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 four 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 acute illness. A formal curriculum in emergency care is taught by PEM trained faculty who staff the unit 24 hours per day.

First-year residents are assigned to three rotations in ambulatory pediatrics, which includes 4 weeks of vacation. These are the first of nine 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, usually assigned in the first half of the year, introduces the residents to their practice. The subsequent rotations involve a full range of practice activities, including: scheduled visits, acute care, and postnatal visits for newborns enrolled in the practice.  Part of the training also includes teaching of telephone medicine and taking phone calls at night from patients with attending support.  In addition, PL-1 residents will 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.  During the ambulatory, elective, newborn nursery and development blocks, they will either cover the inpatient teams at night or take telephone calls at night.  In general, call is usually less than every fourth night when the PL-1 is not on an inpatient service for the block.

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 generally have at least 3 of 4 days off on Thanksgiving weekend.