty Elective Subspecialty Elective NICU
Emergency Medicine Emergency Medicine Academic Primary Care

 

PGY-1
The first year is designed to allow our residents to have a broad base of experience across the pediatric spectrum before deciding on a career path. There is a balance of in- and outpatient rotations with only one month of night team and some night shifts in the emergency department. First-year residents will not be assigned to night team in July or August, allowing them to become acclimated to a new setting and gain experience before caring for patients at night.
PGY-2

Second-year residents have more responsibility. They are team leaders on the floors. They cover deliveries while on their NICU rotation at SSM Health St. Mary’s Hospital, taking every fourth-night call (on average).

They also gain additional critical care experience in the PICU with every fourth night call. During their neurology rotation, our second-year residents often function in a consultative role in addition to being a part of the neurology team. One month on night team rounds out the inpatient rotations for the second-year residents.

Outpatient rotations in the second year provide additional experience in our Danis Pediatrics Center (primary care/ambulatory) and emergency department. During the ambulatory rotation,  second-year residents also complete our Quality Improvement/Patient Safety curriculum. Three subspecialty electives during the second year allow residents to explore different career options in more depth.

PGY-3

Third-year residents also have an additional month of Level 3a NICU at SSM Health St. Mary's Hospital (every fourth-night call) to further hone their neonatal resuscitation and neonatal skills. They will have a third month of emergency medicine and two months on inpatient medicine serving as a floor supervisor. The floor supervisor is a unique role that allows our third-year residents to take on an advanced teaching role and become proficient at managing new admissions to the various floor teams, while at the same time having a greater level of independence in taking care of patients.

The last month of inpatient is chosen by the program director for each resident (with their input) based on educational needs and career plans for that resident. The rotations for this inpatient rotation might be the advanced newborn nursery, advanced NICU, advanced PICU, team leader, hospitalist team, floor supervisor, or night team.

Written Examination and PREP

Residents are required to complete PREP self-assessment questions annually (about 250 questions). PREP is a program developed by the AAP and available online to the residents to assist in preparation for the American Board of Pediatrics Certifying Examination. In addition, by requiring completion of these questions, the program hopes to instill lifelong habits of learning.

All residents are also required to take the yearly American Board of Pediatrics In-Training Examination to help prepare for the American Board of Pediatrics Certification Examination.
Yale curriculum
Noon conference
Morning conference

Community Advocacy through Resident Education (CARE)  

The Community Advocacy through Resident Education (CARE) curriculum is part of a collaborative program called MoCARE which includes the four pediatric residency training programs in the state of Missouri. The goal of MoCARE is to strengthen community pediatrics education for residents and to improve outcomes for Missouri's children through more effective advocacy.

Curriculum

The CARE curriculum is designed with flexibility to allow residents to focus on areas of community pediatrics that spark their interest and passion, fostering sustainable advocacy efforts that will persist even after residents complete their pediatric training. Unlike a conventional residency rotation, the CARE curriculum involves activities such as site visits, lectures and projects that span the entire pediatric residency experience.

During their intern year, residents will gain awareness of community pediatrics through community partner site visits and participation in assigned educational activities during their CARE rotation. These visits will sometimes involve shadowing at a community site, discussing a topic with a community leader or performing a specific community-related task such as a nutrition assessment or educational initiative with a community organization. The site visits and activities are diverse, with each intern engaging with 20 or more partners such as schools, shelters and food pantries throughout their intern year. As a result, residents will begin to understand how these practices can be utilized in your various pediatric practice settings.

Following their intern year, residents will have the opportunity to choose a scholarly project that implements principles of advocacy and community pediatrics. This project can include collaboration with other residents, faculty and community agencies that relate to the project that residents have chosen. At the conclusion of their project, residents will submit a poster presentation that will meet the pediatric residency program scholarly project requirement.

Additionally, at the end of their intern year, residents will be given the opportunity to apply for the MoCARE advocacy track. Two residents will be chosen from each year group to spend their second and third years of residency emphasizing topics in pediatric advocacy and community health. These two rising PGY2 residents will join the six PGY2 advocacy track residents from the three other pediatric residency programs in Missouri at a leadership conference in Columbia, Missouri specifically targeted to leadership and advocacy skills in pediatrics. Additionally, they will spend several elective rotations through the remainder of their residency engaging in both clinical and scholarly endeavors related to improving the health of children throughout the region.

