Loma Linda University Children's Hospital - Pediatric Residency Program - Clinical Setting

Clinical setting

The pediatric residency at Loma Linda University Children's Hospital offers a range of clinical experiences. During rotations through the Children's Hospital at Loma Linda, residents care for patients with complex diseases under the guidance of outstanding clinicians and subspecialists who are available for consultation.

LLUMC and LLUCH

The pediatric department of the Loma Linda University School of Medicine is the largest physician group serving children in southeastern California.

LLUCHLoma Linda University Children's Hospital (LLUCH) is one of the largest providers of children's health care in California and is the pediatric referral center for an area covering over one-fourth of the state. This area is one of the fastest growing in North America. In response to the expanding needs of the community, our service has rapidly expanded leading to the opening of the Children's Hospital in 1993.

The five-story structure is adjacent to the Loma Linda University Medical Center (LLUMC). LLUCH contains over 250 beds dedicated to the care of infants and children. The facilities are state-of-the-art, providing for patient comfort while monitoring all pediatric parameters.

The Children's Hospital includes administration, diagnostic, and operating room areas used only for children and shares other special services offered by the University Medical Center. These services include one of the most sophisticated neuroradiology centers in the nation with all major imaging modalities. The world's first hospital-based proton beam accelerator for cancer treatment is housed beneath the Children's Hospital.

The nurses and ancillary staff are well trained, and the staff-to-patient ratio allows excellent patient care. This frees house staff from the routine responsibilities of venipuncture, IV therapy, and other time-consuming duties. Pediatric education, as well as attending and resident physician staffing of all of our training facilities, are unified under the University's pediatric department.

Our attendings, residents, and nursing staff work closely together, forming a supportive and effective medical team. It is this attitude of cooperation and kindness that perhaps is most enjoyable to those of us who work here and to the patients and families we serve.

Ambulatory pediatrics

Outpatient offices and clinics served by Loma Linda University School of Medicine offer the resident a diverse patient population in a wide range of professional settings. From the pediatric teaching office to the emergency room, residents work with a great deal of autonomy, yet have immediate access to faculty.

Pediatric Teaching Office

The Pediatric Teaching Office is located across the street from Children's Hospital in the Faculty Medical Offices. This is a new office space for us as of 2003. The office is devoted soley to the education of residents and medical students.  It is home for most of the resident continuity clinics which meet weekly. It is a hospital based clinic where residents receive instruction in managing a variety of ambulatory pediatric problems while an attending physician supervises. In addition, residents gain experience in specialty clinics including behavioral development clinic, child neurology clinic, and adolescent clinic.

The Social Action Community Health System (SACHS)
The Social Action Community Health System (SACHS) began 35 years ago as a part-time volunteer effort by Loma Linda University and Medical Center faculty and students who were struck by the large portion of the local community's population that could not access the regular health-care system. SACHS is a three-clinic system that provides low-cost primary care and rehabilitative services for 32,000 patient visits annually. Residents receive instruction in managing a variety of ambulatory pediatric problems while an attending physician supervises.
  • Care for acute and chronic illnesses
  • Mental health services
  • Dental care
  • Physical, occupation, and speech therapy
  • Prenatal care and other women's services
  • Immunization
  • Health promotion and preventative care
  • Specialized care for HIV/AIDS

 

Faculty Medical Office/Specialty Team Center

The Faculty Medical Office and the Specialty Team Center at Loma Linda includes clinics in general pediatrics, the major pediatric subspecialties, and a number of multidisciplinary team clinics, including:

  • Bronchopulmonary dysplasia
  • Craniofacial
  • Cystic fibrosis
  • Diabetes
  • Gastrointestinal/nutrition
  • Metabolic
  • Neonatal Intensive Care Unit high-risk follow-up
  • Neurology
  • Renal transplant
  • Rheumatology
  • Spina bifida

Residents on elective and ambulatory rotations work with attending physicians to obtain excellent outpatient experience in all pediatric specialties.

Emergency departments

One month of the PL-1  and one month of the PL-2 and PL-3 years is spent in our new (opened July 2002) LLUCH Emergency Department. Additional shifts during residency are spent providing pediatric ER coverage.

Pediatric cardiac transplantation--new techniques mean new hearts for infants
Baby Fae surgery
In 1984 Baby Fae, a newborn with hypoplastic left heart syndrome, was given a xenograft heart transplant. This ushered in a new era in infant heart transplantation at Loma Linda and indeed around the world. In late 1985 the first successful neonatal human-to-human heart transplant was performed at Loma Linda University Medical Center, and the program has grown almost exponentially since that time.

