PL-1  Emphasis is placed on the fundamentals of patient care. PL-1s strengthen their interviewing, physical diagnosis, laboratory diagnosis, and oral and written communication skills. Focus is directed toward developing effective and empathetic relationships with the child and family, working as a member of a health care team and therapeutic management of acute illnesses.

PL-2  Focus is directed at building skills in the diagnosis and management of complex and chronic medical problems in the inpatient and outpatient settings as well as managing common pediatric complaints. Supervisory responsibility for care on the inpatient service begins with night and weekend call during specialty rotations and in the consultant role on subspecialty services.

The residents gain experience in subspecialty areas, including pediatric intensive care, emergency medicine, newborn medicine, pediatric surgery, adolescent medicine, developmental pediatrics, endocrinology/diabetes, gastroenterology, cardiology, allergy/pulmonary medicine, immunology, genetics, hematology/ oncology, nephrology, neurology and infectious diseases.

The teaching resident rotation is focused on teaching physical diagnostic skills to third-year students one-on-one with their patients. The teaching resident also participates in various child advocacy programs.

A one-month elective is left open to the interest of the house officer. Many residents use this time to work in other cities and countries. Alternatively, the resident may choose to undertake a scholarly project with a faculty member at St. Louis Children's Hospital. COPE continues as one half-day each week.

PL-3  Emphasis is placed on leadership of a health care team and autonomy as a practitioner. The PL-3 senior supervisory rotations are the inpatient units, emergency department and pediatric intensive care unit. Two to four months of subspecialty rotations include ambulatory and inpatient consultations. A one-month elective, similar to that in the PL-2 year, is provided to each resident. Diagnostic center/general pediatric consultation is a one-month rotation. The resident continues in COPE one half-day each week.