Pediatric Specialty Training

The pediatric residency program at MUSC includes a varied training experience in adolescent medicine that is designed to provide a strong foundation for general adolescent care in pediatric practice. Adolescent medicine clinical services include an adolescent clinic, a school-based clinic at a nearby high school, and an active inpatient consultation service. In addition to this clinical training, didactic sessions in adolescent medicine are scheduled into the resident lecture series to cover the learning objectives regarding care of adolescent patients. The rotation also includes experience in an adolescent substance abuse treatment program and an intensive outpatient eating disorders program. Other specific areas such as sports medicine, private practice adolescent medicine or eating disorder group therapy sessions can be arranged at the request of the resident.

The Division of Pediatric Pulmonology, Allergy and Immunology was established in July 2000. Our division is committed to providing effective and innovative patient care, education about common and rare pulmonary, allergic and immunologic disorders, and clinical research. It is growing in faculty, patient numbers and research projects.

The Allergy and Immunology elective is designed to provide residents with an in depth exposure to the breadth of allergic and immunologic diseases seen in both children and adults. These diseases include but are not limited to: atopic dermatitis, allergic rhinitis and sinus disease, asthma, anaphylaxis, urticaria and angioedema, mastocytosis, drug allergy, insect allergy, contact dermatitis, food allergy, eosinophilic esophagitis, recurrent infections, and immunodeficiency disorders. This elective provides an academic allergy and immunology experience, so problems are typically more complex than in the private practice setting. If residents prefer, they have the option to engage in a private practice allergy and immunology rotation as well. The clinical focus of the elective is in our outpatient clinics, but residents are also expected to see inpatient consults when they arise.

The division of cardiology and cardiothoracic surgery work closely together to care for our infants and children with congenital heart defects. More than 400 major operations and 600 cardiac catheterizations are performed annually. Critically-ill pre-operative and post-operative patients are cared for in our pediatric cardiology intensive care unit. Residents care for cardiology patients on the inpatient cardiac stepdown unit. There is also an elective rotation offered for residents to gain experience in outpatient cardiology and/or inpatient consultations as well as the cardiac intensive care unit. Our pediatric heart program is ranked among the top 10 programs in the nation by U.S. News & World Report.

Child life specialists provide various services to address the social, emotional and developmental needs of infants, children and adolescents. Programming includes assessment and a psychosocial care plan including therapeutic play and developmental support. Intervention strategies foster continued growth and development, minimize adverse reactions to the health care experience and reduce stress and anxiety.

Goals for children include mastery, control, opportunity for choices, self-expression and increased understanding and cooperation with medical treatments and procedures. Child life staff members manage and staff Medical Center playrooms and may be assigned to pediatric clinics, the department of emergency services and hospital units. This group also provides in-service classes and lectures within the University and throughout the community. Topics include child development and psychosocial issues concerning children and health care experiences. Consults are accepted from all services.

The critical care division coordinates the acute care of seriously ill children. We can provide all live sustaining therapies including CVVHD, HFOV, and ECMO.  The division directs patient care in the mixed acuity 28-bed unit that has the ability to care for critically ill children and those needing an intermediate level of care.  We are also the main pediatric burn unit in the area and have dedicated rooms and staff to assist in caring for these patients.  Residents learn to take care of critically ill patients with a wide spectrum of diagnoses and are involved with critical post-operative care.  Residents have the ability to listen and participate in interfacility transports of critically ill children both via phone calls and telemedicine thru 2-way audio-visual communication.

The division of developmental-behavioral pediatrics provides residents with a broad exposure to the evaluation and management of children with a variety of concerns related to development and behavior. Trainees learn to discern atypical and typical development by integrating observations, history, and administration/interpretation of screening and assessment tools. In clinic, common childhood problems are encountered such as temper tantrums and toileting issues, as well as chronic conditions such as attention/deficit-hyperactivity disorder and autism spectrum disorder. Other diagnoses encountered include learning disabilities, intellectual disability, developmental delay, anxiety, and cerebral palsy. Furthermore, there are opportunities for exposure to specialty populations at risk for developmental disabilities in the following clinics: Spina Bifida, NICU Graduate, International Adoption, Cardiac Neurodevelopment, and Down syndrome. An interdisciplinary approach to care for children is highlighted in a number of our clinics. Fellowship training is available in this subspecialty.

