Frequently Asked Questions
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: Yes! And we hope you have the opportunity to hear from them yourselves! No matter where you land, residency will be challenging, rewarding, stimulating, exhausting and thrilling at various times during your three years of training. Barbara Bush Children’s Hospital (BBCH) serves as a community hospital for Portland and a tertiary referral center for Maine, exposing our residents to a variety of clinical pathology on every service while building a strong foundation of pediatric medicine. We work closely and collaboratively with our attendings to provide high quality care to the children of Maine. Outside of work, our residents know how to recharge in one of the most beautiful cities in the country. Our hospital is located in one of the most beautiful small cities in the country, offering unparalleled access to year-round 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.
Q: How do you address resident stress?
A: You’ve probably been told that being a resident is not easy. You’ve also probably gathered that being a resident during a global pandemic has posed some new challenges.
Our program encourages the development of a healthy work/life balance by endorsing duty hour legislation, embedded wellness afternoons, building stress management skills, supporting collective and individual wellness needs, and responding to new stressors swiftly and thoughtfully.
The basic essentials to any stress management program include eating well, sleeping well, exercising, and nurturing supportive relationships. We may be a smaller program, but we are a close-knit program, and take pride in our ability to work closely with one another to support our residents individually.
Each fall, we have a resident retreat where leadership and key faculty hold team building activities, reflection exercises and class-specific check-ins during, and then allow residents the opportunity to relax, socialize and bond overnight. Our program also heads a resident wellness committee, comprised of representatives from each residency year, the chief resident, and associate program director, Pam Dietz. This committee meets regularly to plan monthly program-wide wellness events (BBQs, surfing lessons, hiking, apple picking, holiday parties, bake-offs, skiing/snow tubing, bowling, etc.). And we’ve certainly demonstrated our ability to adapt – When social distancing was necessary due to the pandemic, we put our heads together to create safe events and keep residents connected throughout the year (bonfires, secret santa, valentine’s affirmations, virtual attending-resident trivia, etc.).
In addition, MMC has a GME Resident Wellness Committee that offers hospital wide events, resident wellness grants, free counseling services and Peer-to-Peer support program, free membership to World’s Gym (located 2 miles from the hospital), and in-hospital locations for meditation, lactation and chaplain services. Some of the events hosted in the past include: “Resident & Fellow Appreciation Week,” mindfulness workshops, free rooftop yoga sculpt and strength classes, and a series of virtual concerts during the peak of the pandemic. Please see Graduate Medical Education Wellness Resources for more information on wellness support for residents at Maine Medical Center!
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 residency, 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: What is X+Y Scheduling?
A: This year (2022-2023) we transitioned our curriculum to an X+Y schedule, which we think will help improve outpatient continuity (you will have multiple days every 4 weeks available for your panel), reduce inpatient transitions of care (you will no longer leave inpatient rotations for continuity clinic), and decompress schedules (you will very rarely, if ever, have more than 4 weeks of inpatient blocks back to back). Each year is comprised of 26 2-week blocks. X blocks are rotations where you will not have clinic, and Y blocks are rotations where you will have clinic embedded. Clinic days involve acute care visits, well child checks and follow ups, and time protected for administrative tasks, QI, and wellness.
Q: What is night shift like?
A: Our residents do night float while rotating through the inpatient unit (IPU) and the NICU.
Interns and senior residents do two weeks of nights each 4 week block of NICU. Shifts are generally Thursday through Monday, and run from 7pm to 7am (so 5 nights on, 2 nights off). The resident is the first call for all of the babies in the NICU, and works closely with the neonatal nurse practitioner and the neonatologist. Overnight you’ll be running night rounds, attending deliveries, admitting patients, doing procedures and accompanying the neonatologist to any consultations!
In the IPU, night float is also 5 nights (Sunday through Thursday), and shifts are from 5pm to 6:45am. On average, each intern works 1 stretch of nights per 4 weeks of IPU. This is different from senior residents, who work 2 stretches of nights per 4 weeks of IPU. As you probably noticed, Sunday through Thursday shifts mean Friday and Saturday are uncovered. One of the interns rotating on the IPU doing their week of swing shift (aka the admission shift), will transition to nights on Friday and Saturday and cover the floor with a cross-covering senior resident. As the intern, you are the first call for all patients on the IPU, and your responsibilities include attending to overnight events, admissions, consults and grabbing that last cup of coffee before the cafeteria closes briefly at 2am!
As a senior resident, you inherit additional responsibilities as the overnight team leader. You are second call to the IPU patients, and first call to the PICU patients and newborn nursery patients. You also hold the admission pager (which fields calls from providers in emergency departments, urgent cares and outpatient practices), and triage consults, transfers and direct admissions with the help of the pediatric hospitalists and intensivists.
Q: How often will I be on call?
A: Great question, particularly because this has changed with our transition to the X+Y schedule in the 2022-2023 year! Our call, or “backup system,” is for senior residents (PGY2 and PGY3), and is used in times of short notice absences (emergencies, illness, etc) and when there is extra help needed on the inpatient units (primarily IPU and PICU). Starting this year, senior residents have 7 days of 24hr backup, for an average total of 3 weeks in the entire year. Residents on call will follow their normal rotation schedule, but will be available if called upon. During backup weeks, residents should not be further than a 20 minute drive from the hospital. Outside of these designated weeks, senior residents do not have any call responsibilities – which we think will contribute to better work/life balance!
