MESSAGE FROM THE CHAIRMAN AND PROGRAM DIRECTOR, DEPARTMENT OF PEDIATRICS

This is an exciting time in the field of Pediatrics.  Over the past ten years, we have seen major advances in pediatric tertiary care, as well as a renewed focus on primary care and community outreach. The mission of the Department of Pediatrics at St. Barnabas Hospital is to deliver high-quality and compassionate care to our patients while offering community resources dedicated to children’s health.  The graduate training program of the Department of Pediatrics offers a well-balanced experience in primary care and subspecialty pediatrics.

In addition to serving the children of the Bronx, the Department of Pediatrics is an important component in the New York Presbyterian Hospital (NYPH) Network, which is the largest healthcare network in New York City.

This Network provides the Department of Pediatrics with valuable clinical and administrative support, including specific rotations for Pediatric residents.  The following brochure describes each division of the Department as well as the Residency Training Program.  I would like to personally thank you for considering us for your post-graduate training.

David H. Rubin, MD, FAAP

Chairman and Program Director, Department of Pediatrics

St. Barnabas Hospital

Professor of Clinical Pediatrics

Weill Medical College of Cornell University

ST. BARNABAS HOSPITAL

St. Barnabas Hospital is a not-for-profit, nonsectarian, acute care community hospital located in the heart of the central Bronx.  St. Barnabas, the 15^th largest hospital in New York State, is adjacent to Fordham University, the Bronx Zoo, New York Botanical Gardens and the Arthur Avenue shopping district. The expanding St. Barnabas healthcare delivery system provides inpatient, outpatient and emergency medical and dental services. The hospital’s primary care facilities are conveniently located throughout the Bronx.  

History

St. Barnabas Hospital was established on April 6, 1866 as The Home for the Incurables.  At the time, it was America's first chronic disease hospital, and the world's second (the first such hospital opened three years earlier in England).  Reverend Rodman, the rector of the Grace Episcopal Church, founded the Hospital.  He called together a group of public-spirited citizens to explore how to provide a haven for the so-called incurables, who could not be cared for in existing hospitals.  His goal was to bring hope and medical care to a group that had neither.  Dr. P. C. Pease, the Home for Incurables' first physician, noted that, "...where the faintest hope exists, no efforts are spared nor are any new remedies left untried."  The Home received its first patients in 1867 in a small, frame building. Thirty-three patients were admitted the first year.  The Hospital has since grown to become a major source of healthcare in New York State.  The following list describes some features of the institution:

• Impressive 10-acre landscaped campus

• 461 total hospital beds

• New York State-designated Regional Trauma Center

• New York State-designated AIDS Center

• Training programs for 250 physicians in 9 different specialties

• Pediatric Inpatient Unit and Pediatric Special Care Unit

• Pediatric Emergency Department

• Newborn Nursery and Neonatal Intensive Care Unit (Level 3)

• Child Protection Program/Child Advocacy Center

• Early Intervention Program

• Adolescent Medicine and Teenage Pregnancy Prevention Program

• 6 Pediatric Ambulatory Care sites, including a new $13.6 million 7-story ambulatory care building.

• Pediatric medical library and conference room (with internet access)

• Affiliated with the New York College of Osteopathic Medicine

THE DEPARTMENT OF PEDIATRICS

Since January 1999, under the leadership of Dr. David H. Rubin, the Department of Pediatrics at St. Barnabas Hospital has flourished.  During his tenure, the Department has grown from a faculty of 11 pediatricians to over 45 experienced pediatric primary care attending physicians as well as pediatric subspecialists.  St. Barnabas Hospital is located in a neighborhood with explosive pediatric growth.  During the past three years, the Department experienced an annual growth rate of approximately 20% in both outpatient and inpatient services.  The goal of the Department has been to address the full spectrum of pediatric problems from primary care to complicated diagnostic dilemmas. The Department consists of an Inpatient Unit, a Division of Pediatric Emergency Medicine, a Well Baby and Neonatal Intensive Care Unit and a Division of Ambulatory Care, which provides primary care services at the St. Barnabas Hospital Campus Ambulatory Care Center as well as several satellite primary care locations.

