The Pediatrics Clerkships

The pediatrics rotation is broken up into two separate months. During one month, you'll be doing inpatient pediatrics in the hospital, working with premature babies, infants, toddlers and other children as well as adolescents. Patients are admitted for any of a variety of medical or surgical conditions.

The other month consists of two weeks of outpatient pediatrics in a pediatrician's office, and another two weeks of "specialty clinics" - during which you spend one day with doctors who practice pediatric specialties, such as pediatric cardiology, pulmonology, and so on. The specialty clinic days are largely hospital-based.

 

Basic expectations by house staff:

You only work with house staff during the inpatient month. This seems to be a particularly reasonable bunch of residents, who have been selected by a highly competitive program, and many of them love to teach. You're expected to know your patients well, to see and examine all of your patients in the morning (generally before rounds), and to document their progress in their charts.

There are multiple opportunities for you to show your stuff (i.e. be "pimped") during rounds and lectures, so it pays to read up on the conditions affecting your patients. House staff may expect you to offer treatment suggestions - so try to know what you're talking about.


 
The Rotations
Inpatient

This is your hospital month. You'll get to work with premature babies, many of whom will have recently "graduated" from the Neonatal Intensive Care Unit (NICU). They're generally "feeders & growers" whose nutrition you'll be managing until they get old enough &/or large enough to be discharged. Figuring out their nutritional status becomes fairly routine once you master some basic formulas, which you'll apply regularly. You'll also have older patients who are admitted for multiple reasons. One of the most common is cystic fibrosis (CF), although you'll also see patients with leukemias and respiratory infections on a fairly regular basis.

This can be a fairly intense month, particularly if it's filled with seasonal diseases like respiratory syncytial virus (RSV) or flu or any of about a dozen others. The residents will spend lots of time with you, and the teaching can be exceptional if you're interested.

 

Outpatient

This is your two weeks with a local pediatrician. You'll see all the things you remember when you saw your pediatrician - immunizations, croup, pharynigitis, ear infections (otitis externa, media, and interna), and other disease states. Mostly, however, your time will be taken with "well-child" visits - the regularly scheduled checkups we all remember. You'll be looking for developmental milestones, checking immunization status, and examining children from head to toe, which can sometimes be difficult. Most practices also provide pre-natal visits and counseling (which you'll also see in ob/gyn). Much of the focus during these two weeks is on history taking, diagnosis, presentation skills, and possibly note-writing.

Obviously, the quality of this month is directly tied to how well you fit with the attending or practice to which you're assigned. The staff of the department are great about helping you to work with people who interest you - so if you know a pediatrician you'd like to work with, ask.

 

Specialty Clinics

During these two weeks, you'll see 10 different pediatric specialists at work, for one day each. You're basically expected to show up on time, take an interest, pay attention, and learn what you can. This can be a great opportunity to learn about areas of pediatrics to which you may not have otherwise been exposed. Much of your experience of these two weeks depends on your level of interest and in your aggressiveness about being involved.

The Important Topics