During the PL-3 year, residents assume the greatest amount of responsibility for teaching and supervision of residents and medical students during all aspects of patient care. The greatest level of leadership and knowledge is required in this role, though senior residents still benefit from the guidance of their faculty mentors whenever needed.

The PL-3 resident serves as the senior supervisor for two inpatient rotations at Connecticut Children's Medical Center. Each resident also has three additional blocks of his or her schedule dedicated to the ambulatory practice experience. This includes the continued longitudinal experiences in behavior and development, adolescent care, continuity care, and subspecialty exposure, but with an added level of complexity to allow for necessary growth and sophistication in completing this curriculum. There is a rotation in the NICU at the Connecticut Children's Medical Center with its busy delivery service, and there are additional supervisory experiences provided in the PICU and the emergency department. There are four additional block electives for a total of nine elective block rotations. One of these electives in the PL-3 year is also taken without night call. Additional night float and teaching resident assignments are provided.  Night call is every fourth day during the PICU rotation. Inpatient service is covered after hours by night float, Sunday through Thursday and weekends by residents assigned for duty on two of the four weekends. NICU call is only on two of four weekends. Residents have 10 or 11 sick call assignments over the entire year, and they have reduced calls on ambulatory and elective rotations. E.D. is covered the same as in the PL-2 year. There are four weeks of vacation, and holiday coverage is also the same as in the PL-2 year.