Adolescent Medicine

The Adolescent Medicine Service provides comprehensive primary care and tertiary care for teenagers referred from their community physicians with specialty problems.  This takes place in inpatient as well as out-patient settings.  Training includes both a didactic component and patient interaction. Experience with interviewing, diagnosing and treating adolescents with STDs; family planning issues and substance abuse intervention are just a few of the problems seen in this subspecialty clinic. In addition, there is an active and large population of patients seen with eating disorders, including anorexia nervosa, bulimia nervosa, and binge-eating disorder. There is an opportunity to receive additional GYN training, sports medicine experience and interaction with area mental health professionals who work with adolescents. There are also opportunities to participate in school-based programs, as well as to spend time in an adolescent drug rehabilitation center. Adolescent Medicine includes inpatient coverage of adolescents as well as the Adolescent Clinic. Nurse practitioners and faculty, along with pediatric residents, staff this clinic.

Allergy/Clinical Immunology/Rheumatology

The Division of Allergy/Clinical Immunology/Rheumatology is responsible for specialty clinics as well as inpatient consultations at Children’s Hospital. Over 600 new patients are seen each year, and more than 2,800 clinic visits are made by patients with a variety of allergic, immunologic, and rheumatic disorders.

Cardiology

The Division of Cardiology has four pediatric cardiologists and is responsible for diagnosing and managing both congenital and acquired heart disease in children within the Western New York region. The annual cardiac caseload consists of approximately 1,200 new patients; 3,500 outpatient visits; 500 cardiac admissions; 300 cardiac catheterizations; and 10,000 echocardiograms. This division is very active in teaching on both a resident and medical student level.

Pediatric Critical Care

The Pediatric Critical Care Division is responsible for the care of children who need intensive nursing and medical support, often with highly sophisticated technology. The division has an active teaching program for subspecialty fellows, residents, and medical students. Faculty is engaged in both laboratory and clinical research. Senior residents and students rotate through this division’s eighteen-bed pediatric intensive care unit which serves both medical and surgical patients; approximately 50 percent of its 1,000 yearly admissions are medical patients.

Developmental Pediatrics/Rehabilitation

At the Robert Warner Rehabilitation Center of Children’s Hospital, the goal is to create a partnership between medical, genetic, and rehabilitation professionals and the families of children with special needs in order to optimize the independence of the child. Perhaps nowhere in medicine is the importance of prevention and intervention as critical as in the care of children with developmental or acquired disabilities. Mini-teams are designed for case management of essential rehab diagnostic, monitoring, and equipment services. Children undergo functional, developmental, and/or psychological assessments by multidisciplinary teams. Developmental pediatricians are involved in mental retardation, cerebral palsy, or multiple handicaps. Interdisciplinary teams meet frequently.

Emergency Medicine

The Division of Emergency Medicine at Children’s Hospital is responsible for the care of approximately 45,000 patients per year. Pediatric residents are assigned to the emergency department during all three years of their residency, and are given steadily increasing responsibility for patient care. Emergency medicine residents and family practice residents are also routinely assigned to this fully supervised rotation. This division is part of the Western New York Regional Pediatric Trauma Center and operates the Children’s Express Program (Fast Track Clinic) during the busiest shifts to facilitate the care of less seriously ill and injured patients. Residents are an integral part of this intense learning experience. Division faculty provide medical input for the pediatric component of paramedics functioning in Western New York and operate a pediatric stabilization and transport program. In addition, the Division of Emergency Medicine consults on inpatient child abuse cases.

Endocrinology/Diabetes

The Division of Endocrinology follows approximately 2,000 patients with endocrinopathies and 600 with diabetes. These patients are followed largely on an outpatient basis.  Additionally, the endocrinology service performs about 150 consultations annually on pediatric patients admitted to the pediatric service. The Endocrine staff cares for patients with growth disturbances, thyroid dysfunction, congenital adrenal hyperplasia, gonadal and genital abnormalities, and other endocrinopathies. The Division of Endocrinology is also the referral center for the diagnosis and treatment of infants with congenital hypothyroidism detected by the New York Neonatal Thyroid Screening Program.  House officers also participate in the care of inpatients with Type 1 and Type 2 diabetes throughout their residency and learn the outpatient management during their 8-week endocrinology/diabetes rotation. The residents have also the opportunity to spend a week at the diabetes summer camp sponsored by the American Diabetes Association.

Gastroenterology

The Division of Gastroenterology maintains an active nutritional consultation component and clinic. The faculty manages a consultative service and provides care for the 5,000 patients seen in clinic each year. The inpatient census runs from 10 to 19 patients, with 600 new patient evaluations yearly.

General Pediatrics

The Continuity Clinic, a major teaching aspect of this division, is arranged as a private practice. Pediatric residents spend one to two afternoons per week in this office during their residency training. The principles of well-child supervision, continuity of medical care, growth and development, and anticipatory guidance are all established and practiced. Primary care lectures are given daily. Nurse practitioners and medical students are an integral part of this resident group practice. There is also an annual month-long rotation through the Continuity Clinic.

The Newborn Service is responsible for approximately 40 percent of all newborns at Children’s Hospital. Residents and students rotate through this service caring for approximately 1,200 newborns each year. Daily teaching sessions by a general academic pediatrician and regular interaction with a dysmorphologist, developmental specialists, cardiologists, etc., add to the scope of this rotation.

