Residents and fellows at St. Christopher’s Hospital for Children play an active role in the numerous hospital departments and sections. Click on the links below for a quick overview of their involvement:
Adolescent Medicine Section
The Adolescent Medicine Section provides comprehensive evaluation and management of medical problems in adolescent patients. The Section maintains close contact with pediatric, surgical and gynecologic subspecialists as needed. The Adolescent Medicine team provides teaching and patient consultation to residents at all levels of training and a formal rotation in the second or third year.
Behavioral and Developmental Pediatrics Section
The scope of the Behavioral and Developmental Pediatrics Section covers the evaluation of behavioral abnormalities in children, assessing learning difficulties and screening children to identify developmental problems. The Section supervises a number of support services and coordinates referrals to them for proper assessment and treatment.
Residents gain experience in the Meningomyelocele Clinic and the follow-up program for high risk infants. Residents on elective learn how to do developmental evaluations and integrate findings from psychology, speech and hearing and related disciplines.
Members of the Cardiology Section also serve in St. Christopher's Heart Center for Children, along with staff from the Section of Cardiothoracic Surgery. Together, the sections provide services for the diagnosis and treatment of congenital and acquired diseases of the heart in children and young adults.
Services include an invasive electrophysiology laboratory, holter and transtelephonic monitoring, doppler and fetal screening services, and a program of diagnostic and interventional catheterization including digital imaging. In addition, a surgical program features open- and closed-heart surgery in infants and children, electrophysiologic surgery, use of external assist devices and comprehensive cardiac and cardiopulmonary transplantation program.
Residents may participate with faculty members on investigative work in the areas of myocardial function, fetal physiology and surgery, clinical electrophysiology, exercise physiology, echocardiography, biomedical engineering and transplant physiology.
Clinical Genetics and Dysmorphology Section
This section offers a wide range of clinical and laboratory services in medical genetics. Clinical services include teratogen risk assessment as well as diagnosis and follow-up of children with genetic syndromes and birth defects. Genetic and prenatal counseling is available. Laboratory services are provided for chromosome analysis of peripheral blood, bone marrow, solid tumors, skin and amniotic fluid.
The clinical program encompasses inpatient and outpatient services for children, and outpatient services for adults in the areas of Mendelian genetics, cytogenetics, prenatal diagnosis, congenital malformations, multifactorial diseases, syndromes, mental retardation and related problems.
The resident on elective participates in the evaluation, testing, management, follow-up and counseling of patients (and/or their families) representing a broad spectrum of clinical genetic problems. Responsibilities include care of hospital patients on the genetic service and consultation on patients with genetic problems admitted on other services. Consultation service is provided to other hospitals in the Delaware Valley.
Critical Care Section
The Section of Critical Care at St. Christopher's Hospital for Children is committed to excellence in clinical care, education and research.
In addition to providing family-focused clinical care of a high quality, we aim to provide educational opportunities in clinical care and research for medical students, pediatric residents and subspecialty fellows. Our section provides an academically stimulating environment that promotes excellence in clinical and basic research and other scholarly activity for faculty and trainees. We also promote excellence in clinical care, education and research in related disciplines such as nursing and respiratory care.
The Section of Critical Care oversees a wide range of programs and services available at St. Christopher's Hospital for Children, including:
- Pediatric Critical Care Services, which is provided in the 33-bed clinical areas in the Pediatric Intensive Care Unit (PICU), Cardiac Intensive Care Unit (CCU), Special Care Unit (SCU) and Pediatric Burn Unit
- ACGME approved fellowship program
- Rapid Response Team
- Code Blue Team
- Extra Corporeal Membrane Oxygenation (ECMO)
- Palliative Care Services
- Painless Pediatric Procedural Sedation Services
Emergency Medicine Department
The Department of Emergency Medicine provides emergency care for ill or injured children. The Department treats approximately 60,000 children annually with a wide variety of medical and trauma-related emergencies. As part of a tertiary care pediatric hospital with a complement of pediatric subspecialty consultants, the patient population includes many children with chronic medical conditions. The Emergency Department is staffed 24 hours-a-day by physicians trained in pediatric emergency medicine.