Division of Inpatient Pediatrics/Pediatric Special Care Unit

The Pediatric Inpatient Unit at St. Barnabas Hospital is a sixteen-bed unit managed by our group of pediatric attending physicians.  The unit provides care to children up to eighteen years of age.  Interdisciplinary rounds are held daily on the unit offering our patients and their families needed social as well as medical support.  In our efforts to create a child-friendly environment, all patient rooms have been re-designed with wildlife themes.  In cooperation with the Bronx Zoo, Tats Cru, a local group of artists, has painted each room depicting a different animal species in its natural habitat.  The rooms provide inviting and pleasing environments, which also serve to educate children about wildlife conservation.  Within the unit, the Child Life Room offers patients a safe environment for play.   The Pediatric Special Care Unit (PSCU) is a 4 bed advanced care unit for those children who require an increased level of care not offered on the inpatient pediatric unit. Teaching Rounds are held daily on all patients admitted to the PSCU and the Pediatric Inpatient Unit.

Division of Pediatric Emergency Medicine

The Division of Pediatric Emergency Medicine of St. Barnabas Hospital is a physically separate advanced care facility dedicated to the emergency care of children.  For each of the past 4 years, there has been a 20% annual growth rate in patient volume, bringing the total census to over 25,000 patient visits in 2003.  The case mix of patients seen in the Pediatric Emergency Department is impressive and ranges from simple to extremely complex medical, surgical, and trauma-related problems. Recently, St. Barnabas Hospital became a New York State designated Level 1 Regional Trauma Center, adding a new and exciting facet to the pediatric emergency experience.  The new physical expansion of the Pediatric Emergency Department will be completed shortly and will result in a tripling of our physical space.   

Division of Neonatology

The Division of Neonatology includes the Well Baby Nursery (WBN) and a Level III Neonatal Intensive Care Unit (NICU).  Four full-time neonatologists staff the department, with 24 hour attending coverage.   The impressive group of Attending Neonatologists conducts teaching rounds daily. Due to a greater than 15% increase in annual deliveries, there are plans to expand the division. This will include the NICU and WBN and the development of a high-risk clinic.

The Division of Neonatology is a member of the Bronx Perinatal Consortium and the New York Presbyterian Neonatal Network, allowing for seamless collaboration on clinical cases and research projects.

Division of Ambulatory Pediatrics

The Department of Pediatrics offers children comprehensive pediatric primary care at six locations throughout the Bronx.  The Pediatric Ambulatory Division continues to grow at a rapid pace.  There were approximately 58,000 patients seen during the past year (2003). The Ambulatory Division has several specialized primary care programs serving the Bronx Community:

• The Adolescent Medicine Program, led by pediatricians trained in adolescent medicine, serves the community through school-based health centers, a teen pregnancy program, a juvenile detention health center, and a general adolescent practice. 

• The Child Advocacy Center provides support services for children and families exposed to high-risk environments.  The Center also facilitates diagnostic evaluations and treatment for children who are suspected of being victims of child neglect or abuse.  Evaluations are conducted in a child-friendly setting designed to minimize trauma and maximize safety for the entire family.

• Reach Out and Read, an innovative national program aimed at promoting early childhood literacy, is a major initiative of the Division.  

• The Developmental and Behavioral program applies progressive techniques in the management of a variety of developmental disorders.

• The Early Intervention Program provides advanced diagnostic and therapeutic care to young children with developmental delay.

• The New York State-designated AIDS Center features comprehensive medical care and case management for HIV infected women and newborns.

• The Community Outreach Program includes participation in local health fairs, school educational seminars, community-based organizations, and participation in local and regional TV and radio informational sessions.

Research

Our Department is committed to becoming a premier institution for clinical research dedicated to child health.  As a part of the Clinical Trials Network of the New York-Presbyterian Hospital, we are currently participating in clinical trials with personnel experienced in clinical research.  Our areas of particular interest include pediatric respiratory disease, pediatric infectious diseases, and clinical epidemiology.  In addition to our participation within the network, we have also initiated several clinical research projects related to child safety, pediatric asthma, adolescent psychiatry, pediatric dentistry, and developmental and behavioral pediatrics.  The Residency Research Program includes monthly Research Seminars (focused on principles of epidemiology and methodology), Journal Club, and faculty mentoring of resident initiated research projects. A representative sample of research projects is noted below:

• The utility of video education in primary care pediatrics

• The relationship between juvenile offenders and conduct disorders

• Cost-effectiveness of treatment options for prevention of rheumatic heart disease

• Multicenter comparative study to evaluate the efficacy and safety of levofloxacin

• Effects of Prevnar on positive blood cultures in the Bronx

• Impact of trauma designation on pediatric trauma cases

• A comparison of the use of herbal supplements, vitamins and teas among pediatric and adult populations

