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Curriculum Overview

3+1 Resident Block Schedule

The Pediatrics Residency Program at UTCOM-Chattanooga transitioned to an X+Y (3+1) immersion schedule on July 2019. In this format, each resident spends three weeks on a core or block rotation followed by one week of ambulatory pediatrics. This scheduling format is part of a pilot project (called AIRE) approved by the ACGME Pediatric Residency Review Committee. The goal of this scheduling format is: 

  • Improved patient continuity in pediatric resident clinics
  • Less conflict between inpatient and ambulatory responsibilities
  • Improvement in resident wellness, leading to less burnout
  • Improved patient and resident satisfaction
During core rotations (inpatient/hospital medicine, subspecialty electives, PICU, etc), residents' time is devoted to that rotation. Clinical duties and educational efforts of core rotations are not interrupted for residents to attend continuity clinic.


Sample 3+1 Rotation Master Schedule

Not all residents can be on the 3 week portion or 1 week portion at the same time. We have established 4 cohorts of residents across all PGY levels. Each cohort should include 2-3 residents in each PGY level. Once a resident is in a cohort, they remain in the same cohort for the year. At the beginning of an academic year, the cohorts are staggered and rotations may be shortened to begin the recurring 3+1 pattern.

Sample X+Y Master Schedule. Text version in Accordion labeled Text Version.

Sample 3+1 Rotation Master Schedule - Text version
  Resident - Cohort 1 Resident - Cohort 2 Resident - Cohort 3 Resident - Cohort 4
Week 1 Ambulatory Rotation Rotation Rotation
Week 2 Rotation Ambulatory
Week 3 Rotation Ambulatory
Week 4 Rotation Ambulatory
Week 5 Ambulatory Rotation
Week 6 Rotation Ambulatory
Week 7 Rotation Ambulatory
Week 8 Rotation Ambulatory
Week 9 Ambulatory Rotation
Week 10 Rotation Ambulatory
Week 11 Rotation Ambulatory
Week 12 Rotation Ambulatory
Week 13 Ambulatory Rotation
Week 14 Rotation Ambulatory


Sample Block Rotation (in weeks)

See text version of image below under Sample Block Rotation Text Version.
Sample Block Rotation (in weeks) Text Version
Sample Block Rotation (in weeks) text version
  PGY-1 PGY-2 PGY-3
Hospital Medicine 10 7 9
Night Float - Inpatient (PGY1, 3) PICU (PGY2) 4 3 6
PICU 0 9 0
NICU 3 3 0
Newborn Nursery 4 0 3
Heme/Onc 3 0 3
Emergency Medicine 3 3 3
Developmental / Behavioral 0 3 0
Adolescent 0 3 0
Community Rotation 3 0 0
Psychiatry / Psychology 0 2 0
Elective Rotation 9 6 15
Ambulatory 10 10 10
Vacation 3 3 3

Ambulatory/ Continuity Clinic

Likewise, during the ambulatory weeks, residents can focus strictly on general outpatient pediatrics. Residents spend four half days in the general pediatric continuity clinic and three half days in the acute care clinic. Additional time during the ambulatory weeks include an educational half day to work on research or quality improvement projects and participate in community service and advocacy projects. Residents remain with the same cohort of residents for the ambulatory week for the entire year, allowing the development of a "Group Practice" model and optimizing teaching and learning. Continuity clinic didactics occur once a week with interactive sessions developed and presented by the faculty from the Division of Ambulatory Pediatrics.
The children in continuity clinic are followed for the entire duration of the resident's training. Well children are followed for health promotion visits, children with acute illnesses are managed, and children with chronic illnesses are followed concurrently with pediatric subspecialists. The patients are seen by their regular resident physician for as many of their healthcare visits as possible. This experience simulates the usual practice of private pediatricians. It also helps the resident learn longitudinal, on-going care of children with acute and special health care needs in a way that no month-long rotation can provide. Residents follow 150+ families through the continuity clinic during residency. Our general pediatric clinic is proud to care for a culturally diverse patient population with an extensive list of pathology, which provides our residents with a well-rounded and robust educational experience.