A comprehensive education program in pediatric emergency medicine for residents includes daily case conferences, radiology conferences, biweekly lecture series and procedures workshops. The faculty participates in certification of residents and nurses in Pediatric Advanced Life Support (PALS). Senior medical students and visiting residents from pediatric, emergency medicine and family practice programs also receive training in the Department.
The program includes fellowship training for physicians who have completed pediatric residencies or who have residency training in emergency medicine. Fellows and residents participate with attending pediatric emergency physicians in research activities, which include toxicology, asthma management, rehydration and pediatric injuries.
Endocrinology, Diabetes and Metabolic Disorders Section
This Section provides comprehensive diagnostic and therapeutic services for children and adolescents with endocrine disorders or metabolic disorders, such as hypoglycemia, diabetes mellitus, various types of rickets, and selected inborn defects of carbohydrate, amino acid and urea cycle metabolism.
A special diabetic service uses a multidisciplinary approach to provide medical care, education and support to patients and their families. A support group for teenagers meets monthly.
The Section offers an elective rotation for second- and third-year pediatric residents. This training program provides the resident with the background to diagnose and manage endocrine diseases and to understand the physiology of hormonal regulation in childhood and adolescence.
The Section has an approved fellowship training program of clinical endocrinology and metabolism combined with basic and/or clinical research. Research interests involve problems of growth, pubertal development, thyroid disorders and autoimmune mechanisms of endocrine disease.
Gastroenterology and Nutrition Section
The Gastroenterology and Nutrition Section provides consultative and diagnostic services for children with a variety of gastrointestinal, hepatic and nutritional disorders. A wide spectrum of conditions is seen on both inpatient and outpatient services and includes children with inflammatory bowel disease, malabsorption, peptic disease, neonatal jaundice, failure to thrive and disturbances of gastrointestinal motility.
The GI Diagnostic Laboratory offers diagnostic and therapeutic modalities including gastrointestinal endoscopy, upper and lower GI manometry, intraesophageal pH monitory, hydrogen breath testing and interventional endoscopic procedures.
Ample opportunity exists for interaction and collaboration with the Surgery, Radiology and Anatomic Pathology sections at St. Christopher's.
General Pediatrics Section
This Section has the principal responsibility for the organization, conduct and evaluation of the general pediatrics curriculum on both an outpatient and inpatient basis. In fulfilling this role, the Section is categorized into several divisions.
- Ambulatory Pediatrics Division: The Ambulatory Division of General Pediatrics provides primary comprehensive continuing care for infants and children, most of whom reside in North Philadelphia. The facility also has a full-time social worker and special-needs coordinator. Preclinic conferences on outpatient pediatric issues are conducted daily.
- Diagnostic Referral Service: This group deals with a variety of problems for which families or physicians have requested a second opinion. In addition to office and telephone consultation to outside physicians, the group provides in-hospital consultations to pediatric subspecialty and surgical staff. This service provides backup to pediatric residents doing general pediatric consults.
Members from the practice group rotate as full-time members of the General Pediatrics Section and as attending pediatricians at St. Christopher's. In addition to direct participation in the day-to-day supervision of medical student education, the practice group has direct involvement in the daily education of pediatric residents in General Pediatrics.
The hematology/oncology team is a dedicated mix of physicians, doctoral-level scientists, nurse clinicians, nurses, social workers and play therapists who work together to provide clinical care, research and family support for children under their care.
Hematologists provides medical care for children with hemoglobinopathies, congenital and acquired anemias, and white cell and coagulation disorders. The oncology team follows children with leukemias and solid tumors and is a full member of the Pediatric Oncology Group (POG).
The Hematology Section has programs for both sickle cell anemia and hemophilia. A broad-based referral network assures a steady influx of interesting hematologic and oncologic problems on a consultative and follow-up basis.
In the pediatric hematology/oncology program at St. Christopher's, residents learn to diagnose and manage various hematologic and oncologic disorders in infants, children and adolescents.
Our established research program is a crucial part of the training program, with externally funded research in the areas of platelet-endothelial cell biology, hemophilic arthropathy and sickle cell anemia.
The Section also supports a three-year fellowship training program.
This Section provides consultation or continuing care in the diagnosis and management of possible or diagnosed defects in natural resistance and the immunologic aspects of other diseases.
