Let's face it: the search for the best residency program is challenging. There are a lot of personal factors that play into this professional decision. You can read about and analyze the statistics on our program from the FREIDA website, but at the end of the day, you're looking for an excellent program to train you for a long, rewarding career. We believe this program has the ability to do that, all at a place where the doctors love what they do, enjoy working with their colleagues, treat you as one of their own, and still have time at the end of the day to enjoy the many things they value outside of the hospital.
Q: Are the residents happy?
A: Without a doubt, we think so! Because BBCH serves as a community hospital for Portland and a tertiary referral center for Maine, our residents work hard and become well-trained pediatricians. Our program is small enough that attendings will know your name, but large enough to support active research, busy services, and a variety of pathology. Our residents may work hard, but they have ample opportunity to play hard in the wonderful state of Maine. Our hospital is located in one of the most beautiful small cities in the country, offering unparalleled access to outdoor activities year round and boasting national recognition for the number and quality of restaurants. It is hard to say if it is a byproduct of the city, the program, or the residents themselves, but the residents who train here leave with a solid foundation, fond memories, and life-long friends. We invite you to find out for yourself by visiting us for an interview. We design our interview schedules to provide ample time for each applicant to meet with both faculty and residents and arrange for an evening out with some of our residents on the night before your interview.
Q: How do you address resident stress?
A: Being a resident is not easy, but you already knew that. Our program supports a healthy work/life balance, so residents can learn to manage stress. Essentials to any stress management program include eating well, sleeping well, exercise, and supportive relationships. Our program also supports and endorses Duty Hour legislation, for this is also an important component of monitoring resident stress and fatigue.
At MMC, we have a close-knit group of residents, and we consciously encourage these relationships. Each fall, we have an overnight retreat attended by residents and key faculty where we participate in team building and learning activities, as well as provide the opportunity for resident bonding away from the hospital. Additionally, our program created a resident wellness committee to help prevent resident burnout and to help organize resident wellness events. Comprised of representatives from each residency year, the chief resident, and associate program director, Pam Dietz, this committee meets regularly to plan twice monthly program-wide wellness events (barbecues, surfing lessons, hiking or rock climbing, apple picking, holiday parties, etc.). Employee wellness has not just been a resident initiative, but a department-wide initiative, as we our Pediatric Department Wellness Committee that focuses on wellness initiatives across all members of the department is entering its third year!
All residents at MMC have free membership to World Gym, a fitness center located within two miles of campus. There are a number of running trails and biking routes near the hospital. Multiple beautiful beaches within 20 minutes from campus are perfect for surfing or brave swimmers (the waters can be chilly)! In the winter, some of the local farms open their fields to cross-country skiers. Snow shoeing on local hiking trails is also popular. In the summer, a local farm brings fresh produce to the hospital for sale twice a week and a number of residents belong to a Community Supported Agriculture (CSA). We know that resident wellness is integral to a strong learning experience and to the best patient care.
Additionally, there is access to department-funded counseling services whenever needed. We also have a strong Faculty Advisor Program (see below).
Q: Do residents have an advisor?
A: Yes! As part of our support system for residents, we have a strong Faculty Advisor Program. At the start of intern year, each intern is paired up with an attending physician who serves as a resource and advocate for the resident. As interns develop relationships with other attending physicians and begin to identify more specific career interests, we offer the opportunity for them to select another or multiple advisor(s). Even after identifying a new mentor/advisor, many residents choose to maintain their relationship with their initial advisor.
Q: How often will I be on call?
A: Applicants to any program are typically interested in the workload and call schedule at the programs to which they apply. As a program, we support and endorse duty hour legislation. We recognize that resident fatigue is real, and the ability for our residents to build work/life balance during residency is important. We have an established night team system in all of our inpatient units.
Here is a review of the general call expectations for a pediatric intern:
There is a night team system both within the inpatient unit and in the NICU. In the NICU, night team is from 7pm to 7am. Interns work 2 weeks of nights during their time in the NICU (generally 5 nights on, 2 nights off). NICU night team generally runs from Thursday through Monday.
On the inpatient unit (IPU), each intern works on average 1 week of night team (Sunday- Friday) per month (seniors do two-week blocks of 5 nights on per week). Weekend coverage on the IPU is split into day shift from 7:00AM - 5:00PM and night shift from 5:00PM- 7:00AM. Interns can each expect to work about 4-5 Saturday night shifts per year. Weekend IPU day team coverage consists of one senior resident and two interns who cover the inpatient unit census. There is always a long call intern who works from 7:00AM - 5:00PM. A second intern, the “short call” intern, starts work at 7:00AM and generally stays until 2-3PM (this is flexible depending on the census).
Q: Where do you work? What is the hospital like?
A: The Barbara Bush Children's Hospital (BBCH) is the primary teaching site for all our residents and medical students. The BBCH is a children's hospital within a hospital at the Maine Medical Center. It enjoys and shares all the support and resources of the larger institution. All of the pediatric subspecialties are represented. Our inpatient unit cares for over 2,500 patients per year, our pediatric clinic sees over 7,500 visits yearly and is the patient-centered medical home for 2,400 patients. Our pediatric emergency department has over 22,000 visits per year, our newborn population exceeds 2,900 deliveries per year, and our NICU cares for 900 patients yearly, of which about ¼ are transferred from outside institutions.
