Leadership by senior pediatric residents has been a priority for the Harriet Lane Program since its genesis. The goal of the first two years of the program is to prepare residents to assume leadership of teams and services during their PL3 year. The leadership role is a particularly important feature of the general inpatient teams. Each PL3 resident spends two months, along with a PL3 colleague, teaching and evaluating medical students, a sub-intern, and two pediatric interns assigned to their team.  It is the responsibility of those two senior residents to organize family-centered rounds, supervise the clinical activities of their more junior teammates, and provide clinical teaching that meets the needs of all members of the team. A faculty attending oversees the team for the entire one-month block and has overall responsibility for the patients assigned to him/her, but work rounds are the responsibility of the senior residents. Teaching rounds are held by the attending twice each week.

Throughout the three years of the program, interested residents take on additional leadership responsibilities. Residents from all three classes represent their colleagues on the Program Evaluation Committee, the Resident Advisory Committee of the Harriet Lane Clinic and the Morbidity and Mortality Committee.

• Interns meet with Dr. Shilkofski, Dr. Fadrowski, Dr. Pruette, Dr. Genies, and Dr. Showall each month for lunch. During those meetings interns share their observations about their experiences in the program and make suggestions for improvements—big and small.
• Program Evaluation Committee- Residents have active input as members of the Program Evaluation Committee which meets monthly to discuss curriculum issues, perform an annual review of the program and discuss proposed curriculum changes and innovations. Multiple residents from each level of training (PL-1, PL-2, PL-3 years) are selected to serve on the committee.
• Pediatric Diversity Council - The Pediatric Diversity Council is a newly developed council consisting mostly of pediatric residents with additional involvement from pediatric fellows and faculty. Our goal is to continuously increase and maintain activities within the Department of Pediatrics that both enhance shared and diverse experiences and exposures and foster cultural competency for all trainees while also developing effective strategies to recruit house staff that will enrich the residency program through diversity.
• Morbidity and Mortality conference - The purpose of the conference is to learn from past cases to create an environment where we provide the best and safest care possible. Residents work to investigate the case, interview the disciplines involved, compose the presentation, invite speakers, facilitate the dialogue and work as a member of the improvement team for those cases where systems changes are deemed necessary.
• Harriet Lane Handbook - The internationally recognized Harriet Lane Handbook, thought by many to be the ultimate pediatric resource for patient care, is published every 3 years. The Chief Residents serve as the editors and the senior residents from that particular year author chapters in conjunction with faculty selected for their expertise.