Download Welcome to Pediatrics! . . Abdulmahdi A. Hasan* *Ph,D, pediatric

Welcome to Pediatrics! . .
Abdulmahdi A. Hasan*
*Ph,D, pediatric & Mental Health Nursing ,College of Nursing, Babylon University
Before we get started . . .
What goals do you hope to accomplish during your pediatric clerkship?
What are some things that scare you
about pediatrics?
Orientation Overview
Clerkship Essential Information
Rationale
Expectations
Break!
Evaluation
Learning Activities
Break!
Clinical Topics
Development
Formulas
Writing Rx
IV Fluids
Community Sites
MCG Schedule and Tour
Meet with Chiefs
Why Pediatrics?
You have to!
You will use this knowledge and skill.
All physicians will take care of children at some time in their career!
This may be the only chance you have to learn pediatric medicine
It’s Different!
Growth & Development
Physical
Psychosocial
Prevention & Health Maintenance
Family & Community
Child Advocacy
Goals of Pediatric Clerkship
Acquisition of a basic knowledge of growth and development (physical, physiologic and
psychosocial) and of its clinical application from birth through adolescence.
Acquisition of the knowledge necessary for the diagnosis and initial management of
common acute and chronic illnesses.
An understanding of the approach of pediatricians to the health care of children and
adolescents.
An understanding of the influence of family, community and society on the child in
health and disease.
Goals of Pediatric Clerkship
Development of communication skills that will facilitate the clinical interaction with
children, adolescents and their families, ensuring that complete, accurate data is obtained.
Development of competency in the physical examination of infants, children, and
adolescents.
Development of clinical problem-solving skills
Development of strategies for health promotion as well as disease and injury prevention.
Development of the attitudes and professional behaviors appropriate for clinical practice.
What’s Expected of Me?
Attitudes
Empathy
Compassion
Understanding
What’s Expected of Me?
Attitudes
Empathy
Compassion
Understanding
Skills
Patients
Observation & Experience
What’s Expected of Me?
Attitudes
Empathy
Compassion
Understanding
Skills
Patients
Observation & Experience
Knowledge
Specific Objectives:
Other
What’s Expected of Me?
Reading
Curriculum
Patient-inspired reading
What’s Expected of Me?
Reading
Curriculum
Patient-inspired reading
Conferences
Conferences
All Augusta Students
Weekdays @ 12:15 (Usually Dugas, but check schedule!)
Grand Rounds - Friday @ 8:00
Morning Report: Mon – Thurs @ 8:00
Schedule: Ped5000 Web Page
What makes rounds “Grand”?
“Grand Rounds” is different than “Rounds”
Weekly conference attended by faculty, residents, students, and sometimes ancillary staff
Often a topic is presented by a specialist or a visiting professor
A continuing medical education opportunity
What is “Morning Report”?
Gathering of faculty, residents, and students on Mon.-Thurs. mornings
An intern or senior student presents a case
The chairman or faculty moderates discussion about differential diagnosis and brings out
teaching points
Students, residents, and faculty are expected to participate
Conferences
All Augusta Students
Weekdays @ 12:15 (Usually Dugas, but check schedule!)
Grand Rounds - Friday @ 8:00
Morning Report: Mon – Thurs @ 8:00
Schedule: Ped5000 Web Page
MCG Inpatient Rotation:
General Attending Rounds: Thurs. @ 2pm with General Attending on 4C
Chief Jeopardy: 2nd Mon. @ 3pm with Chief Resident
Off-Campus Sites:
CD’s of Lectures at sites
Lectures also on-line through Vista
(not compatible with Mac, so check out a laptop)
Grand Rounds available by Podcast
http://www.mcg.edu/pediatrics/grandroundsschedule.html
What’s Expected of Me?
Reading
Curriculum
Patient-inspired reading
Conferences
Rounds
What is a “Team”?