In addition to backup, residents that take call are also eligible for PICU transport call (which often coincides with your backup). Same rules apply, but since this is a moonlighting opportunity, compensations are provided.
Q: Where do you work? What is the hospital like?
A: As a pediatric resident, you will train at Barbara Bush Children’s Hospital (BBCH), which is part of Maine Medical Center. We are fortunate to have all pediatric subspecialties represented. Please continue reading below for a brief overview of each unit and check out the “Curriculum” section of our website to review each rotation in much more detail.
Maine Medical Center is part of MaineHealth, which is a network of many hospitals around the state. All of these hospitals utilize Epic as our electronic health record platform to provide a paperless transfer of patient information wherever they are in our system. Resident parking is in the brand new employee parking garage located < 1 mile from the hospital by car and <0.5 mile by foot. Many residents park in the garage and either take the shuttle (4 minutes) or walk (10 minutes) to work.
Our inpatient unit is an active 30-bed unit, with two additional procedural rooms dedicated on the floor. We run interdisciplinary, family-centered iPACE rounds, and work closely with our pediatric subspecialists, pediatric pharmacists, child life specialists, and social workers.
The BBCH Pediatric Intensive Care Unit (PICU) is an 8-bed unit adjacent to the inpatient unit. We have a PICU Transport Service (staffed by residents, PICU nurses and PICU respiratory therapists) that is activated for pediatric patients requiring higher-level care from all over the state. 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, you’ll work in the state of the art Neonatal Intensive Care Unit (NICU), Continuing Care Nursery (CCN), and Newborn Nursery, all of which are located near obstetrical units in the newly renovated Coulombe Family Tower. Our NICU is a 51-bed unit, our CCN is a 20-bed unit and our Nursery is a 20-bed unit. All patient rooms are private, allowing for “rooming-in” of mothers and babies. Our NICU cares for > 900 patients annually, of which ~ ¼ are transferred from outside institutions. Our newborn population averages about 3000 deliveries per year, and approximately 1/3 of this population is served by the pediatric newborn service.
Our resident pediatrics clinic is also located within Maine Medical Center, which makes the hospital a recognizable hub for all inpatient and outpatient pediatric care. We have an in-house behavioral health clinician, making warm-handoffs and coordination of care seamless. With our new X+Y schedule, will have clinic regularly throughout the year on Y-rotations, in addition to dedicated clinic blocks.
The Maine Medical Center Emergency Department is one of the busiest and the only Level 1 Trauma center in the state, and includes a dedicated pediatric wing (10+ beds). It is located at the lower level of the Coulombe Family Tower.
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 $600 for each first year, $1,100 for each second year, and $1,100 for each third-year resident.
Q: How will I get feedback on my performance?
A: Feedback is frequent and regular, including formal written evaluations after completion of a rotation, as well as informal, on-the-spot discussions. The formal feedback 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. These composite evaluations are then reviewed individually with the program director. Evaluations are shared with faculty advisors on a periodic, regular basis. Patients and other health professionals 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: Yes! We take pride in our training program and are always looking for ways to improve it. While we are open to receive resident feedback at anytime, we have a monthly “resident forum” where the chief resident and residents meet to discuss active issues in all areas of the program and solicit input for resolution. 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: How does the program support diversity?
A: Portland is an increasingly diverse city as a refugee resettlement area and a refuge for many asylum seekers. In our resident clinic we have a robust community outreach program that allows us to connect with new immigrant families, complete their initial medical evaluations through our International Clinic, and begin building relationships between provider and patient, as well as their families.
As a program, we strive to learn more about what makes people of all backgrounds unique based on their gender, culture, relationships and race. We also recognize that groups of people have been marginalized and their health impacted by these factors and we are committed to educating ourselves and others to improve care of our patients and the well-being of our community. We have a director of diversity and inclusion for MMC and feel our institution and leadership are also working to learn and grow to identify racism and bias and to make positive changes. The hospital is actively engaged in recruiting a more diverse workforce, including in our residencies, so that we can better serve and represent our Portland community. We include perspectives from our patients and colleagues of under-represented minorities in our recruitment process. We welcome and encourage applicants from all backgrounds to apply to our program.
We also have a “Global Health Local Immersion Experience" elective (see curriculum section) designed to introduce residents to the community resources that help new immigrants and refugees settle in our community.
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, about half of our residents enter primary care a third go on to pediatric fellowships, and about 20% 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 a well-established part of our community and their students complete 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. On the inpatient unit, our residents become senior residents 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. Additionally, third year residents complete a Teaching Elective where they have dedicated time to explore various teaching methods via the “Residents as Teachers” curriculum, and put these skills to practice in morning report sessions, bedside teaching, procedural demonstrations, chalk-talk sessions and much more!
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. Some residents purchase homes or condos. 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.
Q: What is Portland like?
A: Portland is a hidden gem! It is a city full of character, surrounded by sea breeze and salt water, and saturated with ridiculously good food. Ask any of the residents and they will tell you nothing different! Other perks of the area: easy access to the outdoors (trail walks, beaches, biking trails, kayaking/SUPing, surfing, downhill or cross-country skiing, snowshoeing, etc), live concerts (Thompson’s Point outdoor summer concert series, State Theater, Merrill Auditorium), island hopping (check out the Casco Bay Ferry line), and many quaint coastal towns to visit on a weekend trip. We hope you have the chance to visit and see how great the city is. Please don’t hesitate to reach out to us when you’re in town – we have plenty of recommendations!