During the required rotations of Adult emergency medicine for pediatric trained residents, the Pediatric Emergency Medicine Subspecialty Resident is assigned to the Adult Emergency Department at WakeMed Health & Hospitals.  The Pediatric Emergency Medicine Subspecialty Resident functions as a level 1 Emergency Medicine resident and is responsible for direct patient care during the month.  All clinical, on-call and conference responsibilities are dictated for the month by the Department of Emergency Medicine at UNC Hospitals.  The Pediatric Emergency Medicine Subspecialty Resident is supervised by an Emergency Medicine faculty member from WEPPA for that entire month rotation.

During the required Adult trauma rotation, the Pediatric Emergency Medicine Subspecialty Resident is assigned to the trauma service at WakeMed.  The Pediatric Emergency Medicine Subspecialty Resident is expected to participate in all clinical rounds, assigned surgical procedures, and conferences held by the Trauma Service while on that rotation.

For Emergency Medicine (EM) trained residents only: Cardiology, Infectious Disease, Neurology and Neonatology: The emergency medicine trained resident functions as any pediatric resident functions and is supervised by the respective attending faculty.

During the required rotation of Emergency Medical Services (EMS), the Pediatric Emergency Medicine Subspecialty Resident functions as an observer in the EMS system with a structured curriculum of approximately 50 hours a week.  The subspecialty residents are integrated into many components of the Emergency Medical Services based in Wake County.  The Pediatric Emergency Medicine Subspecialty Resident has no clinical responsibilities at the emergency department of WakeMed; teachings are coordinated by the Director of EMS in Wake County.

During the clinical rotation on Pediatric Emergency Medicine: The Pediatric Emergency Medicine Subspecialty Resident will act as a supervisor for the cases seen by the pediatric and emergency medicine residents but will also be encouraged to assume primary responsibility of interesting cases.  They will take referrals from other physicians (offices, clinics, and outside emergency departments) as well as EMS calls to the department.  The subspecialty resident will be involved in referrals to other services and coordinating the care with the consultant.  They will be a constant resource to the nursing and resident staff for educational information and advice.  The subspecialty resident will also be responsible for scheduled resident lectures as well as physician assistant conferences/case reviews.

During the required rotation on the Pediatric Intensive Care Service, the pediatric emergency medicine fellow will be working in the pediatric intensive care unit at UNC Hospitals.  The Pediatric Emergency Medicine Subspecialty Resident is expected to participate in all clinical rounds as well as take on a supervisory role in collaboration with the pediatric intensive care subspecialty resident.  As a supervisor, the Pediatric Emergency Medicine Subspecialty Resident is responsible for coordinating and precepting the pediatric residents who are assigned to the patients in that unit. They are closely monitored by the pediatric critical care medicine faculty. Pediatric Emergency Medicine Subspecialty Residents do not take any call or responsibility in the emergency room during that rotation.  All their clinical responsibilities, and teaching during that month is solely at UNC Hospitals and is done with the Division of Pediatric Critical Care Medicine.

An additional month of PICU is done at WakeMed.  During this time, the subspecialty resident will focus on management of critically ill child and also interact with the pediatric anesthesiologists.  All care will be directly overseen by the pediatric intensivists and allow the subspecialty fellow direct one-to-one teaching.

Procedure Shifts:  For Pediatric trained residents: During this month the subspecialty resident will divide their time between suturing, ultrasound application and available procedures in the hospital on services such as pediatric surgery and PICU.

During the required rotation on Radiology, the Pediatric Emergency Medicine Subspecialty Resident works in conjunction with the pediatric radiologists at WakeMed.  The Pediatric Emergency Medicine Subspecialty Resident interacts with many residents and subspecialty residents during that rotation because of other physicians seeking interpretation of their radiographs.  The function of the Pediatric Emergency Medicine Subspecialty Resident is observational, learning techniques of interpretations of radiographs and other studies used in Pediatric Radiology.  The Pediatric Emergency Medicine Subspecialty Resident is supervised extensively by the Pediatric Radiologist in the Radiology Department during this rotation.

During the Research months in years 1, 2, and 3, the Pediatric Emergency Medicine Subspecialty Resident works with a Pediatric Emergency Medicine attending who acts as a mentor to help with formulating, designing, and instituting a research project.  The chosen field of research interest is selected by the Pediatric Emergency Medicine Subspecialty Resident with guidance from the Program Director and Research Director.  The research interest by this Pediatric Emergency Medicine Subspecialty Resident is then coordinated with a Pediatric Emergency Medicine faculty member who acts as a mentor for the 2-3 years.  If the field of interest is outside the ED, that subspecialty resident is then assigned to an additional mentor outside the Section of Pediatric Emergency Medicine, so as to ensure completion of the project.

During the required Toxicology rotation at Carolina Poison Center, the Pediatric Emergency Medicine Subspecialty Resident works with a toxicologist at the Poison Center.  All of the teaching and training is based out of the toxicology center in Charlotte, North Carolina.  The Pediatric Emergency Medicine Subspecialty Resident is involved in acquiring knowledge through conferences as well as clinical responsibilities, i.e., by taking toxicology calls during that month at the toxicology center.  The Pediatric Emergency Medicine Subspecialty Resident interacts with many subspecialists during that month.