Group of medical staff all responsible for patient care
Often a hierarchy of responsibility:
Attending physician – in charge and ultimately responsible for decisions and outcomes,
teaches, mentors
Resident – usually 2nd or 3rd year – supervises, oversees other members of team, leads,
organizes, teaches
Intern – 1st year of training, responsible for direct patient care, may oversee the students
Senior Medical Students – acting interns; responsible for direct patient care
Junior Medical Students – direct patient care, knows details on their patients
Ancillary Staff – may include nurse practitioners, physician’s assistants, pharmacists,
nurses, respiratory therapists, dieticians, child life
What are “Rounds”?
Many patient care decisions are made during “rounds”.
A gathering of the “team” to discuss all patients under their care
“Sit Down Rounds” – located in a small conference room with formal teaching
“Walk Rounds” (“Bedside Rounds”) – walking from room to room with point of care
teaching
More about “Rounds”
JMS is expected to present their patients including assessment and plan
Intern may add additional information
Resident may elaborate on plan and teach
Attending has final say about assessment and plan, assesses knowledge, and teaches
What’s Expected of Me?
Reading
Curriculum
Patient-inspired reading
Conferences
Rounds
Internet
What’s Expected of Me?
Reading
Curriculum
Patient-inspired reading
Conferences
Rounds
Internet
“Entitlement”
Phase III - A Paradigm Shift
Phase III - A Paradigm Shift
The Ideal Pediatric Site
Ideal:
Inpatient Pediatrics
Newborn Nursery
Ambulatory Pediatrics
Desirable:
Subspecialty
Labor and Delivery
Overnight Call
Office Management
Where Am I Supposed to Be?
Six Week Community Sites
Able to provide all three ideal components
Albany, Columbus MC, Rome, Savannah, Tifton(2)
Two Week Inpatient Sites
General Pediatrics – Gen1, Gen2 (2 teams includes Endo, Rheum, ID, GI, AI)
Hospitalist -- Gen3 (complex Gen Peds, Surgical, Pulmonology)
Subspecialty- SS (Hem-Onc/Nephrology/Cardiology)
Four Week Ambulatory Sites
Where Am I Supposed to Be?
Four Week Community Sites
MCG
One week Nursery AM/Adolescent PM
Three weeks Clinic including some subspecialty
Community Sites
Longitudinal – nursery in early AM, then clinic
Aiken, Athens, Brunswick (2), Calhoun, Dalton, Fayetteville, Ft. Benning, Ft. Stewart,
Jasper, Kennesaw, Marietta (2), Nesbit, Phenix City, Toccoa, Valdosta (2), West Cobb,
Wrens
Augusta Pediatric Associates (APA)
Two weeks at MCG (NBN, Cardiology)
Two weeks APA for general clinic
What’s Expected of Me?
Attitudes
Enthusiastic
Inquisitive
Teachable
Challenge those who teach you
Performance
Clinical Performance Guidelines (Internet)
http://www.mcg.edu/som/clerkships/Pediatrics/feedback.htm
http://www.mcg.edu/som/clerkships/ClinicalPerformanceEval.pdf
Oral Presentations . . . . .
Outpatient Case Presentations
Starting the Presentation: identifying information and chief complaint.
History of Present Illness: Should take no more than half of total time
Organized: logically and chronologically:
Positive and negative symptoms associated with the illness.
Provide any treatment measures used by the family (including non-prescription
treatments)
Other information:
Briefly summarize any other major ongoing medical problems
Briefly summarize medications and allergies.
Outpatient Case Presentations (cont)
Physical examination:
A brief “word picture” of the patient’s appearance is extremely helpful
Include pertinent positive findings and relevant negative findings.
Vital signs should be mentioned if they are pertinent.
Growth parameters (expressed as percentiles on the growth curve) are important in
infants and children presenting for check-ups.
Let your preceptor know if there is a part of the physical exam that you would like help
with.
Finishing the presentation:
Your assessment of the patient (what do you think is going on?)
Your plan (what you would like to do).
Be prepared to support your assessment and plan.
Length of Presentation: 2 minutes or less!
Documentation
Medical Record is a legal document
Document accurately and carefully
Appropriate vs. Not appropriate
Discuss assessment and plan before documenting OR change note after discussion!
