Attendance and presentations at national conferences are encouraged. However, given the limited number of residents available to cover extra shifts, residents attending these conferences should make call switches with colleagues well in advance. Consider asking fellow residents on elective or outpatient rotations. After a call switch is agreed upon between residents, please submit an electronic trade request from the link on the peds.stanford.edu homepage for chief approval. If a resident is unable to find someone to cover their shifts, please discuss with the chiefs. Please do not register for the conference or make travel arrangements prior to finding coverage. The chiefs will try to assist in finding extra coverage, but accommodating all requests is not always possible.
All residents receive $2000 per year ‘educational fund’ to use for travel, hotel and registration at conferences (direct deposited in paycheck). There is an additional $500 educational materials/conference fund available to each resident over the course of residency. All expenses using this fund must be pre-approved by the coordinators prior to purchase. In addition, if you are presenting research that you intend to publish, you may apply for the Scholarly Concentrations Travel Grant.
The program fully supports expanding your educational opportunities outside of the Stanford medical community. Please be aware that you must be in good standing with all of your requirements, inclusive of your scholarly project progress, to take advantage of this privilege.
All elective rotations outside of SHC, LPCH, Kaiser - Santa Clara, and Santa Clara Valley Medical Center must be approved by GME, your class APD, the chiefs, Carrie Rassbach and one of our program coordinators in the residency office (Michelle Brooks or Carrie Johnson) at least 8 weeks prior to the start of the rotation. The appropriate form for away rotations is available on the GME website.
Please do not forget to change or cancel your continuity clinics if you are too far away to attend those clinics!
You must attach competency based goals and objectives for the away rotation, as well as a completed and signed program letter of agreement with the elective site. Please initiate all away rotation requests with both the chiefs and the residency office well in advance. Residents wishing to rotate outside of the state must obtain malpractice coverage from the institution sponsoring the elective.
All house staff are required to accurately report their Clinical and Educational Work hours weekly on MedHub. Residents who are late in reporting their hours and become “locked out” of MedHub must report to the residency office immediately for manual entry of their hours.
Residents can report non‐compliance with residency clinical and educational work hours to the Department of Graduate Medical Education, Medical Director for Education, Ann Dohn in Graduate Medical Education at (650‐723‐5948), or ACGME.”
We follow the Clinical and Educational Work Hours as outlined in the ACGME Common Program Requirements that can be found here. These hours include at-home clinical and educational work as well as moonlighting, which must be approved by the Program Director.
Our residency program is committed to creating a culture of openness, acceptance, and celebration of our collective differences and experiences. We will not tolerate discrimination or acts of intolerance in any form, whether that is towards ethnicity, religious practice, racial, gender identity or sexual orientation.
Resident Resources for Harassment
We are committed to maintaining an environment that is free of unlawful harassment, mistreatment, and intimidation. Harassment includes any behavior or conduct which is based on a protected characteristic and which unreasonably interferes with an individual’s work performance or creates an intimidating, hostile, or offensive work environment. Such behavior is in violation of policy and will not be tolerated.
All employees and managers should be aware that the organization will take appropriate action to prevent unlawful harassment, including sexual harassment and discrimination, that people engaged in such behavior will be subject to corrective action, up to and including termination. No reprisals against house staff reporting suspected harassment or discrimination in good faith will be tolerated.
Should you at any time feel that you have been harassed by a faculty member, staff, nurse, patient, fellow resident, or other trainee either at LPCH or at any satellite locations, we encourage you to speak with one of the following program leaders:
Program director: Carrie Rassbach
Class advisors: Lahia Yemane, Caroline Buckway, Caroline Okorie
Chief residents In the event that you do not feel comfortable speaking with one of the program leaders, you may also speak directly to any of the following people:
Ann Dohn Designated Institutional Officer You may call anonymously; (650) 723-5948
Additionally, should you receive an evaluation which you consider unfair, you may discuss it with your class advisor or program director, and can enter a rebuttal to the evaluation, a document which will be scanned into MedHub as a statement of your perspective.
Illness that interferes with ability to perform resident duties, or specific contagious process that would restrict you from patient contact (e.g. varicella) - as outlined by LPCH Infection Prevention and Control Policy
Other symptoms that could be consistent with COVID-19 - please page or call the chief on call immediately to determine the appropriate policy for further testing.
Mental Health issue that interferes with ability to perform resident duties
Medical appointments that cannot be scheduled outside of clinical hours - please alert the chiefs to these appointments as far in advance as possible so that they can provide adequate cross-coverage.
Residents on a jeopardy rotation for two weeks will not be assigned any days off, unless needed to ensure all work hour restrictions are met.
Residents on a jeopardy rotation for four weeks will be assigned four days off, which may be weekdays or weekends.