The pediatric emergency department at MUSC provides care for over 25,000 patients per year and is a Level 1 Trauma center. The emergency department serves as the front door of the hospital and is a vital part of the greater Charleston community but also receives many transports and referrals as part of the larger MUSC regional network. As such, residents rotating through the emergency department will be exposed to common acute pediatric conditions as well as patients who require more complex and specialized care. There is 24/7 attending coverage in the emergency department and the attendings and pediatric emergency medicine fellows are thoroughly invested in your education. To supplement your clinical learning, our rotation includes a resident-led teaching project, mock codes, numerous online resources, and a newly designed ultrasound curriculum. Residents in the department are expected to be the first line provider for all patient encounters and over your residency our goal is to help you develop the skills and confidence necessary to care for the acutely ill and injured child.

The Division of Pediatric Endocrinology and Diabetes provides services to children from various backgrounds with a wide array of endocrine disorders. Residents are offered a 4 week rotation during which they get to engage in direct outpatient care. Conditions we see include growth disorders (short and talk stature), precocious/delayed puberty, thyroid dysregulation, thyroid cancer, parathyroid disorders, adrenal disorders, pituitary insufficiency/hyperfunctioning, as well as certain cancer patients needing hormone replacement, as well as patients with diabetes mellitus.

The rotation is geared towards maximizing resident learning. It is unique in that each is given a binder of educational materials pertaining to high yield endocrine topics including those typically encountered in primary care pediatrics as well as the boards. These materials are also available online should the learner prefer a digital version. The rotation starts and finishes with an online pre-test and post-test self evaluation which usually demonstrates significant improvement in the learners’ knowledge in endocrinology at the end of the rotation. A direct feedback is usually given regarding each case encountered in clinic to impart on-the-fly learning pearls throughout the day and highlight unique aspects of each patient’s presentation, diagnosis and management as applicable. A didactic learning format is also included during the resident lecture series.

Rotating residents also enjoy joining our dietician as she sees patients with poor weight gain, obesity, and diabetes. This experience is optional towards the end of the rotation.

The Division of Gastroenterology, Hepatology, and Nutrition specializes in the care of children with both digestive and liver diseases.  We operate as a consulting service for inpatient pediatric teams and have a wide array of outpatient clinics.  Some of our subspecialty clinics include Hepatology, Feeding Clinic, NICU Nutrition Clinic, Liver Transplant Clinic, and Inflammatory Bowel Disease Clinic.  In addition, we perform many diagnostic and therapeutic endoscopic procedures.  We work closely with our colleagues in radiology, transplant surgery, general surgery, pulmonology, ENT, and nutrition.  Residents are encouraged to participate in an elective, especially those interested in general pediatrics, given the significant volume of gastroenterological complaints in children, including: constipation, functional abdominal pain, reflux, poor growth, vomiting, and diarrhea.  The rotation can be tailored to an individual residents particular learning objectives.  In addition to participation in our clinical care, residents will also participate in our gastroenterology fellows lecture series.

The general pediatric inpatient service provides residents with a mixture of acute and chronic diagnostic and therapeutic challenges. Patients from the local area provide residents with good exposure to common pediatric problems, and a large number of tertiary care patients with rare diseases are referred from the entire state. Attending hospitalists make daily teaching rounds and are closely involved in the day-to-day operation of all units. The ward service is organized into three teams, each with an upper level resident and interns as well as medical and pharmacy students.

It is the policy of the department to delegate the primary responsibility of caring for all patients to the house staff. The inpatient service is conducted entirely within Shawn Jenkins Children's Hospital so it is not necessary for house staff to rotate through affiliated hospitals for their inpatient experience.

The division of hematology/oncology is responsible for the evaluation, treatment and follow-up care of all patients with hematologic disorders, coagulation defects and malignant diseases. It is also responsible, in collaboration with the adult oncology transplantation team, for pediatric patients undergoing bone marrow transplantation, and it is an integral part of the university wide Hollings Cancer Center. In coordination with the attending hematology/oncology physicians, house staff assigned to this service are responsible for consultations, evaluations and treatment of hospitalized patients. Residents are provided with support from the Department of Pathology and Laboratory Medicine, informal didactic teaching and frequent contact with all members of the division. Upon completion of a rotation on this service, the pediatric house officer will have achieved familiarity with evaluation of hematologic problems, will have the ability to recognize and manage common problems associated with pediatric malignancies and will have acquired the technical and psychological skills to perform these in practice. Fellowship training is available at MUSC.