The BBCH Pediatric Intensive Care Unit (PICU) is a new (opened in 2016) 8 bed unit and is down the hall from the BBCH inpatient unit. Residents rotate through the PICU in their second year of training, and cover the PICU at night during their senior IPU night team rotations.
In another wing of the hospital is the Women and Infants East Tower, which is a four level building housing our state of the art Neonatal Intensive Care Unit (NICU), Step Down Neonatal Unit, Transitional Care Nursery, Labor and Delivery, Post-Partum, Ante-Partum, and Newborn Nursery. An emergency department expansion at the lower level of the East Tower includes a 10 bed dedicated Pediatric ED.
The “Curriculum” section of our website discusses each rotation in much more detail, and the BBCH web site will give you a better feel for our overall hospital.
Lastly the entire hospital (inpatient and outpatient) utilizes the Epic EMR to provide a paperless transfer of patient information wherever they are in our system.
Q: What about benefits and vacations?
A: Our residents' salaries are quite competitive. On top of this we offer a benefits package including medical, dental and disability care, malpractice insurance and life insurance. Vacation time is 21 working days per year. We also do our best to assure 5 days off at either Thanksgiving or Christmas. The department provides educational funds for our residents so they can attend meetings, and/or buy textbooks or journals. This amounts to $400 for each first year, $800 for each second year, and $1,000 for each third-year resident.
Q: How will I get feedback on my performance?
A: Feedback is frequent and regular, including formal written monthly evaluations on each resident. Feedback of this nature is used to evaluate each resident on the core ACGME competencies of Medical Knowledge, Patient Care, Communication, Professionalism, Practice Based Learning and Improvement, and Systems Based Practice. Twice a year, our Clinical Competence Committee (consisting of major rotation supervisors along with the Program Directors) meets to provide an overview of each resident's progress. Our residents discuss these composite evaluations individually with the program director. Evaluations are shared with faculty advisors on a periodic, regular basis. Patients and paraprofessionals also provide feedback to our residents, specifically to address communication and professionalism. We expect our faculty to provide verbal feedback during rotations to address expectations and ways to improve. Residents also complete evaluations of the faculty, rotations, and colleagues. This feedback is used regularly to guide ongoing program development.
Q: Do the residents have input into the program?
A: We have a great training program and are always looking at ways to improve it. Opinions from the residents are welcomed directly or anonymously and are always taken seriously. Monthly, the chief resident meets with the residents in a protected resident-only forum to discuss active issues in all areas of the program and solicit input into the resolution of these issues. Additionally, the chief resident organizes Task Forces for selected units that are joint attending-resident enterprises with a goal of making recommendations to those units for improvement. Residents are also an integral part of our program evaluation/education committee where major programmatic changes and development take place. Residents are not only a part of residency-specific committees, but are also members of many departmental committees. These formal lines of communication help to ensure that the resident perspective is heard, but we also encourage open dialogue between faculty, residents, and support staff for real-time improvement and QI efforts.
Q: Where do residents come from and where do they go?
A: Part of our residency program’s job is to make you employable! Often applicants ask how competitive they will be at the end of residency, whether they are entering practice or a fellowship. The best way to answer this is by our proven track record. On average over the years, 50% of our residents enter primary care and 35% go on to pediatric fellowships, and approximately 15% become pediatric hospitalists. Of those who enter primary care, many join established practices, large and small, within Maine and throughout the country, often becoming leaders in their local communities. Our residents enter competitive specialties regularly and generally match with the top one or two programs of their choice.
Please see Alumni & Fellowship Placements for specific positions and locations where our recent graduates have gone after training, including a list of our resident fellowship placements.
Q: Will I be doing much teaching or supervising?
A: All of our residents are actively involved in supporting our 3rd and 4th year medical student experiences. This may include supervision on inpatient and ambulatory rotations and teaching sessions. Medical students may join a resident in a clinic visit, newborn exam, or hospital admission. The innovative “Maine-Tufts Program in Medicine” is now in its 11th year. The Maine group completes their entire third and fourth year clerkships at Maine Medical Center. Also, we frequently have medical students from Dartmouth, University of Vermont, University of New England COM, and other schools throughout the country. We welcome these learners into our community, and are excited that our residents are a large part of their pediatric clinical medical school experiences.
Our senior residents also have ample opportunities to teach and supervise interns during our inpatient unit months. Our residents become senior residents on the floor during their second year of training, which means more experience in a supervisory role when you’ve completed residency. The senior is not only responsible for organizing teaching time and content, but also directing rounds and admissions. This multi-task management experience serves our residents well when they transition onto fellowship and attending-level work.
Q: What about resident housing?
A: Portland is both a delightful and safe city in which to live. The hospital is located in a residential district, so some of the residents live in apartments, houses, or condos within walking distance of the hospital. Others prefer rural and smaller coastal communities. Many residents find very affordable housing only 5-20 minutes away. Many residents purchase homes or condos when they start training and turn them over to others when they finish their residency. Because most residents participate in the transport call moonlighting opportunity as second and third years, we recommend finding a home less than 20 minutes from the hospital so that you may take this call from home.