Every attempt will be made to evenly distribute cross coverage and jeopardy calls among all the residents in the jeopardy pool at any one time.
Residents on Jeopardy Responsibilities:
You are expected to be in the hospital within 2 hours while on jeopardy. This means you should never be further than 2 hours from LPCH or SCVMC while on jeopardy (this includes traffic!). You should also have arrangements in place in advance if needed for pet-sitting, childcare, personal appointments/plans, etc., so that you are available if needed.
Keep pager on at all times. Do NOT rely on SPOK mobile as it may fail with low battery, poor cell service, or accidental silencing of phone.
Keep cell phone on at all times, as this may be the first method of reaching you, and will be a backup method for contacting you.
Call pages back within 20 minutes. The chiefs may first attempt to reach you be text or phone call if the jeopardy need is not urgent. Once the chief pages you, you have 20 minutes to return the page.
No internal or external moonlighting is permitted while on jeopardy, or during the 8 hours before or after a jeopardy shift.
Please note, even if you have been assigned to a shift during a jeopardy weekend or jeopardy rotation, you are still on call and should have your pager and cell phone on as we may need to change your shift assignments in the face of new jeopardy needs.
If you are on jeopardy but are unable to fulfill your responsibilities (ie: illness, family emergency, etc), you must alert the chiefs PRIOR to being called in for jeopardy, or else this will be considered a violation of jeopardy.
If you are on jeopardy but do not respond within 20 minutes of a page, this will be considered a violation of jeopardy.
If you are in violation of Jeopardy:
You may be required to complete an additional jeopardy assignment of 14 additional days of jeopardy at the discretion of the chiefs and program director.
Pager on by:
Timeframe Available to work shifts
Pager off at:
Noon day prior*
6AM the morning of assigned jeopardy day until the next morning (no later than noon)**
5PM day of jeopardy**
Saturday 6AM until Monday end of night shift (no later than noon)**
2 or 4-week Rotation
5PM Sunday before rotation*
First Monday of rotation at 6AM until end of night shift (no later than noon) on the Monday after the rotation**
6AM Monday after rotation**
* Please note that we are asking you to turn on your pager several hours before a shift would start, to allow the chiefs to contact you about upcoming shifts (example: if you are jeopardized to a 6AM start blue intern shift, it’d be good to be able to reach you the evening before!). If there are extenuating circumstances (flying on a plane, in a Sunday evening wedding, etc) which will make you unreachable in these hours prior to the start of your jeopardy, please notify the chiefs in advance.
** Please note that you may be jeopardized to a shift that extends longer than you are asked to keep your pager on.
Days OFF Jeopardy Rotations:
Days off Jeopardy Rotations
Pager back ON:
Timeframe NOT available for shifts:
Single Day Off
6AM on day off**
5PM on day off**
6AM on the start of day off until 6AM the day after your day off.**
6AM on Saturday**
5PM Sunday* (unless rotation over, then can keep pager off)
6AM Saturday morning to 6AM Monday morning.**
*Please note that we are asking you to turn on your pager several hours before a shift would start, to allow the chiefs to contact you about upcoming shifts (example: if you are jeopardized to a 6AM start blue intern shift, it’d be good to be able to reach you the evening before!). If there are extenuating circumstances (flying on a plane, in a Sunday evening wedding, etc) which will make you unreachable in these hours prior to the start of your jeopardy, please notify the chiefs in advance.
** Please note that you may be jeopardized to a shift that extends slightly longer than you are asked to keep your pager on.
For residents in the Physician Scientist Track, research/elective time is in the same category and residents can select whether they would like to do some clinical electives during their research time. Total research time is dependent on which pathway residents select (IRP, ARP, R38). The following guideline is specific for residents on the Physician-Scientist track:
The following activities will be required during research time:
Clinical service at ½ day continuity clinic every week, or option of full day continuity clinic every 2 weeks
For residents on the IRP during both PGY2 and PGY3 years, 2.5 blocks of research will be call-free while 2.5 blocks of research may include weekend cross-coverage or jeopardy.
For residents on research during Thanksgiving, Christmas or New Year’s, Holiday coverage will be required
For residents on research during class retreats and step-ups (winter-spring), cross-coverage will be required
Required Scholarly Concentrations blocks (resident will choose 1 SC, and SC blocks are part of total research time):
ICCR for Clinical Research Scholarly Concentration
Scholarship Academy for Basic Science Scholarly Concentration
Other Scholarly Concentration Blocks for Med Ed, QI, StAT, Global Health
PALS recertification (during PGY2 year before junior retreat)
The following activities will be optional during research time:
Academic Half Days (Clinical teaching)
Class retreats(apart from PALS, which is required)
While on research blocks, physician-scientist track residents may be asked to cross-cover during the above class-wide and program-wide events (holidays, class retreats, step-ups), but will not be asked to cover research retreats or AHDs
You must obtain approval from the residency office before making any purchases. We cannot guarantee that you will be reimbursed without first obtaining pre-approval.
