171 Ashley Ave.
Charleston, SC 29425
843-792-1414
800-424-MUSC
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Specialty and Sub-specialty Training Programs
Inpatient Training
The inpatient service is a 124-bed children's hospital providing a mixture of acute and chronic
diagnostic and therapeutic challenges. Patients from the local area provide residents with
good exposure to primary and secondary types of problems, and a large number of tertiary care
patients are referred from the entire state. Full-time attending physicians are integral members
of the teams providing care on both the infant and the children's acute disease services.
Attending faculty make daily teaching rounds and are closely involved in the day-to-day operation
of all units.
It is the policy of the department to delegate the primary responsibility of caring for all
patients to the house staff. The inpatient service is conducted entirely within MUSC
Children's Hospital; it is not necessary for house staff to rotate through affiliated hospitals
for their inpatient experience.
Adolescent Medicine
Training in the care of adolescents is an important part of a pediatric residency. The pediatric
residency program at MUSC includes a very strong and diverse training experience in adolescent
medicine that is designed to provide a good foundation for general adolescent care in pediatric
practice. Adolescent medicine clinical services include an adolescent clinic, the Young Mother-Baby
Clinic, a school-based clinic at a nearby high school and an active inpatient consultation service.
The pediatric resident may have experience in all these clinical settings while on the ambulatory
rotation. In addition to this clinical training, didactic sessions in adolescent medicine are
scheduled into the resident lecture series. Residents participate in a month-long adolescent
medicine rotation. The rotation includes experience in all the adolescent clinics as well as
participation in an adolescent substance abuse treatment program and adolescent medicine didactic
seminars. Other specific areas such as sports medicine, private practice adolescent medicine or
eating disorder group therapy sessions can be arranged at the request of the resident.
Cardiology
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Cardiothoracic Surgery
The division of cardiothoracic surgery has an active pediatric cardiac surgery section with
two experienced congenital heart surgeons. Approximately 250 congenital heart operations are
performed annually. The division of pediatric cardiology works very closely with the division of
cardiothoracic Surgery in the care of infants and children with congenital heart defects. There
is a special emphasis on correction of defects early in life.
Continuity Clinic
The resident's Continuity Clinic is located on the Medical University campus. Each intern
begins with a panel of 75 patients, which will grow to 150 patients over three years. Residents
may add newborns and patients they encounter in the hospital, emergency room or outpatient
clinics. Clinic patients receive all of their health care through this system. Patients see
their own resident pediatrician for more than 50 percent of their visits, for all well checks,
for school and behavior problems which can be scheduled in advance, for almost all rechecks for
acute illness, for hospital follow-ups and for some of the initial visits for acute illnesses.
In the Continuity Clinic, residents experience the fun of following patients long enough to get
to know them and their families well. They help patients with illnesses learn how to safely stay
out of hospitals and emergency rooms. They learn how to coordinate care for their patients with
chronic health problems who need consultants. They see the myriad of relatively minor problems
that concern parents, learn how to teach parents to recognize significant problems and encourage
parents to practice good health maintenance with their children. Residents are available after
hours to answer telephones calls, give telephone advice and, when needed, bring patients in to be
seen. Health problems are discussed from an outpatient perspective at a mini-conference held at
the beginning of each morning clinic. Approximately 4,500 patients, an average of 35 patients a
day, are seen. The kept-appointment rate is over 75 percent, and patient satisfaction has been
very good.
Critical Care
The critical care division coordinates the acute care of seriously ill children. The division
directs patient care in the 10-bed Pediatric ICU. Coordination of care also extends to the
Children's Hospital transport team, including emergency transports via MUSC's MEDUCARE
emergency transport system.
Developmental Pediatrics, Child Psychiatry and Genetics
The division of developmental pediatrics operates the Vince Moseley Developmental Evaluation Center
which uses an interdisciplinary team approach in meeting the diagnostic and therapeutic needs of
children with developmental disabilities. The team disciplines include developmental pediatrics,
developmental psychology, occupational therapy, physical therapy, social work, speech/language
pathology and schools. The team of professionals works together with children and their families
through individual assessments, team staffing conferences with community professionals and follow-up
parent conferences. From these interactions, a diagnosis and treatment plan is created to meet the
specific needs of each child and his family. The types of developmental and learning problems
evaluated include: learning disabilities, behavioral and emotional problems, developmental delay
and mental retardation, cerebral palsy, autism, attention deficit hyperactivity disorder, spina
bifida, high risk follow-up, and genetic defects, as well as a variety of other developmentally
disabling neurological impairments. Fellowship training is available in this subspecialty.