Section faculty also conduct a comprehensive multidisciplinary program of care and support for, as well as research on, children affected by HIV and their parents as part of the Philadelphia Pediatric AIDS Demonstration Project and Philadelphia Pediatric AIDS Clinical Trials Unit. Infants of HIV-infected mothers are followed from birth.
Because this program helps keep hospitalization of HIV-infected children and adolescents to a minimum, residents may select the immunology elective to gain significant experience with this disease. The elective offers residents the opportunity to participate in the intensive multidisciplinary outpatient care of these children. Residents will also learn techniques used in national clinical trials, read about and discuss aspects of clinical immunology or pediatric HIV infection and conduct a more in-depth study of one aspect of special interest.
Infectious Diseases Section
The Section of Infectious Diseases provides comprehensive consultation services for the evaluation and treatment of children with infectious diseases. The infectious diseases program, one of the major strengths of the Pediatric Residency Program at St. Christopher's, is excellent post-residency preparation for a career in pediatric practice or academic subspecialization. Among the assets of the program are the variety of clinical material, faculty commitment to patient care and teach, as well as to research, and full-service laboratories with academic directorship.
Residents gain experience in managing common, simple infections in outpatients, such as impetigo, acute otitis media, parasitic diseases and herpes virus infection; life-threatening primary infections, such as septicemia, toxic shock, complicated bronchiolitis, gastroenteritis and varicella; diagnostic enigmas, such as fever of unknown origin, febrile lymphadenopathy and exanthematous diseases; as well as unusual, complex infections in patients with compromised defense mechanisms, such as those that follow organ transplantation, cancer and burns.
The microbiology and virology laboratories at St. Christopher's have doctoral-level directors who are integral to the patient care, teaching and research program of the Section and the institution. Combined teaching occurs in all formats and sites throughout the hospital, from tutorials at the bench in diagnostic laboratories to the bedside, the seminar and the classroom. The integral role residents play on the subspecialty team enables them, in turn, to teach the materials they have learned to other physicians in training.
Research activities of faculty include investigation of the biology and epidemiology of special pathogens, mechanims of antimicrobial resistance, rapid diagnosis of viral infection, vaccines and vaccine-preventable disease, and infection in hospitalized children and in compromised hosts. Residents are encouraged to participate in faculty research projects.
The three-year fellowship in pediatric infectious diseases attracts individuals of the highest caliber who are preparing for a career in academic medicine.
Neonatal Medicine Section
The Section of Neonatal Medicine provides a comprehensive program of care for newborns at St. Christopher's Hospital for Children and at affiliate hospitals. Approximately 300 neonates are transported annually from Delaware Valley area hospitals to St. Christopher's, many of whom require the tertiary care of pediatric surgical and medical subspecialists. Affiliate sites provide routine as well as high-risk delivery room experience.
Residents play an integral part in the nursery services at both institutions. At St. Christopher's, pediatric residents are the primary caregivers for the 30 infants in the NICU under the guidance and supervision of fellows in neonatal-perinatal medicine, the Neonatology faculty and the medical and surgical attending subspecialists. Residents learn to diagnose and treat a wide variety of both common and uncommon maladies, including respiratory failure, heart disease, genetic abnormalities and various congenital malformations, many of which require surgical intervention and the management of critically ill infants on ECMO.
At the Hahnemann site, residents will attend all of the high-risk deliveries and learn the principles and practice of neonatal resuscitation. First- and second-year house officers staff the Intensive Care Nursery, which cares for the very low birthweight infant as well as for other sick newborns. In addition, first-year residents learn well-baby care during rotations through the newborn nursery term.
Research involvement of the faculty and fellows provides additional breadth to the learning experience of pediatric residents. Interests of the Section include the investigation mechanisms for brain injury in the neonatal animal model, including the role of hyperoxia, hypoxemia, hyper and hypocarbia, the effect of dexamethasone on the developing central nervous system, the role of cytokine-mediated brain injury, HIV transmission and therapy, and thymic modulators in the severe combined immunodeficient animal model.
The Section offers a three-year accredited fellowship training program in neonatal-perinatal medicine with three fellows each year. An optional fourth year of basic research fellowship can be arranged according to the candidate's qualifications and interests.
