Med-Peds Ambulatory Training

Medicine-Pediatrics Residency Program

Med-Peds Continuity Practice

The Med-Peds residents have their combined continuity resident practice located at the Wilmington Hospital Health Center (WHHC). Residents spend in general 1-2 half days per week (except during ICU rotations) managing a panel of patients (PGY-1 = 50 patients to PGY-4 = 120 patients) listing the resident as their primary care physician. The residents are in teams which allows them to huddle and work closely using the same exam rooms, medical assistants and preceptors. We have 3 full time med-peds faculty and 6 other med-peds preceptors that do the majority of precepting along with categorical preceptors. Each med-peds resident is assigned a usual half day (Tuesday PM. Wednesday PM, Friday AM and Friday PM) to see patients but based on rotations, residents can see patients during other sessions.

Highlights of the Med-Peds Continuity Practice

  • Patient Centered Medical Home Level 3.
  • Behavioral Health Consultants (on site).
  • Breast Feeding peer assistance.
  • Financial Counselors (on site).
  • Food baskets (on site).
  • Language Services (on site).
  • Long Acting Reversible Contraception (LARC) training and placement.
  • Medical Legal Partnership (collaboration with outside legal services).
  • Pediatric supplies (thermometers, car seats, quilts, cribs).
  • PharmD (on site) .
  • Read Aloud Delaware (Book to each child every well child visit in English or Spanish).
  • Social Worker (on site).
  • Specialists (on site) and by eComm.

In addition, residents have time to participate in weekly population health time, preclinic conferences. All clinicians receive data on their panels and population to design and implement team Quality Improvement projects. All team members are trained on virtual visits.

Acute Ambulatory Care

The Med-Peds residents work in the Pediatric Practice Program (next to the Med-Peds continuity practice) at the Wilmington Hospital Health Center (WHHC) for 1 block each in their PGY-1 and PGY-3 and work at the Rainbow Clinic at Nemours for 1 block during their PGY-2 year seeing newborns discharged from the newborn nursery, acute visits and urgent well child visits to continue to hone pediatric skills.
The Med-Peds residents work in the Wilmington Adult Medicine (where the Med-Peds continuity practice is located) practice during their PGY-1 and PGY-3 year seeing acute visits, preoperative visits and walk-in patients to continue to hone adult skills.

Med-Peds Preceptorship

On elective rotations during the PGY-2 (end), PGY-3 and PGY-4 years, residents choose to work in the ambulatory offices of a primary care med-peds faculty member (can include Westside HealthCare). Residents can also choose to spend some time longitudinally in an ambulatory specialist office if their career goals include specialty care (e.g. sports medicine, hematology).

Federally Qualified Health Center

Med-Peds residents rotate during their PGY-1 year and can choose additional longitudinal or block time to work with Med-Peds faculty at Westside HealthCare that provides care in underserved communities in Delaware.

Center for Special Health Care Needs

Residents will have the opportunity to work in the Center with patients whose primary care physician is in the Center (e.g. cerebral palsy, autism, transplant patients). Residents will also rotate in specialty clinics within the center (e.g. cystic fibrosis, sickle cell, spina bifida, women’s health, inflammatory bowel disease) and also participate at community sites where patients/families go for resources.

Subspecialty Ambulatory Care

On electives, residents go to specialist outpatient offices:

  • Nemours practices: all pediatric specialties
  • Christiana Care practices: Examples includes cardiology, dermatology, endocrinology hematology-oncology, neurology, pulmonary, rheumatology, sports medicine, women’s health
  • Community practices (see both adults and children); Examples includes allergy-immunology, cardiology, dermatology, endocrinology, gastroenterology, hematology-oncology, infectious diseases, neurology, otolaryngology, sports medicine

School Based Health

Med-Peds residents rotate at the University of Delaware Student Health program and an elementary school wellness center to see how care is provided in these important settings.