SOAP Note
Subjective (history)
Objective (physical exam)
Assessment (diagnosis)
Plan (consults, IV fluids, medications, d/c, etc.)
Stretch Break!
How Will I be Evaluated?
Objective (Exams): 40%
Subjective (Clinical): 55%
Professionalism: 5%
Departmental Exam (15%)
Format:
32 MCQs (2 points each = 64 points)
2 Essays (10 points each = 20 points)
Rx/medication order (5 points)
IV Fluid Order (5 points)
Growth Chart (6 points)
Time:
Fourth Friday 9:30AM
1 hour and 45 minutes
Location: Done by computer
Vista
Administered at clinical sites, not in Augusta (except for Augusta/Aiken students
Departmental Exam grades will be posted on Vista
Clinical Teaching Cases
20 Clinical cases at the end of the curriculum
Common scenarios
Keyed to clerkship goals & objectives
Two of these cases will be part of the Departmental Examination, counting for 20% of
the test score
NBME Pediatric Shelf Exam (25%)
Sixth Friday at 8:30 AM
Scoring based upon NBME percentile ranks by quarter
Minimum passing is 5th percentile
Must pass the Shelf to pass the clerkship!
Minimum score for an A is 70th percentile
See Web Page for specifics
How Will I be Evaluated?
Objective: 40%
Departmental Examination (15%)
NBME Pediatric Specialty Exam (25%)
Subjective: 55%
Based upon performance evaluations throughout the rotation
Must achieve an average score of 70% or higher from combination of these evaluations to
pass the rotation.
Meeting Expectations should be 85%
Pediatrics has high expectations
Tips for Performing Well Clinically
DO:
Make life easier for your team – be helpful
Show enthusiasm
Make yourself available
Demonstrate your knowledge
Ask for and respond to feedback
Pick up new patients
DON’T:
Disappear
Say negative things about other physicians
Avoid picking up patients
Pretend you know an answer when you don’t
Study so much that patient care suffers
MCG Feedback Cards
The Problem:
Many students
Many preceptors
Many different clinics
The Solution:
Feedback Cards
MCG Feedback Cards
The Problem:
Many students
Many preceptors
Many different clinics
The Solution:
Feedback Cards
Procedure:
Student gives a card to the preceptor (staff or resident) who precepted him/her the most
for that particular clinic session
Preceptor fills out the card and places it in box
Additional cards are available if an unselected preceptor feels it is needed
Clinic evaluation is based on the cumulative weight of all the evaluation cards
Clinical Performance Grading Scale:
Clinical Performance – 55%
MCG Inpatient (20%):
All evals count equally including resident
MCG Nursery/Ambulatory (35%):
5% Nursery
30% Clinic (Feedback Cards)
Four Week Community Sites (35%):
All evaluations count equally
Augusta Pediatric Associates – APA (35%):
5% MCG Nursery/Adolescent
5% Cardiology
25% APA Evaluation
Clinical Performance – 55%
Six Week Community Sites:
All evaluations count equally
Some sites have a Head Evaluator who gets input from all the others
If you work primarily with 1-2 attendings, it is helpful to let me know
How Will I be Evaluated?
Objective: 40%
Departmental Examination (15%)
NBME Pediatric Specialty Exam (25%)
Subjective: 55%
Professionalism: 5%
Professionalism – 5%
25 points – Complete all Assigned CLIPP Cases
2 points each + 1 point if all done
Vista
CLIPP
Computer-Assisted Learning in Pediatrics Project
31 Interactive clinical cases covering the core content of the Ped5000 Curriculum
Web-Based
Requires each student to register (using Groupwise email address) to get login &
password
Helps ensure all students will have similar exposure to case content selected by the
clerkship director
CLIPP Registration Menu
CLIPP Cases: Menu (partial view)
Example of a CLIPP Case
CLIPP
Student usage of CLIPP will be available to Dr. Leggio for each individual student (such
as which cases each student performed and how long he/she spent on each case). You
will not get credit for doing only a few minutes or a few cards. Needs to be clear that you
did the case!
You are assigned 12 Cases. Recommend doing 3 per week. Assignments on PED 5000
website under Study Aids.