Ann Manganaro Global Health Pathway in Pediatrics (GHPP)

The Ann Manganaro Global Health Pathway in Pediatrics (GHPP) is an opportunity for residents with an interest in pursuing a career that includes global health to gain additional education in international children’s health within the ACGME requirements during their last two years of residency.

During their first year, pediatric interns interested in pursuing this pathway will have the opportunity to apply for review by the GHPP selection committee. Up to two residents each year will be chosen from the applicants to begin the pathway in their second year.

The pathway requires residents to include within their curriculum elective months including infectious diseases, gastroenterology and hematology/oncology. During their second year, they will complete an elective month consisting of a two-week learning experience in an underserved international location, and a two-week global health course held in conjunction with Washington University Medical School. 

During their third year, they will participate in a Medicine Abroad Program (MAP) that includes a retreat focusing on global health issues and a one-month learning experience in a low-resource location abroad.

Finally, the FACES Clinic for immigrant and refugee families will serve as their continuity clinic experience during their third year.

Participants will be required to do additional learning outside of the above electives, and to give a presentation to the medical staff regarding their global health experiences. Upon completion of the GHPP at the end of their third year, participants should have a greater understanding of international child health issues, preparing them for future opportunities in global health.

Conferences 

Grand Rounds

Our Grand Rounds are held Wednesday mornings from 8 a.m. 9 a.m. September through June. Topics vary, from the state of the hospital, to case conferences, to speakers brought in from other institutions around the country, and much more. Residents are expected to attend every Grand Rounds session, with the exception of scheduled off days.

Morning Conferences

On Monday, Tuesday and Thursday mornings, from 8 a.m.-8:30 a.m., interns and our second- and third-year residents) have separate morning conferences. Intern morning conference includes lectures from fellows and attendings, with topics varying from board specific lectures to common pediatric diagnoses. Also, every Tuesday morning, an intern who is on the inpatient wards will give a patient case presentation, with the focus on history, review of systems and physical examination in order to prepare them for senior morning conferences.

These same days, the senior resident morning conference, also referred to as intake conference, involves patient case presentations from residents that are currently on the inpatient wards. This conference is also attended by multiple faculty members, both from subspecialty services and from general medicine. These case conferences focus more on differential diagnosis and discussion, when compared to the intern case reports.

Friday mornings, also from 8 a.m.-8:30 a.m., interns and seniors combine into one conference, where a senior resident rotating on the wards will give a patient case presentation. This conference is a way to involve interns in the discussions that involve more focus on differential diagnoses and disease discussion as a prelude to their senior level conferences.

Noon Conference

These conferences occur daily, Monday through Friday, and run from noon to 1 p.m. Conferences are designed to be specific to the ABP Board Exam. The lecture series is a comprehensive didactic series intended to span over the course of 18 months. These lectures are taught by subspecialty and general academic faculty and address important topics necessary for the education of a general pediatrician and to prepare the residents for the American Board of Pediatrics certifying examination. The residents are expected to attend all of these conferences unless urgent clinical duties prohibit.  Conferences are recorded, as well, and put online to be accessed by all residents using their SLU login information (viewing online does not count for conference credit).

Patient Safety Conference

This conference is held once a month in place of noon conference. It is led by one or two of the third year residents and a faculty mentor, and often focuses on one particular case in which patient safety was at risk, or where harm occurred. This conference focuses on systematic changes that can be made to improve patient outcomes.

Chairman's Conference

Led by the chairman of the Department of Pediatrics, these conferences involve residents and faculty discussing interesting inpatient cases with the interns and senior residents involved in the patient's care.

Intern Lecture Series

The Intern Lecture Series occurs on Wednesday mornings from 8 a.m.-9 a.m. during the first seven weeks of the year,  when Grand Rounds is not held. These lectures offer an overview of various common inpatient topics to help orient interns to the hospital, and to go over management of common disease entities that they will frequently encounter.

Subspecialty Conferences

All services also have their own conferences. Residents attend and participate when they are on the subspecialty service, when one of their patients is discussed by the division, or simply when they have an interest and are available to attend.

