Residency training evolves to meet complex needs

“When I was a resident, stem cell bone marrow transplants didn't exist, nor did liver transplants," says Robert Listernick, MD. "Residents today are caring for children who would not have survived back then."

Chief medical resident Rishi Lulla, MD, shares details about a complicated patient case during the morning report, a daily gathering of residents and faculty members. Seated beside him is Robert Listernick, MD, an attending physician at Children's Memorial Hospital and professor of pediatrics at Northwestern University's Feinberg School of Medicine. Despite a difference of nearly 25 years of experience, Lulla and Listernick are contributing equally to the discussion.

The increasingly active role of the chief resident is one of many ways the residency program has changed since Listernick completed his training at Children's Memorial Hospital in 1982. Today, he is one of the world's leading authorities on care for children with neurofibromatosis, a potentially severe genetic disorder of the nervous system.

When asked what the biggest difference is between then and now, Listernick laughs and says, “Sleep.” In his day, residents were on overnight call at the hospital every third night, making 36-hour shifts and 120-hour workweeks the norm. Today, the Accreditation Council for Graduate Medical Education mandates that residents work no more than an average of 80 hours per week.

Listernick is quick to point out that although today's residents work fewer hours, the nature of the work has intensified with patient cases that are more complex. “The children I cared for as a resident were not as sick as the children we treat at the hospital today.” He explains that in the early 1980s, at-home medical care was not readily available like it is today. As a result, children who were well enough to return home, but required intravenous antibiotic therapy had to remain hospitalized.

“When I was a resident, stem cell bone marrow transplants didn't exist, nor did liver transplants,” says Listernick. “Residents today are caring for children who would not have survived back then.”

Listernick spent a large portion of his residency starting IVs. Today there is a dedicated team focused solely on administering IVs, allowing residents to gain greater experience in more areas of patient care. Listernick faced cases of meningitis nearly every day during his residency training. Residents today rarely see these cases, due to the introduction of the Haemophilus influenzae type b vaccine in the late 1980s. He says the most significant changes he has seen during his career are because of this vaccine.

While Listernick's training focused mostly on inpatient care, Lulla has gained a breadth of experience in primary care, outpatient and subspecialty medicine. Lulla's patients are followed by many of the subspecialists at Children's Memorial on an outpatient basis.

The residency program at Children's Memorial is one of the most sought-after in the country with 25 times more applicants than available positions.

Lulla has completed training in community medicine and child advocacy, which is now a required rotation of all residents. This was not a required rotation during Listernick's medical education, although he was trained to identify and intervene in cases of child abuse and neglect. Residents today attend regular educational sessions on preventive medicine and work with children and families at Children's Memorial Pediatric Services Uptown .

Emphasis on mentoring and pediatric research have remained constant over the years. Today, residents have the opportunity to train with leading scientists at the Children's Memorial Research Center , one of only a handful of institutions in the U.S. dedicated solely to pediatric research.

In addition to new educational components in the program, the composition of participants has changed over the years as well, with more women represented in current residency classes than ever before, according to Sharon M. Unti, MD , residency program director at Children's Memorial and assistant professor of pediatrics at Northwestern University's Feinberg School of Medicine.

Today the residency program at Children's Memorial is one of the most sought-after in the country with 25 times more applicants than available positions. Lulla says he, like others, was drawn to Children's Memorial for its stellar reputation and the opportunity to learn from leading experts like Listernick.

Children's Memorial Hospital seeks philanthropic funding to enhance its programs and services. As a proud partner of the Children's Miracle Network (CMN), all funds raised in the Chicago area through CMN also benefit Children's Memorial. To find out how your support can help the hospital better serve children and families, please contact the Children's Memorial Foundation at 773.880.4237 or Foundation@childrensmemorial.org.