The Multiple Choice Questions on the Departmental Exam will come from standardized,
validated CLIPP Final Exam Questions based on the assigned cases
CLIPP Case Assignments
How Will I be Evaluated?
25 points – Complete all Assigned CLIPP Cases
2 points each + 1 point if all done
30 points – Mid-Rotation Feedback Form
Mid-Rotation Feedback
The student is responsible for :
Printing the form
Giving it to their attending physician
Completing and reviewing it together
Returning it to the clerkship coordinator (fax ATTN: Janis Richardson 706-721-3295)
Must be completed by:
Six Week Sites: end of 4th week
MCG: end of first week of inpatient
Mid-Rotation Feedback Form
Mid-Rotation Feedback Form
How Will I be Evaluated?
25 points – Complete all Assigned CLIPP Cases
2 points each + 1 point if all done
30 points – Mid-Rotation Feedback Form
30 points – SPEL
15 points mid-rotation; 15 points end (minimum 30 patients)
Student Patient Encounter Log
LCME requires MCG to track each student’s clinical experiences
MCG Solution: One45
Web-Based system
Patient encounters should include basic demographic information, 1 or 2 major
diagnoses, and any procedures performed
Maximum of 10 patients per day
Passport: Very Important for tracking procedures & competencies
Patient Tracking Log & Passport
Way for you to track your cases
YOU MUST ENTER DATA INTO ONE45 IN ORDER FOR IT TO COUNT!!!
Students are expected to log patients at least weekly. Less than 30 patients in 6 weeks
will be considered not meeting the requirement unless notified early in rotation about
inadequate numbers of patients.
Clerkship Director will be reviewing logs mid-rotation and making recommendations.
SPEL Required Diagnoses for PED 5000
SPEL Required Diagnoses for PED 5000
SPEL Required Diagnoses for PED 5000
SPEL Required Diagnoses for PED 5000
14 Domains of Patient Types or Core Conditions
20 different patients must be seen:
Health Maintenance (5)
Growth (1)
Nutrition (1) Development (1)
Behavior (1) Upper Resp Tract (2)
Lower Resp Tract (2) GI/GU (1)
Derm/Heme (1)
CNS (1)
Emergent condition (1)
Chronic condition (1)
Fever (1)
Jaundice (1)
One45 Webeval
This is the login screen on One45 to access your personal eDossier.
You can access via emails from evaluation services and at:
www.one45.com/webeval/georgia/public/
How Will I be Evaluated?
25 points – Complete all Assigned CLIPP Cases
2 points each + 1 point if all done
30 points – Mid-Rotation Feedback Form
30 points – SPEL
15 points mid-rotation; 15 points end (minimum 30 patients)
5 points – Timeliness
Points deducted for >5 minutes late for exams, or chronic tardiness to conferences,
rounds, etc.
How Will I be Evaluated?
25 points – Complete all Assigned CLIPP Cases
2 points each + 1 point if all done
30 points – Mid-Rotation Feedback Form
30 points – SPEL
15 points mid-rotation; 15 points end (minimum 30 patients)
5 points – Timeliness
Points deducted for >5 minutes late for exams, or chronic tardiness to conferences,
rounds, etc.
10 points – Communication
E-mails from community sites, e-mails when absent, etc.
How Will I be Evaluated?
Objective: 40%
Departmental Examination (15%)
NBME Pediatric Specialty Exam (25%)
5th percentile nationally to pass
70th percentile nationally for an A
Subjective: 55%
Based upon performance evaluations throughout the rotation
Must achieve an average score of 70% or higher from combination of these evaluations to
pass the rotation.
Professionalism: 5%
Must have score of 70% or higher to pass the rotation.
How Will I be Evaluated?
Grading Policy:
Policy & Evaluation Forms – Posted on the
Ped5000 Web Page
Students who average <70% on the two
written examinations will receive no
than a grade of “C”.
greater
If you have questions, see Dr. Leggio. Students may appeal their grades in accordance
with policies outlined on the clerkship web page.