Research

Scholarly Project

All residents will complete a scholarly project that results in a poster presentation at a minimum. Our residents have routinely presented at the Pediatric Academic Societies (PAS) Meeting, the Pediatric Hospitalist Meeting (PHM), national and regional specialty meetings and local meetings such as the Saint Louis University Primary Care Research Symposium, Saint Louis University Pediatric Science Days, Saint Louis University Graduate Medical Education Resident Research Symposium.

The scholarly projects are based on Boyer’s model of scholarship. His description of scholarship includes the following four categories:

  • The scholarship of discovery, which is consistent with traditional research.
  • The scholarship of integration, which makes connections across disciplines and places specialties in a larger context.
  • The scholarship of application, which demonstrates the vital interaction between research and practice, wherein the one continuously informs the other.
  • The scholarship of teaching (educational scholarship), which emphasizes the creation of new knowledge about teaching and learning in the presence of learners.

Research (Scholarship of Discovery)

The faculty at Saint Louis University and SSM Health Cardinal Glennon Children's Hospital are at the forefront of basic science and clinical research. They enjoy mentoring residents through the residency research project. Select faculty will help guide the residents through Institutional Review Board (IRB) certification, mentor selection, background/ reference review, project implementation and final presentation. Several times during the project, the resident meets with an expert from the Saint Louis University School of Public Health to optimize their research focus, develop a sound strategy for data collection, and then finally for data analysis, statistical representation and presentation to the Department.

Quality Improvement (Scholarship of Application)

All residents will complete the Patient Safety/Quality Improvement curriculum during their ambulatory month in the second year. For those who are interested in making QI the focus of their scholarly work, especially those considering a career in primary care, faculty will mentor you as in the research project (above). You may have the opportunity to join a national QI project with the faculty or you may select your project based on needs that you identify through the second year curriculum. Most residents will seek IRB exemption status or expedited approval for their project.

Advocacy and Global Health (Scholarship of Integration)

The scholarly projects for Global Health and Advocacy tracks will be developed and mentored with the faculty who oversee these two tracks.

Education (Scholarship of Teaching)

There are many opportunities for working with faculty on educational interventions. Sometimes these projects are with national organizations allowing for broad collaboration across residency programs. If you are planning a career in academic pediatrics, an educational project may be right for you.

Faculty And Resident Publications, Abstracts, Presentations and Grants

In the past five years, pediatric residents/fellows and faculty have had over 300 publications including chapters in books, abstracts and articles in critically acclaimed journals. These publications cover all areas of clinical medicine and basic science relating to pediatrics and related areas of medicine.

During the present academic year, numerous funding agencies and local and national organizations supported the research activities of members of the Department of Pediatrics. Active grants for the Department of Pediatrics total more than $7 million at present. Major sources of funds included the National Institutes of Health, the Cystic Fibrosis Foundation, the American Heart Association, the American Diabetes Association, Alpha-1 Antitrypsin society, and private industry. Additionally, the SSM Health Cardinal Glennon Children’s Hospital administration will provide small “Fleur-de-Lis” grants for starting research projects.

Evaluations

 It is the strong opinion of the program directors and chairman that only through continuous mutual input from residents and faculty will Saint Louis University's residency maintain its state-of-the-art pediatric educational experience. Evaluations are taken very seriously, and every effort is made to instill improvements to the program that are deemed necessary based on these evaluations. Evaluations occur through many different means in this program, as listed below.

Resident Evaluations 

Evaluations are performed using the milestones format. Attending physicians use set guidelines to provide monthly written evaluations for each rotation, as well as a semi annual evaluation for the continuity clinic. All evaluations are reviewed by the program directors as soon as they are received. Any problematic evaluations require discussion with the appropriate attending(s) and residents, and the resident's preceptor also receives notification.

Semi-Annual Evaluations

The program directors meet with all residents twice a year to review their overall progress in the program. If a resident is having issues or has received a poor evaluation, meetings between that resident and their preceptor or one of the program directors will occur more frequently to allow for remediation, if deemed necessary, and timely completion of training.

Program Evaluation

House staff are expected to contribute to the assessment of the program and faculty. This occurs in a number of ways.

  • The Program Evaluation and Improvement Committee (PEIC): The committee includes the program directors, multiple additional attending physicians, the chief residents, and four residents from each class (who are selected by their peers). The committee meets monthly to discuss ongoing issues in the program, and residents from each class are expected to report back to their peers following the meetings.