The child psychiatry program is designed to stimulate and encourage the pediatrician's awareness
of the psychological aspects involved in the optimal practice of pediatrics. Consultations
are available for all patients with follow-up plans for treatment as indicated. Individualized
electives are available to learn psychiatric assessment, behavioral management, and
psychopharmacology. The two areas work together closely and operate a developmental/behavioral
clinic to address mental health needs in developmentally disabled children and adolescents.
Genetics is part of the required one-month rotation in the first year of residency through
developmental and behavioral pediatrics. During the third year of training, the pediatric
resident is given the opportunity of taking an additional one-month elective rotation in genetics.
Emergency Medicine
The division of pediatric emergency medicine provides a wide range of pediatric emergency
experiences with supervision by attending physicians. A combination of direct patient care,
teaching sessions, mock codes and resident directed conferences covers all aspects of pediatric
emergency medicine. The development of evaluation management and technical skills is integrated
with teaching the team approach needed to deal with an emergently ill or injured child.
Endocrinology
The division of endocrinology provides a comprehensive program involving the treatment
of children with diabetes mellitus, growth abnormalities, endocrine
disorders and metabolic bone disease. Residents receive intensive didactic training to prepare
them for patient care issues and board exams. The areas of particular interest include
metabolic bone disease, diabetes (type 1 and 2) and childhood obesity. The faculty in the
division of endocrinology maintain active research programs and encourage residents to become
involved in clinical and/or basic research projects. The division also began offering a
fellowship training program in 2001.
Gastroenterology and Nutrition
The gastroenterology/nutrition division diagnoses and manages children with diseases of
the gastrointestinal tract, liver and pancreas and children with nutritional problems,
including failure to thrive, malabsorption, tube feedings and parenteral nutrition.
Close collaboration with the pediatric radiologists, psychologist and surgeons as
well as the pathologist and pulmonologist is maintained on both the inpatient and
outpatient services. Residents are welcome to elect a month rotation with the division
where one-on-one didactic sessions are designed to meet the specific needs of the resident,
who is participating in the GI and nutrition clinics and managing in-house patients.
During this rotation, residents are encouraged to participate in a full range of GI procedures.
General Pediatrics
The general pediatrics division provides a wide range of experiences for the pediatric
resident. The division provides comprehensive care to children in the community and to
children with a wide variety of problems presenting for acute episodic visits.
In addition, general cases referred to MUSC Children's Hospital are cared for by
the general pediatric service. Faculty members are available and present during
all patient contacts to teach residents and students. Regular conferences are
held to discuss issues and topics of importance to general pediatricians in their practices.
The division has a very active research program, and residents frequently conduct research
projects under the guidance of division members.
Click here (pdf) for information on resident international rotations.
Health Services Research/Academic Generalist Fellowship Program
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Hematology/Oncology
The hematology/oncology division is responsible for the evaluation, treatment and follow-up care
of all patients with hematologic disorders, coagulation defects and malignant diseases. It is
also responsible, in collaboration with the adult oncology transplantation team, for pediatric
patients undergoing bone marrow transplantation and it is an integral part of the university wide
Hollings Cancer Center. In coordination with the attending hematology/oncology physicians,
the house officer assigned to this service is responsible for consultations, evaluations and treatments of both hospitalized patients and those seen in the outpatient facility. The house officer is provided with support from the Department of Pathology and Laboratory Medicine, twice-daily rounds, informal didactic teaching and frequent contact with all members of the division.
Upon completion of a rotation on this service, the pediatric house officer will
have achieved familiarity with evaluation of hematologic problems, will have the ability to
recognize and manage common problems associated with pediatric malignancies and will have
acquired the technical and psychological skills to perform these in practice. Additionally,
exposure to multi-institutional therapeutic protocols will help the house officer become
knowledgeable about the most recent advances in the care and treatment of pediatric patients
with malignancies.
Infectious Diseases and Clinical Immunology
The pediatric infectious diseases division provides consultation on a wide variety of infectious
problems. Patients with common pediatric infections are admitted from the local population while
the statewide referral population provides exposure to unusual or severe infections. The pediatric
residents interact with the division through formal or informal consultations and in topic-oriented
teaching sessions. The elective in pediatric infectious diseases gives the resident an opportunity
to see inpatient and outpatient consultations and to review the telephone consultations received
by the division. Participation in clinical research projects by interested residents is encouraged.
Internal Medicine & Pediatrics (Med/Peds)
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Neonatal-Perinatal Medicine
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Nephrology
The pediatric nephrology division provides statewide tertiary diagnostic and therapeutic
services for children with kidney and urinary tract diseases. A maintenance peritoneal dialysis
program performs more than 500 dialyses per year. A home peritoneal dialysis training program is
also provided. More than 1,500 visits are handled in the weekly pediatric nephrology clinic each year.