In accordance with policies from the Curriculum Office, documentation of the student’s
appeal will be made in the student’s final clerkship evaluation, regardless of the outcome.
Food for Thought . . . .
“The natural method of teaching the student begins with the patient, continues with the
patient, and ends his studies with the patient, using books and lectures as tools, as means
to an end”
Sir William Osler, M.D.
Write-Ups
Format: Pediatric History & Physical Exam
http://www.mcg.edu/som/clerkships/pediatrics/database.htm
No formal discussion required
Write-Ups: How Many?
Expectations:
Every patient admitted to the service by a junior medical student should have a student
write-up in the chart
At least one write-up per night/day on-call
Feedback should be obtained from the resident who evaluated the patient with the
student.
“Real World” experience . . . . . .
Formal Write-Ups
None required
Call
Six Week Community Teaching Sites:
Varies depending on location
MCG:
Inpatient: 3 short calls until 9pm (one on a Fri, Sat, or Sun); all students on inpatient will
come in to round on weekends and holidays unless scheduled day off.
Call nights may be switched with approval of all involved parties provided number of
calls remains unchanged.
General Team vs. Subspecialty Team
In One45 send the form called “Pediatric Night Call Feedback” to the resident you
worked with on-call!
Each student will be scheduled ONE weekend day off during Inpatient
Look on PED5000 website for more info about Inpatient!
Outpatient: No calls, weekends, or holidays
The “Duh” List
Use this forum as a way of providing information that you feel would be very helpful or
useful to junior medical students beginning their pediatric clerkship.
At the end of each rotation, I will incorporate new student comments into the existing
“Duh” list for the benefit of future students.
“Living Document”
Found on Vista
The “Duh” List
Other Issues
Dress for Success
Wear nametags and/or coats
CMC Badges
Wash your hands!
Soap or foam
Parents notice!
Patient Safety
Crib rails up
Hand on patient
Patient Privacy
Do NOT copy patient charts
Shred check out sheets
Other Issues
Feedback
Formative
“On-going”
Most important for students
Ask and it shall be given . . .
Summative
Generally at end of clerkship
Students perceive as most important
Subjective
Verbal and written
Solicit it!
Give it!
Policy
Appropriate Treatment of Students
Be aware that there is a policy
Feedback ≠ Mistreatment
Being told that your presentations are disorganized is not mistreatment.
Examples
Addressing students in a way that would generally be considered humiliating, dismissive,
ridiculing, berating, embarrassing or disrespectful by others
Asking students to perform personal chores
Telling inappropriate stories or jokes
Behaving in an aggressive manner (e.g., yelling, throwing objects, cursing, threatening
physical harm) that creates a hostile learning environment
Assigning tasks or denying educational opportunities with the intent of punishment
Making disparaging comments about students, faculty, patients or staff
Touching students or residents in a sexual manner
Taking credit for a student’s or resident’s work
Intentional neglect
What to do . . .
If you believe you have been mistreated:
A) Contact your lawyer
B) Don’t tell – your grade will be effected
C) Tell the clerkship director
D) Warn your fellow students!
Power Chart Rules
DO NOT FOR ANY REASON TRY TO ACCESS POWERCHART FROM ANY
COMPUTER OUTSIDE THE HOSPITAL AND CLINICS!!!!
If you attempt to access from home (or even the library or student center) you risk having
Power Chart privileges revoked for ALL students!
Absences
Cannot miss more than 5 days per SOM policy
See policy for excused vs. unexcused absences
Call Janis Richardson (721-3781)
Contact Supervising Physician (attending or resident)
Failure to communicate will be reflected in your professionalism grade!
Student Education Library
Laptops
Available for check out when off-campus
Recommended for those with Macs
Textbooks
Rudolph’s Fundamentals of Pediatrics
Nelsons Essentials of Pediatrics
Oski’s Essential Pediatrics
Woodhead’s Pediatric Clerkship Guide
Appleton & Lange Review of Pediatrics
Others . . . .
If you check out a book, you are responsible for it. Do not write in the book or abuse it.
Students returning books in poor condition will have to buy them!
