Curriculum Overview

3+1 Resident Block Schedule (AIRE Study)

The Pediatrics Residency Program at UTCOM-Chattanooga transitioned to an X+Y (3+1) immersion schedule on July 2019. In this format, each resident spends three weeks on a core or block rotation followed by one week of ambulatory pediatrics. This scheduling format is part of a pilot project (called AIRE) approved by the ACGME Pediatric Residency Review Committee. The goal of this scheduling format is:

Improved continuity in pediatric resident clinics
Less conflict between inpatient and ambulatory responsibilities
Improvement in resident wellness, leading to less burnout
Improved patient and resident satisfaction

During core rotations (inpatient/hospital medicine, subspecialty electives, PICU, etc), residents' time is devoted to that rotation. Clinical duties and educational efforts of core rotations are not interrupted for residents to attend continuity clinic.

Sample Block Rotation (in weeks)

Sample Block Rotation Table

Sample Block Rotation as a table (in weeks)
	PGY-1	PGY-2	PGY-3
Hospital Medicine	12	7	9
NICU	3	3	0
Emergency Medicine	3	3	3
Community Rotation	3	0	0
Ambulatory	10	10	10
Night Float	3	3	6
Newborn Nursery	3	0	3
Developmental/Behavior	0	3	0
Psychology	0	2	0
Vacation	3	3	3
PICU	0	9	0
Heme/Onc	3	0	3
Adolescent	0	3	0
Elective Rotation	9	6	15

Ambulatory/ Continuity Clinic

Likewise, during the ambulatory weeks, residents can focus strictly on general outpatient pediatrics. Residents spend four half days in the general pediatric continuity clinic and three half days in the acute care clinic. Additional time during the ambulatory weeks include an educational half day to work on research or quality improvement projects and participate in community service and advocacy projects. Residents remain with the same cohort of residents for the ambulatory week for the entire year, allowing the development of a "Group Practice" model and optimizing teaching and learning. Continuity clinic didactics occur once a week with interactive sessions developed and presented by the faculty from the Division of Ambulatory Pediatrics.

The children in continuity clinic are followed for the entire duration of the resident's training. Well children are followed for health promotion visits, children with acute illnesses are managed, and children with chronic illnesses are followed concurrently with pediatric subspecialists. The patients are seen by their regular resident physician for as many of their healthcare visits as possible. This experience simulates the usual practice of private pediatricians. It also helps the resident learn longitudinal, on-going care of children with acute and special health care needs in a way that no month-long rotation can provide. Residents follow 150+ families through the continuity clinic during residency. Our general pediatric clinic is proud to care for a culturally diverse patient population with an extensive list of pathology, which provides our residents with a well-rounded and robust educational experience.

Sample Ambulatory Week

	Monday	Tuesday	Wednesday	Thursday	Friday
Morning	Continuity Clinic	Acute Care Clinic	Continuity Clinic	Acute Care Clinic	Acute Care Clinic/ Multidisciplinary Clinics
Afternoon	Continuity Clinic	Acute Care Clinic	Continuity Clinic	Independent Study	Didactic Lecture Block

Intern Bootcamp

One unique aspect of the 3+1 schedule at UTCOM is the inclusion of an initial four-week bootcamp month. New interns spend one week in each of the key areas of the hospital: inpatient wards, night float, newborn nursery and ambulatory clinic, allowing interns to understand the workings of the entire system beginning with the first month of their residency. *In the color graphic above, the weeks of bootcamp are counted as part of the clinical rotations, rather than their own bootcamp rotation.

Didactic Teachings

	Monday	Tuesday	Wednesday	Thursday	Friday
Morning	Morning Report	Board Review or Ambulatory Lecture	Grand Rounds	Morning Report
Afternoon					Didactic Lecture Block