Sample Ambulatory Week

  Monday Tuesday Wednesday Thursday Friday
Morning Continuity Clinic Acute Care Clinic Continuity Clinic Acute Care Clinic Acute Care Clinic
Afternoon Continuity Clinic Acute Care Clinic Continuity Clinic Independent Study Didactic Lecture Block

Intern Bootcamp

One unique aspect of the 3+1 schedule at UTCOM is the inclusion of an initial four-week bootcamp month. New interns spend one week in each of the key areas of the hospital: inpatient wards, night float, newborn nursery and ambulatory clinic, allowing interns to understand the workings of the entire system beginning with the first month of their residency. *In the color graphic above, the weeks of bootcamp are counted as part of the clinical rotations, rather than their own bootcamp rotation.

Sample Bootcamp Rotation Schedule

Text version of image in the accordion below labeled Sample Bootcamp Rotation Schedule - Text Version.

Sample Bootcamp Rotation Schedule - Text version
  Resident - Cohort 1 Resident - Cohort 2 Resident - Cohort 3 Resident - Cohort 4
Week 1 Ambulatory Newborn Nursery Inpatient Days Inpatient Nights
Week 2 Inpatient Nights Ambulatory Newborn Nursery Inpatient Days
Week 3 Inpatient Days Inpatient Nights Ambulatory Newborn Nursery
Week 4 Newborn Nursery Inpatient Days Inpatient Nights Ambulatory


Sample Bootcamp Didactic Schedule

New residents receive special lectures during the month of July to further ease the transition from medical school to residency. The responsibilities of a resident can be a large jump from the role of a medical student and these lectures lay out expectations and include small group workshops. All residents participate in the Friday lecture block during bootcamp for refresher lectures.

Text version of graphic is below in accordion titled Sample bootcamp didactic text version.

Sample Bootcamp Didactic Schedule - Text Version

July Bootcamp (example)



Monday Tuesday Wednesday Thursday Friday




Clinic Closed


8 am: Intro to Rapid Response (Bennett), MSB140


8 am: IPASS Workshop (Cary), MSB140


Friday Lecture (MSB140)
12 pm: Hospital Emergencies
1 - 3 pm: Basic PRocedures (IV, Cath, LP) (Hines)


8 am: Overview of MR(Cary), MSB140




8 am: Endo Emergencies (Martin), MSB140
12 pm: Mentor small group Lunch


8 am: SBAR (Garcia), MSB140


Friday Lecture (MSB140)
12 pm: Heme/Onc (Herring)
1 pm: QI N&B: 101 & Refresher (Bennett)
2 pm: Donor Services (Layne)


8 am: Intro to Res Software (Thurston), MSB140




8 am: Inpatient Pathways (Bennett), MSB140


8 am: Legal Issues (Heise), MSB140


Friday Lecture (CHOC):
12 pm: Cardiac Emergencies, (Morrical), CHOC Overlook
1 - 3 pm: Sutures / Splinting (Brown/Adams), CHOC Overlook and Ortho Clinic=


8 am: CPS Nuts and Bolts (Kate Wilson), MSB140




8 am: Medication Errors (Gerwin), MSB140


8 am: Newborn Emergencies (Goins), MSB140


Friday Lecture (MSB140)
12 pm: Neuro Emergencies (Thomas)
1 pm: Intro to Research (Rowin)
2 pm: Mock Code Training (Klingborg)


8 am: Intro to Telehealth (Pigg), MSB140



Didactic Teachings 

  Monday Tuesday Wednesday Thursday Friday
Morning Board Review Ambulatory Lecture Grand Rounds Morning Report  

Didactic Lecture


Aug 1, 2023