During this year, residents are given primary patient care responsibility under direct supervision of senior residents and staff.  The emphasis is on primary care of pediatric patients from newborns to adolescents. Interns spend three months on the inpatient ward (one as day shift, one as night shift and one at Children's National Medical Center), 1 month in the neonatal intensive care unit, two months on the newborn service (one as night shift) and 2 months in the general pediatric clinic. One month rotations are completed on the adolescent medicine service, developmental-behavioral pediatrics, and in the emergency room at Children’s National Medical Center. 

The second year is designed to introduce the resident to more sub-specialized patient care and to learn how to supervise junior residents in inpatient settings and in the nursery.  Rotations are offered in community pediatrics, anesthesia, child abuse, orthopedics & sports medicine, pediatric critical care (at INOVA Fairfax Children's Hospital), the NICU (one block at WR and one block at INOVA Fairfax Children's Hospital), inpatient ward, and in 4-5 electives. 

In the third year, residents gain skills as teaching chiefs on the inpatient services and in the clinics. Rotations in subspecialty electives and the pediatric ICU at Children's National Medical Center are offered. Two semi-independent rotations prepare graduating residents for their first duty station by approximating attending duties, responsibilities, and privileges at two high-volume sites: one outpatient ambulatory pediatrics month at Malcolm Grow Medical Center at Andrews Air Force Base, and one inpatient nursery rotation at either Womack Army Medical Center at Fort Bragg, NC or at Blanchfield Army Community Hospital at Fort Campbell, KY. In the final block of the year, residents complete a Transition to Practice Rotation before graduation to prepare for work after residency. 

Electives in every pediatric subspecialty are offered by on-site faculty specializing in nephrology, genetics, rheumatology, gastroenterology, endocrinology, cardiology (including specialists in electrophysiology and fetal cardiology), hematology-oncology, infectious diseases, and pulmonology. Pediatric electives are also available on-site at Walter Reed Bethesda in pediatric anesthesia, dermatology, allergy/immunology, radiology, urology and other surgical subspecialties. Rotations in Humanitarian Medicine, Research, and Teaching are available as well. Residents are encouraged to help develop new electives that specifically meet their individualized career plans.

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The program offers significant opportunity to individualize their curriculum. Residents have 11 or more block rotations in which their education is tailored to both their future as a military pediatrician and to their chosen career path. Four of the individualized blocks must be electives in core subspecialties of their choosing, and one must be an outpatient experience in pediatric orthopedics and sports medicine. The remaining 6 or more blocks are chosen by the resident based on their personal interests and goals (e.g. research, subspecialty fellowship, international health, advocacy, or others).