The BCRP for the implements new ACGME changes

As new ACGME Pediatric Program Requirements are implemented starting in AY 2025-2026 and continuing into AY 2026-2027, there will be substantial changes in the allocation of time in the program among Inpatient Experiences, Ambulatory Experiences and Individualized Curriculum. We are excited to implement these new ACGME changes which will provide residents with an outstanding balance of learning opportunities! Overall, we will phase in these new requirements over 2 years and there will be a re-balancing of the residency curriculum with reductions of inpatient experiences and increases in the amount of time spent in ambulatory experiences and individualized curricula.

Inpatient Experiences

The BCRP has always provided a broad and in-depth exposure to inpatient pediatric medicine. With the implementation of the new ACGME requirements, we will reduce the amount of time spent on inpatient rotationsby about 12 weeks over 3 years. In doing so, we have two major educational priorities: 1) provide a broad exposure to general pediatrics inpatient experiences; and 2) ensure adequate time on critical care rotations to expose residents to the sickest patients in the hospital.

Ambulatory Experiences

Our program will expand ambulatory time throughout the program, especially in the first two years. We will introduce an Ambulatory Subspecialty Selective experience as a 2-week rotation in the first year and a 2-week rotation in the second year from a curated list of subspecialty rotations at BCH (Hematology and Endocrinology) and BMC (Neurology). In AY 2026-27, there will be new Ambulatory Subspecialty Selectives at BCH (Cardiology) and at BMC (Cardiology) during the PGY2 year. A new General Pediatrics Ambulatory rotation will feature ample time in the urgent care clinics at BCH and BMC, as well as in “specialized” general pediatrics clinics such as Healthy Weight, Grow Clinic, the Pains and Incontinence Program and the Headache Clinic. Behavioral and Mental Health curriculum is being expanded from 2 weeks to 4 weeks over the 3 years. These ambulatory experiences offer residents the opportunity to see a variety of patients as they first present for care in the general pediatrics ambulatory clinic setting.

Individualized Curriculum

We have catalogued nearly 80 elective experiences for residents to select for their individualized curriculum. Of the 40 weeks of individualized curriculum, 20 weeks will be Elective time during which residents may choose to focus on more in-depth clinical or scholarly experiences, including a unique feature of the BCRP, the Academic Development Block. The remaining 20 weeks is devoted to Subspecialty experiences which will include time on inpatient subspecialty consultation services and in ambulatory subspecialty clinics. The individualized curriculum is intended to support the learning needs and career plans for each individual resident.

BCRP Coaching Program

The BCRP launched a Coaching Program in the Fall of 2023. Coaches meet with their residents “Coachees” at least 6 times per year and develop a longitudinal relationship with them over their years of training. To enhance their effectiveness as Coaches and to facilitate the development of skills and coaching strategies, we offer Coaches a Faculty Development. We intend study the impact of the Coaching Program on the professional development of residents, the feeling of connectedness of trainees to the faculty and the BCRP leadership and the impact of the program on Coaches’ satisfaction and professional identity. We believe that this program will also have a positive impact on resident wellness.

BCRP Educational Units and the A+B+C Sequence of Rotations

In the 2022-2023 Academic Year, the BCRP made a transformative change to X+Y scheduling. We have further refined this X+Y model of 6-week Educational Units with what we now term A+B+C. There are eight 6-week Educational Units per year with an additional 4-week period over the holidays (Christmas, New Year’s, Hanukkah). A+B+C represent the three 2-week blocks in each Educational Unit. A+B blocks feature mainly inpatient rotations but will also include ambulatory and individualized curricular time as we rebalance time in training. C blocks will include Electives, Ambulatory Subspecialty rotations, Subspecialty rotations (a mix of ambulatory clinics and inpatient consult services), Primary Care, Developmental Behavioral Pediatrics, Adolescent Medicine, Behavioral and Mental Health and the Teach Rotations. We are committed to providing an optimal exposure to the breadth of pediatrics and an opportunity to balance inpatient and ambulatory time.

Medical Team Associate Program

Several years ago, we introduced a program of Medical Team Associates (MTA) on the Pediatric Hospital Medicine (PHM) Teams to further enhance the clinical learning environment: MTA’s serve the inpatient teams to offload tasks from residents, such as arranging for tests and procedures, obtaining medical records, scheduling interpreters, arranging for durable medical equipment for discharge, scheduling follow-up visits and the like. Other programs who have similar staff have found that it makes a huge difference for residents by allowing for more time to be at the bedside or to participate in self-directed learning activities. The MTA Program has had a positive impact on workload and wellness the program is expanding beyond PHM teams to GI. We anticipate that this expansion will continue on inpatient services.

Pediatric Hospital Medicine Teams

Pediatrics Hospital Medicine (PHM) Teams A, B and C consist of a supervising resident and two interns with approximately 12 patients per team. There is a fourth team, PHM D, which is a non-teaching service staffed by a PHM attending physician and a Nurse Practitioner. PHM Teams (A, B, C) provide inpatient care to patients with a variety common inpatient general pediatric conditions and also provide care for patients with behavioral and mental health conditions who require inpatient hospitalization. PHM D provides inpatient care with a unique focus on patients with behavioral and mental health conditions. Every Thursday from 8:00 to 8:30 am in the Housestaff Lounge, supervising residents will lead PHM Chat, a case-based discussion with a recent patient on the PHM teams. Each Friday from 8:00 to 8:30 am in the Housestaff Lounge, interns will lead PHM Chat. These cases feature clinical conundrums and illustrative, bread-and-butter teaching cases to share clinical pearls.

Admit Teams

In AY 2025-26, we launched two Admit Teams, Twilight (3 pm to 11 pm) and Overnight (11 pm to 7 am) that will handle all of the admissions to PHM Teams. A separate team will cover all of the existing patients already admitted on PHM Teams A, B, and C after the afternoon handoff at 5 pm