Who’s In Charge?
See Web Page for phone numbers and addresses for your venue.
Where the buck stops . . . .
Lisa E. Leggio, MD
Ms. Janis Richardson
Childhood Development
Childhood development occurs in a predictable pattern:
Gross Motor: Cephalocaudal progression in first year
Language
1 or 2 words by 12-15 months
2 word sentences by 2 years
All speech understandable by 4 years
Fine Motor
Reaches for objects by 5-6 months
Gross pincer grasp by 9 months; fine pincer grasp 12 months
Copy circle by 4 years
Personal-Social
Smile responsively by 2 months
Wave bye-bye by 14 months
Developmental Screening
Denver Developmental Screening Test (DDST)
Used for assessing development in children less than 6 years old
Development assessed in 4 categories
Abnormal:
2 or more delays in two or more categories
Suspect:
2 or more delays in one category
One or more categories have at least one delay
Infant Formulas – the basics
Cow’s Milk-based
Enfamil Lipil with iron (DHA and ARA)
Similac Advance with iron (DHA and ARA)
Enfamil AR (added rice/anti-reflux)
Lactose Free
Hydrolyzed Whey-based
Carnation Good Start
Soy-based lactose-free
Prosobee
Isomil
Goodstart Soy
Specialty Formulas – Need Rx
Casein hydrolysate (Elemental)
Alimentum
Nutramigen
Pregestimil
Amino-acid-based
Neocate
Pre-Term Formulas (22 cal/oz)
Neosure Advance
Enfacare Lipil
Pre-Term Formulas (24 cal/oz)
Enfamil Premature Lipil
How much should babies eat?
Calories
100 cal/kg/day
kg x 100cal/kg/d divided by 20 cal/oz
kg x 5 oz/kg/day = oz/day
Example:
3kg baby
3kg x 5 oz/d = 15 oz/day
If feeding q3h (8 times/day) = about 2oz q3h
Breastmilk
Solids
Formula fed start at 4-6 months
Breast fed start at 6 months
Breast is Best
AAP recommends exclusive BF for 6months and continuing 12months or until both
mother and baby are ready to wean.
Formula Companies can STILL make money!
Prescription Writing
for Pediatrics
The Patient
S: 10 month old with three day h/o URI sxs woke last night screaming, pulling ears, and
felt hot. Attends daycare.
O: Wt. 10 kg, T 40 On exam fussy, but consolable in no acute distress. AFOSF, Clear
rhinorrhea, moist mucous membranes. Right TM is pearly grey, translucent with normal
landmarks. Left TM is erythematous, opaque, and bulging with decreased mobility.
Exam is otherwise unremarkable.
A: Left Acute Otitis Media (AOM)
The Plan:
Drug: Amoxicillin
Format:
Tablets: 250mg, 500, 875: 125, 200, 250, 400CH
Suspension: 125mg/5ml, 200/5, 250/5, 400/5
Dose: 80-90 mg/kg/day
Route: po (orally) vs. pr, os/od, aural
Frequency:
Qday (daily), BID (twice daily), TID (three times)
Duration: 5 days or 10 days
The Calculation
10kg x 80mg/kg/d = 800 mg/d divide by 2 times/d
400mg bid – comes in 400mg/5ml
5ml = 1 tsp
Disp: 5ml x 2 times/d x 10 days = 100ml
The Rx:
Amoxicillin 400mg/5ml susp
Disp: 100ml
Sig: 1tsp po bid x 10 days
Refill: 0
IV Fluids
What kind of Fluids?
Dextrose
typically 5%
Sodium
Na = 3 mEq/100mL of MIVF
Our pt was getting 1580 mL of MIVF (16 100’s or 1.6L)
3 mEq/100ml/d x 16 100mLs = 48 mEq/d
48mEq/1600mL = x/1000mL = 48/1.6L = 30 mEq/L
Potassium
K = 2 mEq/100mL of MIVF
2 mEq/100ml/d x 16 100 mLs = 32 mEq/d
32mEq/1600ml/d = 32/1.6L = 20 mEq/L
But What Fluid?