Reimbursements are to be avoided whenever possible. In most cases, we will provide you with the program’s purchasing credit card (Pcard) or make an online purchase for you with the Pcard.
You must submit itemized receipts in addition to the credit card slip.
REQUESTS FOR REIMBURSEMENTS MUST BE SUBMITTED WITHIN 30 DAYS OF INCURRING THE CHARGE.
Please select one of the following links to the form that fits your need:
For requests to use program funds for purchases: Use this form for requests pertaining to Wellness Committee activities, conference and travel, educational materials, residency-related meeting expenses, etc.
For research grant incentives (e.g., gift cards) - If you are awarded one of our research grants and have incorporated participant incentives into your project’s budget, then use this form to request purchasing the incentives, typically gift cards.
Social media is a powerful tool that can lead to collaboration and improved patient care. However, it also has the potential to divulge protected patient information, place residents in inappropriate patient-physician relationships, and lower society’s trust and opinion of this Program and the profession of medicine. The purpose of this policy is to mitigate this risk.
This policy applies to all Pediatrics Residents of the Stanford University School of Medicine. This policy is intended to supplement not supersede existing social media policies set forth by Stanford University Hospital and Clinics and Lucile Packard Children’s Hospital.
The Program Leadership is responsible for interpreting and updating this Policy.
Pediatrics Residency Program of Stanford University School of Medicine
Committee composed of the Program Director, Associate Program Directors, and Chief Residents of the Pediatrics Residency Program at Stanford School of Medicine
Protected Health Information
Individually identifiable health Information that relates to a patient’s past, present or future physical or mental health or condition, the provision of health care to a patient, or the past, present, or future payment for health care provided to a patient. This includes all information that you access, use or disclose – in any form, verbal, electronic or physical – about patients or their relatives.
Means all electronic media used to transmit ideas, concepts, images, and opinions. It includes, but is not limited to, Facebook, MySpace, LinkedIn, YouTube, Twitter, Instagram, Tumblr, blogs, personal websites, wiki’s, podcasts, and list serves.
The following requirements must be followed when using social media:
Protected Health Information, including photographs, may not be placed on personal social media sites;
For the purposes of education, descriptions of patient cases and clinical images may be posted to password protected professional sites once the data has been de-identified and patient consent obtained;
Residents should not establish or maintain social media relationships with patients and/or their families, this includes initiating or accepting “friend” requests on Facebook;
The Lucile Packard Children’s Hospital, Stanford University Hospital, Stanford School of Medicine, and Santa Clara Valley Medical Center name and logo may not be used in social media without specific written consent from the hospital’s media relations department;
All content must abide by all local, state, and federal laws;
Residents may not give medical advice, unless engaged in an educational activity supervised by an attending physician and with permission from the Program Director; and
Residents may not post comments that disparage the Program, their colleagues, supervisors, patients, patient’s families, or ancillary hospital staff.
Even if the content does not violate the above guidelines, it may impact future career and employment opportunities. It is important to remember that whatever is posted to social media should be considered public and permanent information no matter what privacy settings are used. Therefore, residents should pause to consider the consequences of their social media posts and should not use obscenities, profanity, or vulgar language, and language that is threatening or defamatory.
If a violation of this policy occurs, the content will need to be removed immediately and can result in disciplinary action up to dismissal from the program.
Exceptions to this policy must be preapproved in writing by the Program Leadership.
PALS and NRP Certification expire every 2 years. Most juniors will be PALS re-certified during junior retreat and most NRP will be re-certified during the NICU rotation. However, if this is missed for any reason, please contact the chiefs to arrange for a make-up session.
Supervising medical staff physicians will adhere to the ACGME requirements pertaining to the level of supervision for residents in a training program. Supervision may be exercised through a variety of methods. Some activities require the physical presence of the supervising faculty member (direct supervision). For many aspects of patient care, the supervisor may be a more advanced resident, fellow or mid-level provider, e.g. APP. Other portions of care provided by the resident can be adequately supervised by the immediate availability of the supervising faculty member or resident physician, either in the institution (indirect supervision with direct supervision immediately available); or by means of telephonic and/or electronic modalities (indirect supervision with direct supervision available). In some circumstances, supervision may include post-hoc review of resident delivered care with feedback as to the appropriateness of that care (oversight).
To ensure patient safety and quality patient care while providing the opportunity to maximize the resident educational experience, supervising medical staff physicians need to be available to the resident in person or by telephone 24 hours a day when on clinical duty.