Weekly seminars deal with renal pathology, nephrology, urology, and patient-care problems.
The house officer is exposed to a variety of renal problems and participates in the care of
chronic dialysis patients. The nephrology elective offers an in-depth exposure, wherein the
house officer is given the chance to review the current literature and to participate in
clinical research.
Neurology
During the second training year, the pediatric resident is offered a rotation in child
neurology with supervision by child neurologists. Experience includes basic information
in pediatric neurological diseases, electroencephalography, neuroanatomy and neurophysiology.
The uses and limitations of special diagnostic studies, including cerebrospinal fluid
examination, video-EEG, and both CT and MRI scanning are considered. A clinical
approach stressing acquisition of knowledge and skills in neurological diagnosis in
the outpatient department as well as at the bedside and clinical pathological correlation is stressed.
Ophthalmology
The Albert Florens Storm Eye Institute has four pediatric ophthalmology faculty who
are available both for inpatient and outpatient service consultations. The staff manages
a large variety of ophthalmic disorders in children and assists in the diagnosis of
neurological and general systemic diseases. Lectures and seminars are available periodically
throughout the year. Pediatric residents are encouraged to spend elective time on the service
where they will become familiar with the in office diagnosis and management of common pediatric
ophthalmic disorders.
Pulmonology, Allergy and Immunology
The division of pediatric pulmonology, allergy and immunology (PPAI) came into existence in July 2000.
It is committed to providing effective and innovative patient care, education about common and rare pulmonary, allergic and immunologic disorders,
and research. It is growing in faculty, patient numbers and research projects.
Division faculty admit their patients to Team 2, so attendings make daily management/teaching rounds
with members of that team. Faculty perform consults whenever requested. Residents on the elective
and the requesting team benefit from the consult. Faculty do case-based teaching in small groups
two to four times per month. Mid- and upper-level residents who take the PPAI elective will
attend the division's three main clinics: cystic fibrosis (CF), allergy and pulmonary. Division
faculty regularly attend and contribute to morning report and provide lectures whenever requested.
The general patient groups seen in this division include allergies of all kinds, asthma, apnea,
BPD, CF, congenital abnormalities, immunodeficiencies, lung infections, neurologic disorders,
respiratory failure, restrictive lung diseases, sleep disorders and other miscellaneous conditions.
The division utilizes and teaches the concept of healthcare provision by a multi-disciplinary team.
Residents also learn a great deal about the indications for and information to be obtained
from various types of testing, including allergy testing, bronchoscopy, exercise testing,
pulmonary function testing and sleep studies.
When taking the PPAI elective, residents are strongly encouraged to do a literature review of a
topic of relevance to their future career goal. Residents interested in doing research are
encouraged to do a project with division faculty. Resident teaching is intended to provide
whatever the trainee needs. The faculty and team recognize the varying career goals of each
trainee and try to provide an experience of maximal benefit to the individual.
Radiology
The division of pediatric radiology in the department of radiology is staffed by three
fully trained full-time pediatric radiologists who have dual appointments in pediatrics
and radiology. In addition to working with the entire spectrum of pediatric radiologic
investigative procedures, they are intimately involved in resident teaching and research.
Daily conferences are held with the pediatric clinical subspecialist and house staff.
A pediatric radiology elective is offered.
Transport Service
The Children's Hospital has an established transport team especially designed for the
neonatal and pediatric patient up to age 16. This team consists of a transport nurse and
a respiratory therapist with medical control provided by the divisions of critical care and
neonatology. A fully staffed medical transport service comprised of a helicopter, airplane, and
mobile intensive care ground ambulance greatly enhance the Children's Hospital transport
capabilities.
Child Life
The child life department focuses on the psychosocial needs of pediatric patients. Child life
specialists provide diverse services to address the social, emotional and developmental needs
of infants, children and adolescents. Programming includes assessment and a psychosocial care plan
including therapeutic play and developmental support. Intervention strategies foster continued
growth and development, minimize adverse reactions to the health care experience and reduce
stress and anxiety.
Goals for children include mastery, control, opportunity for choices, self-expression and
increased understanding and cooperation with medical treatments and procedures. The department
supports family-centered care initiatives and developmentally appropriate care throughout the
Medical Center. Child life staff members manage and staff Medical Center playrooms and may
be assigned to pediatric clinics, the department of emergency services and hospital units. Child
life provides in-service classes and lectures within health care settings and throughout
the community. Topics include child development and psychosocial issues concerning
children and health care experiences. Consults are accepted from all services.
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