The pediatric infectious diseases division provides consultation on a wide variety of infectious problems. Patients with common pediatric infections are admitted from the local population while the statewide referral population provides exposure to unusual or severe infections. The pediatric residents interact with the division through formal or informal consultations and in topic-oriented teaching sessions. The elective in pediatric infectious diseases gives the resident an opportunity to see inpatient and outpatient consultations. Participation in clinical research projects by interested residents is encouraged.

The neonatal-perinatal medicine division specializes in taking care of neonates, especially critically ill and premature newborns. The NICU at MUSC is a private-room 82 bed Level IV unit that offers services from all surgical subspecialties and ECMO. Our brand new NICU also has state-of-the-art couplet care rooms for postpartum mothers and their infants admitted to the NICU. Residents participate in direct patient care, learning to take care of a broad scope of neonatal diagnoses. They also participate in delivery attendance, learning critical neonatal resuscitation skills. Residents also have the opportunity to spend elective time in the NICU, focusing on procedures and delivery room experience. 

Alison Chapman, MD
Assistant Professor of Pediatrics, Division of Neonatology
MUSC Shawn Jenkins Children’s Hospital
10 McClennan Banks Drive, MSC 915
Charleston, SC 29425-9150
Phone: 843-792-2112
Fax: 843-792-8801

The pediatric nephrology division is a national leader in clinical care and clinical research providing statewide tertiary services for children with kidney and urinary tract diseases.   The division boasts internationally recognized expertise in transplant, glomerular disease and critical care nephrology. The division provides the  full breadth of care and exposure for residents including an expansive inpatient experience involving patients with renal transplants, end stage kidney disease, glomerular disease, and critical care nephrology.  The Medial University of South Carolina is only center in the state that performs renal transplants.  During their rotations the residents have an opportunity to rotate on the inpatient service which averages between 10-20 patients per day across the hospital in all clinical areas.  As part of the inpatient rotation the resident will have the opportunity to observe renal biopsies.  The pediatric nephrology division also provides a robust outpatient clinical service with up to 9 half days of clinic per week seeing over 2500 visits per year.  This includes a wide exposure to common and rare problems in pediatric nephrology (hematuria, proteinuria, chronic kidney disease, glomerular disease, hypertension, nephrolithiasis, urologic conditions, etc.)  There is also exposure to multidisciplinary clinics including renal transplant, pediatric rheumatology, and pediatric cardiology.   The nephrology rotation provides an in-depth exposure to nephrology with the flexibility to tailor the rotation to the goals of the trainee. The nephrology elective offers an in-depth exposure, wherein the house officer is given the chance to review the current literature and to participate in clinical research.

The Pediatric Neurology division provides tertiary diagnostic and therapeutic services for children with a wide variety of neurologic disorders.   The division specializes in the care of children with epilepsy, cerebral palsy, neurogenetic, movement and headache disorders.   Clinical services include ambulatory pediatric neurology, an inpatient consult service, and a robust video-EEG program.   There is close collaborations with pediatric neuroradiology, neurosurgery and dietary services for the ketogenic diet.   Resident will be expose to general clinical neurologic issues as well as electroencephalography, and the uses and limitations of special diagnostic studies, including video-EEG, CT and MRI brain scanning.  Residents will work closely with a senior Child Neurology Resident/Fellow and Attending on a daily basis.   Resident experiences can be tailored for inpatient, outpatient or a combination of both.  Upon completion of a rotation on service, the pediatric resident will have achieved familiarity with the evaluation and examination of children with general neurologic problems and will have the ability to recognize and manage common problems with seizures, tics and headaches.

The Albert Florens Storm Eye Institute has four pediatric ophthalmology faculty members who are available both for inpatient and outpatient service consultations. The staff manage a large variety of ophthalmic disorders in children and assist in the diagnosis of neurological and general systemic diseases. Lectures and seminars are available periodically throughout the year. Pediatric residents are encouraged to spend elective time on the service where they will become familiar with the in-office diagnosis and management of common pediatric ophthalmic disorders.

The Pediatric Palliative Care Program was started in 2015. This interdisciplinary team is one of the fastest growing within the pediatrics department. Consisting of physicians, advanced practice nurses, social work, chaplains, bereavement coordinator, volunteers, complimentary therapists and other support staff, the program works with children and families facing serious illness to:

• Help reduce suffering and improve quality of life
• Aid families in setting goals and making medical decisions that reflect their unique beliefs and values
• Partner with families and other specialists to develop a care plan that is most appropriate for each patient and their goals.