• Neurobiological basis of attention and its development

Teaching

All faculty of the Department of Pediatrics maintain academic appointments at the Weill Medical College of Cornell University, and have trained at leading pediatric residencies throughout the country.  The Department of Pediatrics also serves as a site for the pediatric clerkship and primary care rotations for medical students from the Weill Medical College of Cornell University.  Since its inception at our hospital, this program has consistently received the highest student evaluations, and is currently the most requested site for the Weill third year pediatric clerkship.  We also serve as a clerkship site for students from Ross University School of Medicine, the New York College of Osteopathic Medicine (NYCOM), the Columbia University Nurse Practitioner program, and the Physician Assistant Studies Program of the New York Institute of Technology.  Medical education is considered a high priority in the Department.

Some of our Departmental conferences are listed below:

• Weekly Pediatric Grand Rounds

• Morning Report

• Monthly Morbidity and Mortality Conference

• Pediatric Research Seminar

• Pediatric Journal Club

• Ambulatory (Primary Care) Pediatric Conferences

• Pediatric Emergency Medicine Conferences

• Neonatal Conferences

• Core Curriculum Conferences conducted by Pediatric Subspecialists

• Daily Inpatient Rounds

• Radiology Rounds

• Noontime Core Pediatric Conference

THE PEDIATRIC RESIDENCY PROGRAM:  THE CURRICULUM

The Pediatric Residency Training Program at St. Barnabas Hospital is an ACGME approved Residency Program (3203521416) that provides medical school graduates with the essentials of the entire Pediatric educational curriculum - ranging from Pediatric Primary Care to Subspecialty and Intensive Care training, as well as the tools to become leaders in the field of Pediatrics.  The training experience emphasizes the management of general and subspecialty problems in both primary care and hospital settings.  Rotations at St. Barnabas Hospital and the New York Presbyterian Hospital’s (NYPH) Cornell and Columbia campuses provide both the intensity and diversity needed for a well-rounded competency based pediatric education.  Our residency offers in-depth clinical experiences, progressively increasing individual responsibility, and opportunities for elective study and research. All rotations are organized in blocks of 4-weeks; there are 13 blocks per year. 

PL-1 Internship: The Basics 

The PL-1 year is designed to provide the intern with experience and education pertaining to all aspects of the care of the hospitalized and ambulatory pediatric patient.  It is essential that interns assume the responsibility for patient care decisions with the supervision of senior residents and attending physicians.  Through inpatient rotations at St. Barnabas Hospital and the New York Presbyterian Hospital - Columbia Campus, interns learn the diagnosis and management of common pediatric problems. They also study the management of sick newborns at the St. Barnabas NICU.  The Well Baby Nursery rotation provides the framework for the year’s focus on general pediatric care.  Interns also actively participate in the Pediatric Primary Care Ambulatory Group Practice, where they follow their own patients throughout their three years of training.  All PL-1 residents are assigned to one clinical location (either St. Barnabas Hospital Pediatric Primary Care Clinic or the Pediatric Primary Care Clinic at Grand Concourse) where they will begin to participate as a resident primary care continuity provider between 1 and 4 half days per week (depending on rotation). They will be identified as a patient’s pediatrician and will follow that patient through all scheduled and, when possible, non-scheduled appointments throughout their three year residency. Block rotations in the Outpatient Pediatrics and Pediatric Emergency Department give interns a feel for the important link between the ambulatory and inpatient settings.  Finally, it is during the PL-1 year that the design and implementation of the resident’s research project begins to take shape with the assistance of faculty mentors and core research conferences.

PL-2 Junior Resident: Transition to Leadership 

The second year allows the resident to take on greater supervisory and decision-making roles during two block rotations on the Inpatient service and two block rotations in the Pediatric Emergency Department.  Residents also spend one block rotation on the Pediatric Oncology Service at NYPH Columbia Campus.  Management of acutely ill children is the primary focus of the rotation at the NYPH Cornell Campus’ Pediatric Intensive Care Unit.  Ambulatory-based rotations in Adolescent Medicine, Allergy/Immunology, Child Development and Neurology provide residents with the depth of knowledge they need to become well-rounded pediatricians.   Residents may spend one block rotation as elective time in any clinical or academic pursuit, in consultation with the program director.   

