The adolescent division provides an excellent overview in the care of teenagers. The resident is intimately involved in patient evaluation in several clinics including a large local HMO and the resident teaching clinic. These experiences develop diagnostic therapeutic skills for a wide spectrum of adolescent health problems.
The allergy/immunology division, with close involvement from the allied field of pediatric pulmonary medicine, provides residents an excellent opportunity to become proficient in caring for patients in this area. The combination of dedicated faculty earnest about teaching, and the extensive clinical experience obtained in the large and busy outpatient clinic, active ICU, and ward inpatient services result in a well-balanced educational program.
The section of behavioral pediatrics is involved in evaluating and treating children with many complaints including attention deficit disorders, sleep disorders, and discipline problems. During their one-month rotation, residents participate in providing care at the Loma Linda Faculty Medical Office and at the pediatric teaching office and also visit various schools and agencies that comprise the community supportive network. Some of the patients whom the resident evaluates may be followed by the resident in the weekly continuity clinic.
The cardiology division follows a diverse inpatient population, providing consultative support to the other pediatric services. Residents are encouraged to attend echocardiograms, diagnostic and therapeutic cardiac catheterizations, as well as cardiac surgeries. An exciting aspect of this rotation is the opportunity to be part of one of the world's largest pediatric heart transplant program. In the outpatient clinic experience, an interpretation of cardiac murmurs and follow-up of cardiac problems under the direct supervision of an attending cardiologist is especially valuable.
A pediatric dermatology rotation is available to residents to be trained under specialist in an outpatient setting. One-on-one training with a dermatologist, in-patient consults and outpatient procedures are all part of the hands on experience that is available to the residents.
Inpatient duties during the endocrine elective include consultations for patients with newly discovered disorders and follow-up of established patients admitted with exacerbations of their disease. The majority of the resident's time, however, is spent in the outpatient setting. Weekly multidisciplinary diabetes team clinics are held in addition to daily clinics for initial evaluation and follow-up of patients with other endocrine disorders. During the summer months, residents may also participate in week-long camps for children of various ages with diabetes held in the nearby San Bernardino Mountains.
The evaluation of possible child abuse is one of the most difficult and stressful aspects of pediatric practice. During this rotation, you have the opportunity to work with one of the top forensic pediatricians in the nation. Through this exposure, the resident develops diagnostic expertise while attending multidisciplinary clinics for the evaluation of possible physical and sexual abuse. Residents learn about the treatment of such children and the legal aspects of child abuse as they pertain to the child, family, and physician is also provided.
The gastroenterology rotation consists of both inpatient and outpatient services. Inpatients include those with failure to thrive and other nutritional disorders as well as those with intrinsic bowel or liver disease. House staff have the opportunity to assist with numerous procedures such as liver biopsies and endoscopy. They are also exposed to the intricacies of nutritional supplementation. Outpatient clinics, including the multidisciplinary cystic fibrosis and total parenteral nutrition clinics, as well as general gastroenterology clinics, provide an essential aspect of the learning experience.
The outpatient experience in genetics includes participation in both the newborn and maternal serum alpha fetoprotein screening program, genetic counseling, prenatal diagnosis, and evaluation of a wide variety of genetic diseases and dysmorphology in clinic patients. Inpatient consultations provide the opportunity to evaluate birth defects, heritable diseases, and metabolic disorders in newborns and children of all ages. Residents are also exposed to chromosome analysis in the cytogenetics laboratory.
Hematology/oncology experiences are available in both the inpatient and outpatient settings. The inpatient service includes daily care of the approximately 30 patients hospitalized for treatment of neoplasms or blood dyscrasias as well as consultations on ward and nursery patients. Pediatric nurse practitioners assist with these inpatient duties. The outpatient service includes daily clinics for the evaluation of new patients and follow-up of established patients. Proficiency in performing bone marrow exams, in evaluating peripheral blood smears, and in administering chemotherapy are some of the skills that may be obtained during this rotation.
Much of the morbidity and mortality in pediatrics is still related to infectious diseases, so it is no surprise that this service has an active consulting role in many of our inpatients. Outpatient clinics and monthly infectious disease conferences augment the learning experience.
Loma Linda's newest rotation! Team "L" is a community hospitalist rotation at White Memorial Medical Center in East Los Angeles. The senior resident will take care of a general pediatric ward that concentrates on usual diagnoses seen by a general pediatrician in the community. The resident will work with Loma Linda medical and physician assistant students, as well as supervise White Memorial or Glendale Adventist family medicine interns. Community pediatric hospitalists who are also Loma Linda University faculty members will supervise the team.
Loma Linda offers a full range of services for children with renal disorders including peritoneal dialysis, hemodialysis, and renal transplantation. In addition to caring for chronic renal failure patients, the residents are also involved with inpatient and outpatient evaluation and follow-up of a wide variety of acute and chronic renal disorders.
We are fortunate to have excellent child neurologists and a world-class neuroradiology service. The resident benefits from a complete range of neurological problems in both the inpatient setting and in a busy outpatient clinic.
This rotation emphasizes the community outreach activities that general pediatrician are often involved with. During this month, the resident is able to lecture at schools and community centers, participate in outreach projects with homeless children, work at clinics for underserved youth, in addition to many other advocacy and outreach opportunities.
Residents receive training in the evaluation and care of congenital hip dislocation, scoliosis, spina bifida, club foot, and a number of other areas pertinent to the pediatrician. The month-long elective includes participation in surgical procedures, daily rounds, lectures, conferences, and general as well as specialty clinics.
The division of child psychiatry offers exposure to the various aspects of child and adolescent psychiatric and emotional disorders while working with a full staff of psychiatrists, psychologists, and counselors in both outpatient and inpatient settings. The resident participates in evaluation of the child, and often the family as well, in providing comprehensive outpatient service.
An elective rotation is available to residents who desire training in the exciting field of rheumatology. Residents work side-by-side with a pediatric trained rheumatologist in both the in-patient and out-patient settings.
LLUCH is the pediatric surgery referral center for much of Southern California. During this elective, the pediatric resident works directly with the pediatric surgery attendings and participates in surgical procedures, trauma care, pre- and post-operative evaluations, daily rounds, outpatient clinics, didactic lectures, and conferences. We are fortunate to have the support of surgeons with pediatric expertise in all surgical subspecialties including cardiothoracic, plastic, urology, and head and neck.