Rotations with the Palliative Team are scheduled as individualized electives. Residents will spend the majority of their time working with families admitted throughout the hospital. Most encounters occur in the various intensive care units. Additional potential experiences include consultation in the Advanced Fetal Care Center and in home hospice visits. This rotation is ideal for any resident who anticipates a career caring for children with life limiting illness, ICU work, neonatology, or those who seek to improve communication skills.

The Pediatric Hospital Medicine (PHM) teams proudly serves children and adolescents at the MUSC Shawn Jenkins Children’s Hospital (SJCH), opened in 2020. The 3 hospital medicine teams work mainly on the 8th and 9th floor of SJCH: these floors contain 54 of the total 250 beds in SJCH.

 The patients have a variety of medical needs and present with acute and chronic diagnostic and therapeutic challenges. Patients from the local area provide residents with good exposure to common pediatric problems and a large number of tertiary care patients with rare diseases are referred from the entire state. Charleston is a travel-destination, and so it is not unusual to have visitors to our city who need medical care.

The PHM attending physicians are integral members of the teams and make daily teaching rounds. They are closely involved in the day-to-day operation of the three teams. MUSC has a PHM fellowship. PHM fellows each spend 8 weeks a year on one of the PHM teams, enhancing the learning experience for residents and students. Each of the three hospital medicine teams generally has an upper level resident and two interns as well as medical students and pediatric pharmacy staff/trainees. 

It is the goal of the Pediatric Hospital Medicine group to delegate the primary responsibility of caring for all patients to the house staff. Our clinical service is conducted entirely within the SJCH; it is not necessary for house staff to rotate through affiliated hospitals for their inpatient experience.

The division of pediatric pulmonology is committed to providing effective and innovative patient care, education about common and rare respiratory disorders, and research. Currently there are three faculty members who manage outpatient clinics as well as the inpatient consult service.

Division faculty admit their patients to the general pediatric team and make daily management/teaching rounds with members of that team. Residents who take the pediatric pulmonary elective will have exposure to patients in both the inpatient and outpatient setting, though the rotation is highly adaptable depending on the trainee’s education and career goals. There is also the opportunity to attend the cystic fibrosis (CF) clinic as well as the potential for experiences with respiratory therapists (inpatient setting) and in the pulmonary function testing laboratory setting. Division faculty regularly attend and contribute to morning report and provide education during the pulmonary education block as part of the resident academic half day.

The general patient groups seen by this division include asthma, apnea, bronchopulmonary dysplasia, CF, congenital lung abnormalities, respiratory infections, neurologic disorders, acute and chronic respiratory failure, restrictive lung diseases, sleep disorders ,and other miscellaneous respiratory conditions. Patients with chronic respiratory failure requiring tracheostomy and home ventilation are also managed by our providers. Residents will also learn about the indications for and information to be obtained from various types of testing including flexible bronchoscopy, exercise testing, pulmonary function testing, and sleep studies.

The division of pediatric radiology is staffed by five full-time pediatric radiologists who have formal fellowship training and subspecialty certification in pediatric radiology. In addition to working with the entire spectrum of pediatric radiologic investigative procedures, they are intimately involved in resident teaching and research. Daily ICU rounds and weekly multidisciplinary conferences are held with the pediatric clinical subspecialists and house staff. A pediatric radiology elective is offered, which can be tailored to highlight the role of imaging in your specific area of interest/future fellowship.

The Division of Rheumatology is a subspecialty offering expertise in diagnosis of autoimmune diseases, musculoskeletal pain syndromes, periodic and prolonged fever conditions, multisystem inflammatory conditions, and connective tissue diseases. Treatment strategies are designed to capture all aspects of the child’s life; multidisciplinary, comprehensive, compassionate care. Rheumatology collaborates with all the subspecialties; in particular, ophthalmology, dermatology, orthopedics, nephrology, neurology and psychology. Residents who take the pediatric rheumatology rotation will gain experience both in the outpatient and inpatient settings.

The Children's Hospital has an established transport team especially designed for the neonatal and pediatric patient up to age 16. This team consists of a transport nurse and a respiratory therapist with medical control provided by the divisions of critical care and neonatology. A fully staffed medical transport service comprised of a helicopter, airplane, and mobile intensive care ground ambulance greatly enhances the Children's Hospital transport capabilities.