 PL-3 Senior Resident: Independence and Teaching 

Third year residents function as leaders among housestaff and medical students at St. Barnabas Hospital.  The rotations in Outpatient Pediatrics and Community Medicine enable senior residents to become familiar with a variety of settings outside of the hospital.  There are also 2 block rotations of elective time that the resident can use to supplement his/her core educational experience. Residents are also given the opportunity to complete research projects initiated during the PL-1 year and present their findings in a formal setting.

Ambulatory Group Practice: The Continuity of Care 

Based on a resident’s training period of 10 one-half day sessions per week, all house officers spend between 1 - 4 sessions per week in the Group Practice Continuity Clinic (depending on specific year of training and rotation) where they longitudinally follow a cohort of patients through all aspects of well and sick pediatric care.  All residents are assigned to one of two locations for their pediatric primary care continuity clinic: the St. Barnabas Hospital Pediatric Primary Care Clinic or the Pediatric Primary Care Clinic at Grand Concourse. Both locations include experienced full-time pediatric primary care faculty who care for their own panel of patients in addition to serving as preceptors for residents. Residents will also rotate through these same assigned locations for their outpatient pediatric rotations.  These sites give residents the experience of practicing in a supervised pediatric primary care practice – very similar to one they may find themselves working in after graduation. The practices include an appointment system that accommodates personal appointments and walk-in visits, and comprehensive on-site and telephone coverage. These sites also serve as monitors of patient consultative visits outside of the clinic and any hospitalizations and/or emergency room visits.

Residency Rotations

YEAR 1

3 Rotations    General Pediatric Inpatient Service

1 Rotation      NYPH/Columbia General Pediatric Service

3 Rotations    Pediatric Emergency Department

1 Rotation      Neonatal Intensive Care 

1 Rotation      Well Baby Nursery

1 Rotation      Cardiology Selective

1 Rotations    Outpatient Service

1 Rotation       Infectious Disease Selective

4 weeks          Vacation 

YEAR 2

2 Rotations General Pediatric Inpatient Service

1 Rotation   NYPH/Columbia Pediatric Oncology Service

2 Rotations  Pediatric Emergency Department

1 Rotation   Neonatal Intensive Care

1 Rotation   NYPH/Cornell Pediatric Intensive Care 

1 Rotation   Developmental/Behavioral/Neurology

1 Rotation   Allergy/Immunology

1 Rotation   Outpatient Service

1 Rotation   Adolescent Medicine

1 Rotation   Elective

4  Weeks    Vacation

YEAR 3

3 Rotations General Pediatric Inpatient Service

2 Rotations Pediatric Emergency Department

1 Rotation   Neonatal Intensive Care

1 Rotation   Developmental/Behavioral/Neurology

1 Rotation   Community Medicine

1 Rotation   Outpatient Service

3 Rotations Elective

4 Weeks    Vacation

Benefits and Salary

The following benefits are available to all residents:

• Professional liability coverage for all activities that are approved components of the resident program

• Health Insurance

• Dental insurance

• Prescription drug plan

• Disability insurance

• Uniforms 

• Vacation: 4 weeks

The salaries listed below are those for 2003-2004:

PL1: $41,000

PL2: $43,500

PL3: $46,500

There is no place like the Big Apple!  St. Barnabas Hospital is just a 20-minute drive away from the heart of New York City.  There are endless possibilities for cultural and social activities in the city that never sleeps, such as Broadway theaters, the South Street Seaport, Madison Square Garden, Yankee and Shea Stadiums, Lincoln Center, the Metropolitan Museum of Art, the Statue of Liberty, the Empire State Building, Central Park, Greenwich Village and Times Square, to name only a few.  In short, it is a great place to live and work!    

DEPARTMENT OF PEDIATRICS FACULTY LISTING

(Residency and Fellowship institutions are included; all Faculty hold academic appointments at the Weill Medical College of Cornell University)

Pediatric Residency Program                         

David H. Rubin, MD, Chairman, Department of Pediatrics and Program Director                                                                              

David Fagan, MD, Associate Program Director

David Fox, MD, Associate Program Director

Ambulatory Staff                                                           

David Perlstein, MD, Director, Ambulatory Pediatrics: New York Hospital/Cornell University

Nina Agrawal, MD, Medical Director, Child Advocacy Center: New York Hospital/Cornell University, New York University Medical Center/Bellevue Hospital