    Residents are required to provide monthly evaluations of each attending physician that they work with, which is done through the website New Innovations. These evaluations are entirely anonymous.
  • Each year the individual resident classes have a two-day retreat. These are held off campus and only involve that individual resident class. Third year resident retreat is typically in August, second-year resident retreat is typically in September, and the intern retreat is typically in October or November. These retreats provide an avenue for unbiased, anonymous discussion on the pros and cons of the program, and possible solutions to any ongoing problems. Summaries of these discussions are presented directly to the chair of the Department of Pediatrics, with the goal to address and improve the problems, if possible.
  • The chair also meets annually with each resident class to discuss their thoughts on the program, and these meetings also lead to discussions among the leaders in the department about ways to improve the program.
  • Each year in the spring, residents complete an anonymous online survey regarding the program. The results of this survey are compiled and reviewed by the Program Evaluation and Improvement Committee, and discussions are held, if necessary, on how to address problems that have been identified.

Inpatient Rotations

Residents care for patients admitted to SSM Health Cardinal Glennon Hospital with a variety of diagnoses, ranging from common pediatric illnesses to complex subspecialty conditions. Four inpatient teams provide patient care, each consisting of medical students and interns under the leadership of a senior resident and an attending physician.

Inpatient subspecialty services include pulmonology/cardiology, hematology-oncology/endocrinology, gastroenterology/clinic medicine, nephrology/clinic medicine, allergy-immunology and adolescent medicine . This balanced exposure to general pediatric medicine in addition to comprehensive subspecialty fields  prepares our residents for a future in primary care or further specialized training.

NICU

Pediatric residents care for neonatal intensive care patients in two distinct educational settings. Residents care for critically ill neonates with a wide variety of diseases in the 79 bed Level 3c regional perinatal center at SSM Health Cardinal Glennon Children’s Hospital. Residents do not have overnight call responsibilities during their Level 3c NICU experience.

Residents gain additional neonatal intensive care experience, including neonatal resuscitation immediately following birth, serving infants of high-risk obstetric mothers at our 30-bed Level 3a perinatal center at SSM Health St. Mary’s Hospital. Residents are on-call every four to five nights on average during their St. Mary’s neonatology rotation.

PICU

A 21-bed pediatric intensive care unit at SSM Health Cardinal Glennon Hospital admits critically ill patients with a variety of severe medical, surgical (including cardiothoracic surgery, neurosurgery, and solid organ transplant), and Level 1 trauma diagnoses. The unit also offers extracorporeal membrane oxygenation (ECMO) capabilities. Senior residents complete this month-long rotation and gain the clinical experience needed to recognize and initiate care for a diverse range of life-threatening conditions.

Outpatient Rotations

Emergency medicine experience takes place in the emergency department at SSM Health Cardinal Glennon Children's Hospital, a Level 1 Trauma Center, caring for critically ill children who are often transferred from various regions in the bi-state area for specialized care. In addition to being staffed by residents, the emergency room provides 24-hour on site pediatric emergency medicine attending coverage. In the ED, residents have the opportunity to acquire skills including resuscitation of critically ill children, initial evaluation and treatment of a variety of medical and surgical problems, as well as suturing and splinting.

Residents also complete rotations in ambulatory medicine in their first and second years at the Danis Pediatric Center located on site at SSM Health Cardinal Glennon Children’s Hospital. Here, residents have the opportunity to provide care for both acute and well child visits in their clinic, obtaining continuity over the course of three years.

Unique to pediatric programs, residents at Cardinal Glennon also get the opportunity to experience the services available to children in the community. The longitudinal CARE (Community Advocacy through Resident Education) experience includes touring child care centers, visiting pediatric patients on home nursing visits, and assisting in lead inspections while on outpatient rotations.

All residents will also see patients at the Knights of Columbus Developmental Center (KOC) during their developmental medicine rotation in the first year of training. Located on block west of the main hospital, KOC is a state-of-the-art facility, providing multidisciplinary care to children with a variety of developmental disorders.