The Division of General Pediatrics is also responsible for practice sites outside Children’s Hospital, including Columbus Community Health Center (West Side Health Center) and Jesse Nash Health Center. These clinics care for a large indigent population and are staffed by division members. Together, the clinics are responsible for about 25,000 patient visits yearly. Their primary goal is to fine tune the health-care delivery system to meet the needs of the people they serve.

The PACT (Parents and Children Together) Clinic was established to care for children of drug-abusing mothers. Its goal is to provide these children with comprehensive care through a unique program of surrogate mother support and integrated, multidisciplined care. Ongoing research provides outcomes of long-term follow-up and results of intervention techniques.

Genetics

The Division of Genetics provides clinical genetic evaluation and care for approximately 700 outpatients and inpatients each year at Children’s Hospital. Additional patients are seen at urban and rural outreach sites and at other hospitals in the metropolitan area. The Cytogenetics Laboratory completes 1,700 chromosome analyses annually, including 1,000 from prenatal diagnostic cases; the Robert Guthrie Biochemical Genetics Laboratory performs over 3,000 metabolic tests each year. The division’s active laboratory and clinical research programs emphasize molecular and biochemical approaches to the understanding of major human genetic disorders.

Hematology/Oncology

The Division of Hematology/Oncology logs more than 1,000 clinic visits annually as it oversees the care of 105 new patients each year. The division is also responsible for more than 30 inpatient consultations monthly. Specialized centers exist for the care of patients with sickle cell disease, hemophilia and malignancies. There are inpatient floors and outpatient clinics at both Children’s Hospital and the Roswell Park Cancer Institute, where the specialized care of children with hematologic and oncologic diagnoses is provided by residents and faculty. In addition, there are opportunities for house staff and students to participate in numerous research projects.

Infectious Disease

The Division of Infectious Diseases provides consultations on patients with infectious diseases, teaches graduate students at the M.D. and Ph.D. levels, and conducts research in clinical microbiology, virology, and immunology. Consultations on 300 to 350 inpatients and outpatients are performed annually. A clinic for the diagnosis and management of pediatric AIDS cases – including new therapeutic protocols and complete multidisciplinary support – has been established. The division is heavily involved in the clinical investigation of infectious diseases, in clinical trials of antiviral agents, and in basic science research in bacterial and viral immunology. Additionally, the division is intimately involved with the Bacteriology, Virology, and Molecular Diagnostics Laboratories; in particular, the development and application of new diagnostic tests such as PCR tests.

Neonatology

Children’s Hospital is the site for the Regional Perinatal Center for Western New York. A variety of patients are treated by the obstetricians, perinatologists, neonatologists, and anesthesiologists at this multidisciplinary center. The Children’s Hospital of Buffalo has 3,000 deliveries yearly, combining inner-city high-risk populations, regional referrals of high-risk patients, and general community obstetrics – all of which generate approximately 850 admissions to the Neonatal Intensive Care Unit annually. About 350 infants are transported each year to this Regional Neonatal Intensive Care Unit from 26 community hospitals in Western New York and northern Pennsylvania. The neonatal unit has 54 beds, is staffed by 126 nurses, 9 respiratory therapists, 5 blood gas technicians, and 14 neonatal transport nurses. The neonatology experience includes primary patient care responsibility for critically ill and convalescent intensive care patients, work rounds with attendings and fellows, educational conferences, and delivery room attendance.

Nephrology

The Division of Nephrology has an active clinical and teaching service with two full-time attending physicians and an active fellowship training program. This division logs 1,500 clinic visits annually (involving 180 new patients each year) and has an average of 15 inpatients on the service each month. Training focuses on renal physiology, immunopatology, dialysis (hemo- and peritoneal), continuous renal replacement therapies, renal biopsy, and renal transplantation.

Pediatric Medical Education

The Division of Pediatric Medical Education is involved with the planning, coordination, and delivery of the subject content of pediatrics to medical students and pediatric residents.  Its administrative structure includes a director of the residency program, an associate director, as well as a director of student education and two chief residents. All lectures, meetings, conferences, student interviews, etc., as well as ongoing efforts to track resident and student progress, are coordinated through this essential office. The division is also responsible for an integral credentialing program and serves as the center for most postgraduate CME activity. A very busy recruitment program is housed here. It is the pediatric resident academic home.

Pulmonary Medicine

The Division of Pulmonary Medicine, which includes the Cystic Fibrosis Center, is a busy in- and outpatient clinical service. Approximately 250 new patients each year supplement the patient base of the more than 1,500 children evaluated annually as outpatients. The division runs clinics for patients with cystic fibrosis, apnea, bronchopulmonary dysplasia, and general pulmonary problems, as well as for children who use home ventilators. Inpatient care for children and young adults with CF and other pulmonary disorders is also provided. The division maintains an active pediatric flexible bronchoscopy service, and residents are encouraged to observe these procedures. The Apnea Evaluation Unit is certified by New York State. The Cystic Fibrosis Center is nationally accredited for critical care, teaching, and research. It is the referral center for all CF patients in the Western New York region and is an active participant in multicenter trials to evaluate new treatment options.

Division of Community Physicians

This unique division is made up of community pediatricians with Department of Pediatrics and University appointments who meet regularly to discuss issues pertinent to the practice of primary care pediatricians. They are actively engaged in collaborative research efforts. This division is fully integrated into the Department of Pediatrics and reports to the Pediatric Chairman.