Ahisu Ayeni MD: Metropolitan Hospital       

Janine Clark, MD: New York University/Bellevue Hospital

Omar Chowdhury, MD: Interfaith Medical Center

David Fagan, MD: Children's Hospital of New York/Columbia University

Claudia Ferran, MD: New York Presbyterian Hospital/Cornell University

Karen Greer, MD: Children's Hospital of Philadelphia/University of Pennsylvania

Lori Keschner, MD: New York Presbyterian Hospital/Cornell University

Elizabeth Kwon, MD, MPH: New York Presbyterian Hospital/Cornell University, Harvard University School of Public Health

Rachel Lewis, MD: Children's Hospital of New York/Columbia University

Asha Mandava, MD: New York University Medical Center/Bellevue Hospital

Roger Morales, MD: Children's Hospital of New York/Columbia University

Trina Peduzzi, MD: Children's Hospital of Pittsburgh

Rosemary Pezzullo, MD: Massachusetts General Hospital/Harvard University

Paulo Pina, MD: New York University Medical Center/Bellevue Hospital

Luz Reyes, MD: St Luke’s/Roosevelt Hospital

Abraham Rice, MD: Kaiser Permanente Foundation, Oakland, CA.

Karen Sawitz, MD: Children's Hospital of New York/Columbia University

Peter Strauss, MD: Yale-New Haven Children’s Hospital

Inpatient Pediatrics

David Fox, MD, Director, Inpatient Pediatrics-Children’s Hospital of New York/Columbia University

Kotha Sudharani, MD: Methodist Hospital

Nadeige Genece, MD: Children's Hospital of Philadelphia/University of  Pennsylvania

Craig Barkan, MD: Schneider Children’s Hospital

Neonatology                                                   

Lazaro Lezcano, MD, Director, Neonatology: Interfaith Hospital, Mt. Sinai Hospital

Ronald Arevalo, MD: Overlook Hospital, New York Presbyterian Hospital/Cornell University

Marie Lourdes Bautista, MD: Flushing Hospital/North Shore Hospital/New York University

Feliciano Emralino, MD: Fellowship-Elmhurst Hospital, Schneider Children's Hospital/Long Island Jewish Medical Center     

Pediatric Emergency Medicine 

Stacey Suecoff, MD, Director, Pediatric Emergency Medicine: New York Presbyterian Hospital/Cornell University, Jacobi Hospital        

Cesar Arias, MD: Jacobi Medical Center, Bronx-Lebanon Hospital Center

Bruce Henry, MD: State Univ of NY-Syracuse, Children’s Hospital  of NJ - Newark

David Listman, MD, Yale-New Haven Children’s Hospital  (Residency and Fellowship)

David H. Rubin, MD: University of California, San Francisco, Yale University

Subspecialty Staff                                                       

Suchitra Acharya, MD, Pediatric Hematology/Oncology: Westchester County Medical Center, Memorial Sloan Kettering Cancer Center/New York Hospital/Cornell University

Paola Carugno, MD: Behavior/Development: Albert Einstein College of Medicine, Kennedy Center

Jessica Davis, MD, Genetics: Children's Hospital of New York/Columbia University,  Albert Einstein College of Medicine

Candace Erickson, MD, MPH, Behavior/Development:: St. Christopher’s Hospital, University of Maryland

Marc Foca, MD, Pediatric Infectious Disease: Children's Hospital of New York/Columbia University

Jim Horne, DO, Adolescent Medicine: Newark Beth Israel Medical Center, North Shore Hospital

Syed Hosain, MD, Pediatric Neurology: NYU/Bellevue Hospital, New York Presbyterian Hospital-Cornell and Kreiger Institute

Haeyoung Hwang, MD, Pediatric Allergy/Immunology: Georgetown University, Ruth/St. Luke’s Hospital Medical Center

Valerie Johnson, MD, Pediatric Nephrology: Mt Sinai Hospital, Albert Einstein College of Medicine

Philip Kazlow, MD, Pediatric Gastroenterology: Mt. Sinai School of Medicine and Hospitals

Ian Marshall, MD, Pediatric Endocrinology: Long Island Jewish Hospital, New York Presbyterian Hospital -Cornell

William Middlesworth, MD, Pediatric Surgery: University of Maryland, Babies and Children’s Hospital/Columbia University

Natalie Neu, MD, MPH, Pediatric Infectious Disease: University of Michigan, Children’s Hospital of New York/Columbia University

Myles Schiller, MD, Pediatric Cardiology: New York Presbyterian Hospital/Cornell University (Residency and Fellowship)