Other subspecialty experiences, including adolescent medicine, neurology and subspecialty electives, are mixed inpatient and outpatient rotations. Residents are involved in caring for children in the clinics as well as observing specialty-specific outpatient procedures (endoscopy, bronchoscopy, cardiac catheterization, to name a few), and following patients on the inpatient services, providing specialty-specific consultation services with the oversight of the subspecialty faculty.

Electives and Other Rotations

Residents will have a total of six months of subspecialty electives plus a month of neurology over the three years of their residency. On these rotations, residents will have hands-on experience of assessment and evaluation of patients under the direct supervision of faculty and fellows. Below is a list of available electives. In addition, as a part of the individualized curriculum (for those not on the advocacy or global health tracks) however, there is an opportunity to design your elective with a faculty member and the approval of the program director.

Allergy/Immunology
Cardiology
Endocrinology
Gastroenterology
Genetics
Hematology/Oncology
Infectious Disease
Nephrology
Pulmonology
Rheumatology
Neurology (required in second year)
Child Psychiatry
Dermatology
Ophthalmology
Otolaryngology
Orthopedics/Sports Medicine
Pediatric Radiology
Pediatric Surgery
Anesthesia /Sedation
Radiology

 

Continuity Clinic

Residents have their continuity clinic at Danis Pediatric Center, which sees almost 20,000 visits per year. Danis Pediatrics combines the excellence of SSM Health Cardinal Glennon Children's Hospital and Saint Louis University School of Medicine to develop a model of pediatric practice to serve as an example of excellent medical care for students and residents.

Each resident is assigned to a continuity clinic preceptor and day although, to accommodate the resident schedule, residents will have clinic on other days as well. At a minimum the residents will each have a half-day clinic 36 times per year, most residents will be in clinic well over 40 half-days. Third residents may choose to have their continuity clinic continue at Danis Pediatrics or elect to switch a community site or to a subspecialty clinic (with faculty approval).

First-year residents see three to four patients per session, second-year residents see four to six patients per session, and third-year residents see seven to eight patients per session. Each resident’s clinic includes children of all ages, children with chronic diseases, well children, and children with a variety of social and behavioral problems. The continuity clinic allows for a longitudinal experience of both routine and complex patients.

Continuity patients can obtain advice after hours through a nurse answering service with resident and attending back up. Second and third-year residents rotate providing backup to the nurse line from 4:30 p.m. to 10 p.m. on weekdays and 8 a.m. to 10 p.m. on weekends and holidays. Residents always have faculty backup.

Approximately 80 percent of patients at Danis Pediatric Center are covered by Medicaid. The physicians and staff take a very active role in the care of patients with chronic medical problems, with an additional focus on the social determinants of health and their impact on families. In addition to the medical and nursing staff, Danis Pediatrics has a psychologist and two dedicated social workers. The practice has initiatives in child foster care, refugee health, foreign adoption, perinatal depression, parenting interventions, infant mortality, food insecurity and recently enrolled in Missouri Health Net's Primary Care Health Home program. 

Ambulatory Services

Each year, more than 160,000 patient visits are made to the Ambulatory Care Center and Emergency Services. Ambulatory care services are provided through 45 general and subspecialty care clinics, including:

  • Adolescent Medicine
  • Allergy/Immunology
  • Audiology
  • Bleeding and Blood Clotting Disorders
  • Cardiology
  • Cardiothoracic Surgery
  • Cerebral Palsy
  • Child Protection
  • Cleft Palate
  • Clinical Nutrition
  • Dental Services
  • Dermatology
  • Developmental Pediatrics
  • Endocrinology/Diabetes
  • ENT
  • F.A.C.E.S. (Foreign Adoption)
  • Gastroenterology/Hepatology
  • Genetics
  • Gynecology
  • Hematology/Oncology
  • Infectious Disease
  • Medical Diagnostic
  • Myelomeningocele
  • Nephrology
  • Neurofibromatosis
  • Neurology
  • Neurophysiology/EEG
  • Neurosurgery
  • Nursery Follow-up
  • Ophthalmology
  • Orthopedics
  • Pediatric Rehabilitation
  • Plastic Surgery
  • Pulmonary Medicine/Cystic Fibrosis Center
  • Psychiatry
  • Psychology
  • Resident Continuity
  • Scoliosis
  • Sleep
  • Surgery
  • Therapy Services (PT/OT/ST)
  • Urology
  • Weight Management