The major goal of the first year of training is to develop and refine clinical skills, including pediatric problem solving and differential diagnosis, by assuming responsibility for caring for both well patients, and those with a wide variety of pediatric illnesses. A close working relationship with a team of supervisory residents and attending faculty provide a supportive environment in which the PL-1 resident gains confidence in clinical assessment and decision-making. The rotations are structured and taught to ensure optimal educational benefit.

Each PL-1 will spend three four-week rotations on the inpatient services at Connecticut Children's Medical Center, caring for hospitalized patients from all socioeconomic backgrounds. The PL-1 resident has primary responsibility for 5-10 patients, with supervision by senior housestaff and attending faculty.

A block rotation in the Pediatric Emergency Medicine Department introduces the PL-1 resident to the principles and skills needed in this area. Residents will care for a full spectrum of children with emergent needs, including injuries due to trauma, toxic ingestions, and intercurrent illness. A formal curriculum in emergency care is taught by PEM trained faculty who staff the unit 24 hours per day. The experience also includes important exposure to and teaching of telephone medicine in pediatrics and use of a rapid care center.

First-year residents are assigned to four rotations in ambulatory pediatrics, which includes 4 weeks of vacation. These are the first of 10 blocks that occur in the same practice setting throughout the three years, and where most residents also participate in their weekly continuity sessions. The initial rotation, assigned in the first three months, introduces the residents to their practice. Subsequent rotations involve a full range of practice activities, including: scheduled visits, intercurrent care, and postnatal visits for newborns enrolled in the practice. PL-1 residents will also have introductions to behavioral and development pediatrics, community service, and a longitudinal community service activity integrated into the ambulatory assignments. The community service experience occurs in multiple sites throughout the Hartford area. This experience is the equivalent of 1 block rotation.

The block rotation in behavioral and development pediatrics is provided in the first year. The needs of the newborn are also addressed in two rotations of the first year, with one block of well baby care and the other rotation in neonatal intensive care. The PL-1 typically cares for 5-10 sick neonates while in the NICU. There are two block electives during the PL-1 year.

PL-1 residents are assigned to every fourth night call during inpatient rotations, and during one or two cross-over months from their ambulatory experience. During the rest of the ambulatory blocks, they have less than every fourth evening (5:30-9:30pm) or weekend day (11-11) in the Emergency Department taking phone calls for their practice with full faculty back up. Calls are taken from home at other times during these assignments. ED experience is provided in day and evening shifts and there is limited or no call from required rotations.

PL-1 residents have 4 weeks of vacation scheduled during the ambulatory rotations. National holidays are covered as weekend days, so only those on call are on duty. Each resident is scheduled to have a holiday break of four days at either Christmas or New Year's, but other holiday time away can be arranged.  Residents have at least 3 of 4 days off on Thanksgiving weekend.