When a resident is involved in the care of the patient, the responsible supervising staff physician must maintain personal involvement in that patient’s care. The supervising staff physician is fully responsible to oversee the care of the patient and directs the appropriate intensity of resident supervision based on the nature of the patient’s condition, the likelihood of major changes in the management plan, the complexity of care, and the experience and judgment of the resident being supervised. All patient care services must be rendered under the oversight of the responsible supervising staff physician, a supervising provider or be personally furnished by the supervising staff physician or provider.
The residency program leadership will consistently ensure that residents know which supervising medical staff physician is on call and how to reach this individual.
Supervising medical staff physicians will demonstrate compliance with any residency review committee citations related to this supervisory function.
Residents may only exercise privileges for patient activities and procedures for which his/her supervising physician or supervising provider has been appropriately credentialed.
Supervising medical staff physicians are responsible for determining when a resident is unable to function at the level required to provide safe, high quality care to assigned patients. They have the authority to adjust duty hours downward to ensure that residents that are overly fatigued do not place patients at risk.
Individual residents must be aware of their limitations and not attempt to provide clinical services or do procedures for which they are not trained. They must know the graduated level of responsibility described for their level of training and not practice outside of that scope of service.
Each resident is responsible for communicating significant patient care issues or changes in patient condition to the supervising medical staff physician and such communication must be documented in the medical record, inclusive but not limited to, significant decline in patient condition, a rapid response call to patient bedside, request to discharge patient against medical advice, patient transfer to the ICU, patient/family request for DNAR order, patient need for any invasive procedure, patient death.
Failure to function within graduated levels of responsibility, communicate significant patient care issues to the supervising physician, or appropriately document the level of supervising physician oversight may result in the removal of the resident from patient care activities.
Graduated Levels of Responsibility
The privilege of progressive authority and responsibility, conditional independence, and a supervisory role in patient care delegated to each resident must be assigned by the program director and faculty members. As they advance in their training program, residents should be given progressive responsibility for care of patients. The determination of a resident’s ability to provide care to patients without a supervising physician present, or to act in a teaching capacity is based on the resident’s clinical experience, judgment, knowledge, and technical skill. It is the decision of the supervising physician as to which activities the resident will be allowed to perform within the context of the assigned levels of responsibility.
The Residency Program Director defines the levels of responsibilities for each year of residency training by preparing a description of the types of clinical activities residents may perform. Graduated levels of responsibility will be in accordance with ACGME and JCAHO guidelines and this documentation will be made available to the LPCH Medical Staff Office annually. These activities are delineated for each resident on: https://www.stanfordchildrens.org/en/mss/policies/index
In compliance with ACGME standards, PGY-1 residents should be supervised either directly or indirectly with direct supervision immediately available.
Documentation of Supervision of Residents
The medical record must clearly demonstrate the involvement of the supervising medical staff physician in resident patient care. Documentation of supervision must be entered into the medical record by the supervising physician or reflected within the resident progress note or other appropriate entries in the medical record (e.g., procedure reports, pathology reports, imaging reports, consultations, discharge summaries).
Levels of Supervision and Responsibility:
Direct supervision: the supervising physician is physically present with the resident and the patient
Indirect supervision with direct supervision immediately available – the supervising physician is physically within the hospital or other site of patient care, and is immediately available to provide direct supervision.
Indirect supervision with direct supervision available – the supervising physician is not physically present within the hospital or other site of patient care, but is immediately available by means of telephonic and/or electronic modalities, and is available to provide Direct Supervision
Oversight – The supervising physician is available to provide review of procedures/encounters with feedback provided after care is delivered.
Supervising Medical Staff Physician The attending level physician responsible for patient care
Supervising provider A more advanced resident, fellow or mid-level provider who can offer oversight for activities and procedures for which that advanced level resident, fellow or provider is credentialed to perform independently
You need to take Step 3 during your intern year to qualify for the California Medical License. This is a 2 day exam and should be scheduled when you can easily be away from the program for at least one of those days. Step 3 must be scheduled during vacation or during an outpatient rotation. We are happy to help you plan this early in the year so it does not add to the stress of being an intern.
Please schedule your STEP 3 exam before October 1st.
To get reimbursed by GME for CA Medical License, plan to take and have passed by May 1st
As soon as your exam is scheduled, at least 4 weeks in advance of your exam, please email the chief residents AND the rotation director if you are missing any days of the rotation. Rotation directors are listed on the 5 minute summary documents for each rotation.
Please try to include a weekend day (not required, just encouraged) in order to miss only one day of your rotation
Please do not schedule the same day as night float weekend shifts or jeopardy weekends.
Please avoid scheduling on your continuity clinic day, particularly if your clinic is at Gardner as the patients on your panel would have to be rescheduled. If this is not possible, please discuss with chiefs before scheduling your exam.
Schedule during the following rotations:
Development & Behavior
Community (exception: not on Tuesdays or Thursdays)
Ask the chiefs if you need help deciding when to take the exam