Welcome to the Silver Service! Your time on Silver exposes you to a wide range of complex medical diseases seen among the pediatric population, including patients with primary Gastroenterology, Endocrinology, and Rheumatology conditions. You will round with fellows and attendings from each of these subspecialties. In the winter and early spring months, you will also be taking care of patients on the Pediatric Hospital Medicine service.


Before Your Rotation

  • Review the Goals and Objectives
  • The senior residents for each block should reach out to the team 1-2 months in advance to discuss scheduling, which will then be reviewed by the Chief Residents.
  • All oncoming team members must receive verbal patient sign-out from the outgoing team; you should also review the off-service notes in Epic by the outgoing interns.


  • PL-1 residents: 2-4 week blocks, typically for a total of 4-8 weeks over the course of the year
  • PL-2 residents: 2-4 week blocks, typically a total of 4 weeks over the course of the year
  • Days off: Total of 4 weekend days over the course of a 4-week rotation (or 2 days for 2-week rotations), scheduled by senior residents
  • Daily schedule as follows:
    • Day team arrives for sign-out at 6 AM for sign-out. Night Team will sign out to day team after they have signed out to Maroon residents.
    • One intern and one senior are designated as “long” each day and will stay through evening sign-out (which begins at 6 PM)
  • Typical Rounding Schedule
    • 9-9:30 AM  Rheumatology
    • 9:30-10:30 AM  Gastroenterology
    • 10:30-11 AM  Endocrinology
    • During winter and spring, PHM rounding typically begins at 9 AM, subsequent rounds occur 30-45 minutes later than typical schedule
  • Afternoon teaching is to be scheduled amongst fellows, residents, attendings

Roles and Responsibilities

PGY-1 Intern Responsibilities:

  • Interns work day shifts
  • Perform the primary patient care role
  • Pre-round on patients and write daily progress notes and orders
  • Present patients on rounds with complete and concise assessment and plan
  • Call consults as soon as possible, after formulating a specific question for them
  • Take care of daily work associated with patient care
  • Communicate with patients, families, and primary physicians
  • Fax discharge summary to primary care physician in a timely manner (ideally within 24 hours of discharge and prior to patient’s follow-up appointment)
  • Attend morning and noon conference daily with 75% attendance expected

PGY-2 Senior Resident Responsibilities:

  • Seniors are in charge of all patients on the service and will carry patients when patient load is high
  • One senior resident must be in house until 6 PM to sign out to the Night Team
  • Oversee and conduct sign-out
  • Keep EPIC sign-out and problem lists up to date
  • Help interns with daily plans for patients
  • Double-check all of the work completed by interns
  • Examine all patients daily prior to morning report
  • Attend morning and noon conference daily with 75% attendance expected


The Silver team works in the conference room just across from the staff elevators on Comer 5. Patients admitted to Silver Service will be on Comer 5 and 6 floors.