Thomas Jefferson UniversitySidney Kimmel Medical College

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Pediatrics 350

Pediatrics is the study of young people or the “youngins’” if you are from the South.  Among other things, you will learn about care and nutrition of newborn infants, developmental milestones, immunization schedules, well-child care, and disease states in children.  It is important to learn what is normal and abnormal in child development and health.
At the beginning of the rotation, you will receive three booklets: two on outpatient pediatrics and one on inpatient pediatrics. These books are helpful as quick references for topics like nutrition, developmental milestones, presenting patients, and immunization schedules.

Some say there are two patients in the room during a pediatric encounter – the child and the parent. Parents will often be anxious when their child is sick. Reassurance is a big part of the job. During your pediatrics rotation, you may rotate through the inpatient ward, the NICU, outpatient offices, and/or the emergency department.

Textbooks – bold texts are recommended

  • The department recommends Nelson Essentials of Pediatrics and Oski's Essential Pediatrics. These are good reference books to read up on suggested topics, but may be difficult to read cover-to-cover in six weeks. In addition, the 5 Minute Pediatric Consult (written by Jefferson’s own Dr. Chung) is a great resource to come up with a differential diagnosis.
  • Rudolph's Fundamentals of Pediatrics is a great reference for the course and modules.  Don’t expect to read it cover to cover but it is a good companion book.
  • Blueprints in Pediatrics is a great book to use for both the rotation and for studying for Step 2 of the boards. Blueprints highlights the important aspects of pediatric conditions, but you may need to go to a textbook for more details and pictures.
  • The Harriet Lane Handbook is a pocket-sized resource used by most of the house staff. There is a ton of information in this book, including a drug formulary with the pediatric dosing guide, important calculations, growth charts, and overviews of important diseases. Since the residents carry them, it is not necessary for a third year student to purchase one. However, if you are doing your sub-internship, it may be helpful to borrow a copy since you will have more patients and be doing a lot of drug dosing calculations.

Evaluation

Modules: The modules consist of a packet of patient scenarios that you will review with attendings during the clerkship. These can be time-consuming, but they address a vast amount of relevant pediatric information.

Written Exam: The written exam is a standard multiple-choice NBME shelf examination. A suggested topics list should be available for some guidance of what to study. As mentioned above, the modules should be helpful in studying for the exam.

Videotaped H & P: You are required to have one patient encounters videotaped to review with an attending. One visit should be done at the beginning of the outpatient time and the other visit should be done near the end. The purpose of this is to assess and show improvement in your patient interviewing skills. These are not intended to provoke anxiety; rather they should be helpful for your clinical development.

Notes

Notes are written in the standard SOAP format with a few modifications. Always ask early how the resident/attendings like the notes to be written. When a child's parent is not available when you are pre-rounding, it is especially helpful to ask the nurses how the patient did overnight and read the nursing notes. Daily weights should be recorded since medications are mostly weight-based. Plotting a child's measurements on a growth chart may be important. For fluid intake, "ins" are written as both total and in "cc/kg/day" values. For "outs", both total and "cc/kg/hour" values are calculated. Also, be aware that there are different normal values for vital signs such as respiratory rates, heart rates, and blood pressure depending on the age of the child.

Call

The call schedule varies depending on where you are rotating but required call is rare during your pediatrics rotation.