Description

The Pediatric Residency Advocacy Rotation at SUNY Upstate introduces first-year residents to community-based advocacy through partnership with the Early Childhood Alliance Onondaga (ECA) Help Me Grow (HMG).

Residents learn about the social and structural factors affecting children’s health and development in Onondaga County, and the rotation provides firsthand exposure to community organizations, parents, and advocates. By experiencing “the other side of the referral,” residents build understanding of local resources, gain confidence guiding families to appropriate supports, and learn about early childhood development through first-hand experience with utilizing the Ages and Stages Questionnaire and how HMG uses it with families. This approach strengthens relationships between medical providers and community systems, aligning care with families’ real-world needs.

Need / Problem Statement

Traditional residency programs emphasize physical health but provide limited exposure to the broader social and environmental factors influencing child and family well-being.

Many SUNY Upstate residents come from diverse regions or countries and are unfamiliar with local community challenges. This gap limited residents’ ability to connect families with appropriate supports and navigate social service systems. The Advocacy Rotation was developed to:

• Expand residents’ understanding of social drivers of health
• Improve familiarity with local community services and resources
• Strengthen pediatricians’ ability to make warm handoffs and act as system navigators
• Encourage more compassionate and comprehensive care that reflects family realities

Process

One attending physician at SUNY Upstate initiated and designed the rotation which included:  

• Consultation with attending physicians and local organizations to identify suitable partners
• Development of a framework balancing clinical and advocacy learning
• Coordination with residency leadership to ensure time allocation within the first-year schedule
• Finalization and refinement over a 6 to 12-month design-to-implementation period

Partnership

Partnerships with families and community organizations are central to this innovation.

• Parents and caregivers participate in resident experiences through ECA/HMG, offering insight into their lived experiences.
• Though not part of the original design, community feedback led to meaningful additions to resources, including The Brain Architecture Game, which demonstrates how early experiences shape brain development.
• Physicians and social workers serve on ECA advisory and leadership committees, creating a sustainable bridge between the medical system and community-based organizations, ensuring residents gain advocacy experience grounded in family realities.

Implementation

Implementation followed extensive relationship-building between SUNY Upstate, ECA, and HMG.  

• Key stages and timeline: After initial partnership development and curriculum planning (first 6–12 months), resident cohorts pilot tested and refined scheduling, community engagement, and supervision.
• Staffing: One attending physician oversees the rotation while social workers and faculty facilitate residents’ learning and integrate them into clinical workflows.
• Integration and ownership: With the rotation as a required part of first-year training, consistency is ensured. Wellness activities and advocacy lectures are integrated to promote reflection and connection and ongoing communication with skeptical residents helps sustain engagement.

Changes & Outcomes

Since its launch, the rotation has transformed how residents view their role as pediatricians.

This innovation has fostered a culture shift toward advocacy, collaboration, and family-centered care in the following areas:

• Family engagement: Residents now make more effective, personalized referrals to community resources (e.g., HealthySteps, food pantries, diaper banks) and experience meaningful connections through “warm handoffs” to support services.
• Provider well-being: Residents report greater satisfaction and purpose through advocacy involvement and experience deeper empathy and the value of holistic, community-centered care.
• System outcomes, including:
  • Strengthened collaboration between the medical center and local organizations
  • Residents are inspired to pursue advocacy projects or community research during or after training
  • Some alumni replicate similar efforts in their future practices

Measurement for Success

• Continued inclusion of the Advocacy Rotation in the first-year curriculum, even amid new national training requirements introduced in 2025
• Qualitative feedback from residents and community partners on engagement, relevance, and skill development
• Tracking the number of residents who pursue advocacy or community partnerships after completion
• Observation of more effective and efficient family referrals to community resources
• Informal evaluation of resident well-being and satisfaction through reflective discussions and debriefs

Payment & Funding

This investment has yielded long-term value by fostering trust, advocacy skills, and important community partnerships. 

• Funding type: Supported by PSP funds for meals, wellness items, and evaluation activities
• Anticipated gains: While there was no direct financial return, there were significant human and relational benefits, including:
  
  • Improved family access to community supports through informed physician referrals
  • Increased provider well-being and strengthened cross-sector collaboration
  • Self-sustaining model that continues without the need for ongoing external funding

Resources

• ECA and UPAC Resident Survey and Interview Findings 

To learn more about this innovation please email Summer Merrick, Director of Help Me Grow at the ECA: [email protected].