The Quarter System: Partitioning of Ambulatory and Inpatient Time in Intern Year

In Intern Year, the Keystone Quarter provides an integrated 12-week block that serves as a foundational experience in ambulatory pediatrics, child advocacy, developmental and behavioral pediatrics, emergency medicine, and longitudinal ambulatory experiences. The Quarter System facilitates an integrated approach to didactic instruction via two weekly Keystone Quarter Seminar Series for the 10-11 residents assigned to the block. One series of seminars is devoted to child advocacy and the other to developmental and behavioral pediatrics and primary care. Residents flow through the Intern Year schedule in a pattern of 12 weeks of inpatient rotations alternating with 12 weeks of ambulatory training. Apart from the Keystone Quarter, the other three Quarters (one ambulatory-focused and two inpatient-focused) feature more traditional 4-week block experiences clustered within each 12-week block:

  • Adolescent Medicine – Newborn Medicine – Night Ward Team and Vacation
  • General Pediatrics Inpatient Wards
    • BMC Wards
    • BCH 9E, BCH 7W (PEAR), BCH 6E (HAIR)
    • BCH Short Stay Unit
  • BWH and BMC Neonatal Intensive Care Units and BCH Intermediate Care Program (a step-up unit)

Overall, the adoption of the Quarter System increases the amount of ambulatory training time in the Intern Year compared to traditional pediatric training models. We believe this approach provides a strong foundation in general pediatrics, greater opportunities for longitudinal care, and a comprehensive understanding of community resources.