The Section of Nephrology provides immediate and long-term care in the evaluation and treatment of children with acute and chronic renal disease, urinary tract infections, kidney stones, hypertension, and all types of fluid, electrolyte and acid-base disturbances. We have a large and active pediatric dialysis and renal transplantation center. The Center provides dialysis for both acute and chronic patients, either at home or at the hospital, in cooperation with an active pediatric transplantation service.
Educational opportunities for the resident include daily rounds, outpatient and didactic conferences, journal club meetings, and conferences with the Urology Section and Department of Radiology, to provide evaluation and care of a wide range of urological problems. Weekly and monthly conferences focus on dialysis and renal transplantation programs, to allow a multidisciplinary approach toward individualized patient care.
Research activities of the Section focus predominantly on pediatric clinical investigations. The areas of research include cytotoxic therapy for nephritis and nephrotic syndrome; vitamin D therapy for renal osteodystrophy, hypertension and kidney stones; electrolyte abnormalities in acute renal failure; clinical aspects of chronic renal failure; and dialysis and transplantation with emphasis on growth, nutrition, osteodystrophy, hypertension, infections and neurologic problems.
The Neurology Section provides comprehensive diagnostic services and therapy for acute and chronic disorders of the central and peripheral nervous systems. Pediatric neurologists evaluate both common symptoms, such as headache syndromes, school failure and developmental failure, as well as unusual disease including seizures, neuromuscular abnormalities, coma and metabolic encephalopathy.
The Neurology Section conducts a number of specialized clinics. The Pediatric Epilepsy Program focuses on the investigation and design of therapy for patients with seizures. The program includes standard EEG, ambulatory EEG, video EEG, direct corticography, neurophysiologic investigation and surgical intervention by a neurosurgeon who specializes in epilepsy. Other programs include a metabolic center for therapy of PKU and neuromuscular clinic.
The Section of Neurology treats 7,000 outpatients annually, and an additional 1,000 inpatients.
Epilepsy and seizures comprise about half of the total patient visits.
Through the format of daily rounds with the attending child neurologist and participation in conferences including neuropathology, neuroradiology, neurosurgery, neuro-ophthalmology and review of current literature, residents and fellows gain experience in the application of neuroscientific principles to clinical problems.
Research projects of the Section include studies of trace metal metabolism, defects in neurotransmitter function in infantile spasms and the role of opioid metabolites in the genesis of seizures, among others.
The Child Neurology fellowship training program equips the physician for certification in neurology with special competency in child neurology.
Pediatric Pulmonology Section
As one of the largest pediatric pulmonary and cystic fibrosis centers in the nation, the Pediatric Pulmonology Section at St. Christopher's Hospital for Children offers rich clinical experience and many research opportunities to residents.
The Section provides a bronchopulmonary dysplasia service, apnea and sleep-related disorders evaluation, fiberoptic bronchoscopy, sweat testing, advanced pulmonary function testing for infants and children, exercise testing, home mechanical ventilation, emergency outpatient consultations, medical-surgical thoracic evaluations, and intensive respiratory care.
Residents have ample opportunity to participate in the management of patients with cystic fibrosis, bronchopulmonary dysplasia, asthma, recurrent pneumonia, immunologic deficiencies, congenital lung disease, acute lung injury, pulmonary complications of cardiac and neuromuscular disorders and a variety of acute and chronic respiratory diseases. This experience occurs through the outpatient office, the inpatient service, consultations and the Intensive Care Unit.
Residents also gain experience in the indications, performance and interpretation of procedures such as chest roentgenograms, standard pulmonary function tests, provocative tests of airway reactivity, infant pulmonary function testing, bronchoscopy, lung scans, tracheostomy care, endotracheal intubation and mechanical ventilation.
Basic and clinical research exists in the areas of respiratory physiology, airway growth and development, cystic fibrosis microbiology and therapy, mechanisms of cor pulmonale, nutrition, and the genetic basis of pulmonary diseases.
The Section of Rheumatology provides comprehensive consultative services, as well as immediate and long-term care, for the evaluation and treatment of children with a wide spectrum of rheumatic diseases. A multidisciplinary approach to these chronic medical disorders draws on the experience of nurse clinicians, occupational therapists, physical therapists and other support staff.