Currently, Loma Linda has performed more pediatric heart transplants than any other center. The transplant program presents a unique opportunity for the pediatric resident to be involved with a very special population of patients. Elective and/or research opportunities are readily available for the motivated house officer.

Research opportunities-- increasing the scope of knowledge

The department of pediatrics offers exciting opportunities for residents. Candidates are offered one of several research areas in which to focus their research questions. Typically, residents will work closely with one of the faculty members in the department of pediatrics. This may either be ongoing research of the faculty member or a topic of the candidate's choice conducted in cooperation with the faculty member. The qualified resident may, at the discretion of the department's research governance committee, work independently on a problem of his or her own choosing.

A research project is encouraged but not required. The department of pediatrics offers the opportunity to conduct research in several areas of clinical and basic science. These include such areas as:

  • Behavioral development
  • Birth defects
  • Bone and mineral metabolism
  • Cardiac development
  • Cerebral blood flow
  • Endocrinology
  • Fetal breathing and temperature regulation
  • Gastroenterology
  • Infant nutrition
  • Lung development and infant mechanical respiration
  • Neural regulation of sexual maturation
  • Neurology and developmental neuroscience
  • Ophthalmology
  • Organ (cardiac and kidney) transplantation
  • Parturition
  • Pediatric oncology
  • X-linked genetic disorders

Additionally, the department of pediatrics encourages the pursuit of cooperative research with other departments at Loma Linda University and surrounding universities.

The department offers on a competitive award basis the opportunity for attainment of grant funds. Funds are also available from several sources on the Loma Linda campus as well as traditional extramural sources. The department maintains several research laboratories equipped for both clinical and basic science investigations of pediatric concerns. Additionally, research support groups are available for weekly discussions and didactic sessions. These range in scope from covering the fundamentals of research to advanced topics on research design and analysis. As one of the largest tertiary care facilities in Southern California, residents interested in pediatric research have access to one of the most varied patient populations of any hospital in the United States.

PICU

The pediatric intensive care unit (PICU) at LLUCH is a 25-bed state-of-the-art facility which serves the entire four-county Inland Empire, with a population of over four million. The unit averages 110 admissions per month which include all medical and surgical problems. Approximately one-half of the admissions are brought in by transport services, including ground vehicles, helicopters, and fixed-winged aircraft. Residents routinely participate in the transport of critically ill children from outlying hospitals.

Second- and third-year residents on the intensive care rotation are the primary physicians in the management of acutely ill and injured patients under the guidance of fully trained pediatric intensivists. Residents are exposed to and instructed in the complicated pathophysiology of acute illness, principles of invasive and noninvasive monitoring, and all medical procedures. Significant experience is gained in invasive procedures such as controlled intubation and placement of arterial and central venous lines.

Residents consider the PICU rotation to be one of the most educational and valuable clinical experiences. For the motivated and aggressive resident, ample clinical research opportunities exist.

NICU--a world-class level-3 facility

Physician/babyThe neonatology division is a large, dynamic section of the pediatric department. Residents find that the time they spend in the Neonatal Intensive Care Unit (NICU) is some of the most educationally challenging and enjoyable of their pediatric training.

The attending staff of 13 full-time neonatologists have diverse clinical experience and research interests which provide a well-rounded exposure to all aspects in the care of the neonate.

The 72-bed level-3 NICU at the Loma Linda University Children's Hospital is one of the largest and most modern facilities in California.

With its unique location in one of the most rapidly growing areas of the United States and several nationally and internationally acclaimed specialty services, the NICU at Loma Linda has become a major referral center for infants with cardiac, neurologic, surgical, and genetic problems. Opportunities abound for pediatric residents to manage premature infants as well as infants with other unique problems.

The phenomenal expansion of medical knowledge, advances in technology available in caring for newborns, and rapid population growth in the surrounding community have led to greater opportunities as well as greater demands on resident training programs.

The NICU has endeavored to provide innovative solutions to minimize negative effects on resident training. Contract physicians, neonatal nurse practitioners, a nurse-managed transport system, and computerized progress notes are used to lessen the demand on the pediatric residents and to heighten their educational experience in the NICU.

Our commitment is to provide pediatric residents with not only the best educational experience in neonatology possible but also with concern for all aspects of their development as pediatricians.