But what if 10% dehydrated?
Volume:
For each 1% dehydration add 10 ml/kg
10% x 10ml/kg = 100ml/kg
24kg x 100 ml/kg = 2400 ml
Na:
Add 8mEq/100ml of Deficit
8mEq x 24 = 192 mEq
K:
Add 6mEq/100ml of Deficit
6mEq x 24 = 144 mEq
Add Maintenance to Deficit
What if he needed a bolus?
Need to use crystalloid that will stay in intravascular space
Normal Saline
Lactated Ringers
Albumin
Blood
Bolus volume is 20ml/kg IV fast (push if in shock; otherwise over 20-30 minutes)
So for this patient:
24kg x 20ml/kg = 480 mL
Normal Saline 480 mL IV over 20 minutes
IV Fluids
Where Am I Supposed to Be . . .
At MCG?
Where Am I Supposed to Be?
Four Weeks Outpatient
One week Nursery AM/Adolescent PM (NBN)
Three weeks Clinic (A,B,C,D,E,F)
General Clinic and Subspecialty Clinics
Each student exposed to 1-2 subspecialties (Allergy, Hem/Onc, ID, Neph, Neuro,
Rheum)
Cardiology (PICU, NICU, Cardiology Clinic) – 1 week “hybrid” experience
Two Weeks Inpatient
General Pediatrics – Gen1, Gen2 (2 teams includes Endo, Rheum, ID, GI, AI)
Hospitalist -- Gen3 (complex Gen Peds, Surgical, Pulmonology)
Subspecialty- SS (Hem-Onc/Nephrology/Cardiology)
Rotation Schedules
Your schedule was sent in the Orientation e-mail
NB = Newborn Nursery
Gen and SS are inpatient weeks
A,B,C,D,E,F are clinic weeks
You have one ½ day of Study time per week during outpatient only.
Newborn Nursery (NBN)
One week long (see schedule)
Mornings – rounds, circs
Afternoons in Adolescent
See (study day) on schedule
Review PED5000 Web Page
Nursery Orientation
Nursery Presentation
Review Curriculum for Newborns
Cardiology
“Hybrid” Experience
Will see patients in the PICU, NICU, and floor
Mostly outpatient
Learn murmurs, ECG, Echocardiograms
Subspecialty Clinics
Each student will have exposure to at least one subspecialty
(A) Cardiology x 1 week; General x 2 weeks
(B) Allergy, Neurology, General x 3 weeks
(C) Allergy, ID, General x 3 weeks
(D) Nephrology, General x 3 weeks
(E) Hem/Onc, Rheum, General x 3 weeks
(F) Rheum, Neurology, General x 3 weeks
Adolescent Medicine
Schedule:
Afternoons during Nursery week
Assigned readings
Read Orientation to Adolescent Clinic and Assigned Readings before the first day!
Assigned reading available on Vista
Allergy-Immunology Clinic
Note: Clinic Starts at 8:00!
Read the orientation material on the website before your first day in allergy clinic.
Students are expected to have read this material before they come to clinic.
General Clinic
All students will have exposure to General Clinic
Routine Health Assessments
Immunizations
Anticipatory Guidance
Common acute and chronic illnesses
Morning Clinic begins after Morning Report
Afternoon Clinic begins at 1pm (return promptly after noon conference!)
Let your attending know if you have a noon conference!
Call
Inpatient weeks only:
3 short calls until 9pm (one is Fri., Sat., or Sun.)
You are expected to WORK!
Send your resident the Pediatric Night Call Feedback form via One45.
No going home post-call
Students will round and work on all weekends and holidays even if not on call!
You will be scheduled ONE weekend day off during inpatient.
An Opportunity
Reach Out and Read
Books are given at well checks 6mos to 5yrs
Read aloud to patients in waiting room
Models reading for parents
Will hopefully increase parent’s interest in reading aloud
Volunteer during your afternoon off
E-mail Dr. Leggio after you’ve volunteered with a brief paragraph about your experience.
“Name read to children in the waiting room as part of our Reach Out and Read program
to promote literacy.” will be added to your comments.