The curriculum and rotations of the Penn-CHOP Internal Medicine-Pediatrics Program are as follows:

X + Y (6 + 2)

• Both of our categorical programs are on the X + Y schedule with six weeks spent inpatient and two weeks spent outpatient
• Med-Peds residents tend to spend six weeks inpatient on one side, then two weeks outpatient, and then switch to the other side

Inpatient (or X)

• Inpatient rotations on the Medicine side are two weeks long while most rotations on the Pediatrics side are two weeks long, with a few exceptions that are four weeks long
• Med-Peds residents have four weeks of vacation each year that come from the X weeks; they also have a handful of days off around the winter holidays
• Elective weeks (which start second year) come from the X weeks
• While inpatient, we attend the conferences that our colleagues attend, except on Thursdays when we have Med-Peds noon conference

Intern Year (MP1)

• General Medicine days and night float
• Medical Intensive Care Unit (MICU)
• Adult Cardiology, Gastroenterology, Oncology, and/or Pulmonology services
• General Pediatrics
• Pediatric Hematology, Nephrology, Pulmonology, and Complex Care services
• Well Baby Nursery
• Neonatal Intensive Care Unit (NICU)
• Adult (HUP) and Pediatric (CHOP) Emergency Department

PGY2 (MP2)

• Elective time
• Senior resident experiences on Medicine rotations
• General Medicine days and night float
• Geriatrics
• MICU
• Adult Cardiology, Gastroenterology, Oncology, and/or Pulmonology services
• General Pediatrics
• Pediatric Oncology, Gastroenterology, and/or Rheumatology services
• Pediatric Development rotation
• HUP and CHOP Emergency Department

PGY3 (MP3)

• Elective time
• Senior resident experiences on Medicine and Pediatric rotations
• General Medicine days and night float
• MICU 
• Adult Cardiovascular Critical Care Unit (CCU)
• Adult Cardiology, Gastroenterology, Oncology, and/or Pulmonology services
• General Pediatrics
• Pediatric Hematology, Nephrology, Pulmonology, Endocrinology, Allergy/Immunology, Metabolism, Neurology, Adolescent and/or Complex Care services
• Pediatric Intensive Care Unit (PICU)
• Pediatric outpatient Cardiology
• Pediatric outpatient Adolescent

PGY4 (MP4)

• Combination of many of the rotations listed for PGY3/MP3
• NICU senior

Med-Peds Primary Care (MPPC)

• Also known as Y for Pediatrics and ILM for Medicine
• At the end of residency, Med-Peds residents should feel comfortable providing outpatient preventative care to children and adults, as well as initial workup of common outpatient complaints. They should be familiar with current guidelines and resources to provide primary care to patients of all ages.
• Med-Peds residents attend the categorical Medicine and Pediatrics academic half-days while also having a Med-Peds specific academic half-day.
• Med-Peds residents have a few of “admin” sessions every MPPC to work on inbox and panel management.
• Med-Peds residents have one wellness half-day every MPPC.
• Med-Peds residents have one to five open half-days to explore anything they would like, such as career opportunities, research, community clinics, subspecialty clinics, etc.
• Established community experiences: Puentes de Salud, Philadelphia FIGHT, YHEP, Esperanza, Prevention Point, Philadelphia Health Centers, Adult and Pediatric Refugee Clinic

Intern Year (MP1)

• Establish basic understanding of guidelines related to common outpatient visits/topics in medicine and pediatrics, including newborn and well childcare, pediatric screening tests, vaccines, puberty, women’s health, diabetes, hyperlipidemia, hypertension, CKD, COPD and asthma
• Introduction and orientation to clinic systems, differences in HUP and CHOP Epic, clinic staff and services, results and follow up, letters and telephone medicine

PGY2 (MP2)

• Learn general outpatient approach to symptom-based problems and appreciate differences across the age spectrum for common complaints, including headache, URI, UTI, rashes, hematuria/proteinuria, growth abnormalities, failure to thrive, musculoskeletal complaints
• Understand role of the general practitioner as consultant with regards to sports physical and preoperative evaluation
• Increase efficiency in clinic by seeing increased numbers of patients and improving use of clinic resources

PGY3 (MP3)

• Develop further understanding of psychosomatic and psychosocial conditions: chronic pain and substance abuse, aging, IBS, chronic fatigue, fibromyalgia, ADHD, anxiety, depression, eating disorders, parenting and discipline
• Appreciate challenges caring for marginalized populations: refugee health, language support services
• Observe differences in academic and community practice setting
• Tailor subspecialty experiences to career goals

PGY4 (MP4)

• Focus on teaching skills in clinic and didactic seminars: Med-Peds conference topic, prepare talk for categorical conferences
• Use evidence-based medicine to answer clinical questions
• Prepare for independent practice: solidify clinical experience with increased number patients per week, telephone medicine and necessary procedures

Other Longitudinal Med-Peds Curricula

All Med-Peds residents participate in these curricula.

Quality Improvement (QI)

• MP1: basics of QI
• MP2: plan and start class QI project
• MP3: complete Plan-Do-Study-Act (PDSA) cycle
• MP4: write up abstract

Transitions

• MP1: transitions basics
• MP2: attend transitions clinic
• MP3: transitions 201 with social workers and community healthcare workers
• MP4: attend transitions clinic

Medical Education

• MP1: give Peds intern report
• MP2: give Med-Peds journal club
• MP3: give Med-Peds noon conference and Peds primary care noon conference
• MP4: give Medicine senior report, give Peds morning report, facilitate Peds intern report, teach session at Peds clinics

Community and Advocacy

• MP1: visit WIC (Women, Infants, and Children) Office and PEC (People’s Emergency Center)
• MP2: attend HMHK (Healthy Mind Healthy Kids) Clinic, Dependency Court and Refugee Clinic
• MP3: attend HHI (Homeless Health Initiative) Clinic and Philadelphia Health Centers
• MP4: complete advocacy project (started as MP1 or MP2)