Rheumatologic and musculoskeletal problems commonly encountered include juvenile rheumatoid arthritis, systemic lupus erythematosus, juvenile dermatomyositis, limb pains of childhood, various spondyloarthropathies, Lyme disease, acute rheumatic fever and scleroderma.
The Section provides an elective rotation for residents interested in a rheumatology program. A rheumatology/orthopedics elective is also available. These electives allow the resident to act as primary consultant to the busy outpatient and inpatient services.
Daily rounds provide an opportunity to discuss specific patients, and once a week, certain clinical problems are presented in more formal discussions. This experience provides residents with a current information base on the pathogenesis of rheumatic diseases, as well as the knowledge and experience to handle many clinical situations.
Section staff involved in ongoing clinical research invite the interested resident either to participate throughout the year, or to complete a relevant literature search on a particular clinical problem while on rotation, with the ultimate intent of publishing his or her experience in a peer review journal.
The Department of Anatomic Pathology
The Anatomic Pathology Department examines approximately 4,000 surgical cases per year and also conducts autopsies. Visiting pathology residents or fellows share responsibility to performing work in these areas and actively participate in regularly scheduled general pediatric conferences and specific pediatric pathology conferences, including perinatology, pediatric neuropathology, cardiopathology, nephropathology and pulmonary pathology.
The Department offers a board-approved, one-year residency or fellowship in pediatric pathologic anatomy to anatomic pathology residents interested in pursuing this area as their career in or to general pathologists needing pediatric pathology experience.
Department of Anesthesia and Critical Care Section
Pediatric anesthesia at St. Christopher's Hospital for Children provides a comprehensive and challenging experience. The Department's pediatric anesthesia fellows, visiting anesthesia residents, pediatric residents on elective at St. Christopher's and nurse anesthesia students are closely supervised by board-certified anesthesiologists who have specialized in both pediatric anesthesia and pediatric critical care.
More than 10,000 general anesthetics are performed each year. Half of these are administered to relatively healthy children undergoing routine surgical procedures, while the other half are administered to children with complicated medical problems. Some critically ill patients need major surgical procedures, including children with heart disease required open-or closed heart surgery; end-stage renal disease requiring a dialysis access site or a renal transplant; major burns requiring excision and grafting or debridement; upper airway obstruction requiring direct laryngoscopy, bronchoscopy and perhaps tracheotomy; heart or liver failure requiring transplantation; and neonates with surgical emergencies.
The Department also offers training in managing problems that occur in the recovery room, in the critical care units and resuscitation throughout the hospital.
Department of Child Psychiatry
The Department of Child Psychiatry provides education and patient care through the Child Psychiatry Consultation Service.
This service offers psychiatric evaluation and treatment for children hospitalized for medical and surgical care; psychiatric consultation for patients seen in the emergency room; a teaching service to pediatric residents, medical students and child psychiatry fellows; and programs of research in child psychiatry and behavioral pediatrics.
Pediatric residents may take an elective in child psychiatry in the PL-2 or PL-3 year.
During this rotation, they receive training in psychiatric and behavioral evaluation of pediatric patients, as well as an introduction to psychiatric diagnosis and treatment. Residents provide consultation to admitting services under the supervision of the attending psychiatrist.
Department of Radiology
The Department of Radiology provides a wide range of pediatric imaging services including general diagnostic radiology, ultrasound, nuclear medicine, angiography, computed tomography (CT) and magnetic resonance imaging (MRI). Interventional radiographic services include assistance for organ biopsy (e.g., renal cyst aspiration, percutaneous nephrostomy).
A fellowship in pediatric radiology is designed to offer the radiologist-in-training experience in the roentgen manifestations of disease and the medical problems peculiar to infants and children. Approximately 60,000 examinations are performed yearly, including special procedures such as angiography, ultrasound, nuclear medicine, CT and MRI. To facilitate servicing this volume, the fellow participates and shares responsibility in the clinical, technical, teaching, research and administrative activities of the Department.
Residents also do rotations in the hospital’s special units including the Pediatric Burn Center, Intensive Care Unit, Special Care Unit, Cardiac Care Unit and the Neonatal Intensive Care Unit.