WELCOME!! It is a pleasure to welcome
you to Pediatrics and to Children's National Medical We hope this experience
will provide you with a positive perspective about Pediatrics, Mary C. Ottolini, M.D.,
MPH Kathy Fergusson SCHEDULE The third year pediatric clerkship consists of two four-week periods during which time students are assigned to either an inpatient medical ward, an outpatient rotation (Children's Health Center, Adams Morgan, Private Practice settings, Comp Clinic, and the Adolescent Clinic among others), an affiliated community hospital Holy Cross, Anne Arundel Medical Center or the GW Nursery. Most students will spend approximately one week in the term nursery at either Holy Cross, or GW. Students will not have identical exposure to patient problems and are expected to communicate with one another about their experiences. When possible, each student will be assigned to a house officer who will work closely with and help evaluate the student at the completion of the rotation. Students will have an opportunity to participate in all activities including work and attending rounds, multidisciplinary conferences, etc. The workday formally begins at variable times depending on the rotation and students on inpatient services should have all necessary information on their patients before rounds begin on the wards. Those at other institutions will follow schedules at those institutions. Students are expected to notify the senior resident or attending in charge if they are unable to be at their assigned ward/outpatient rotation. Student day is every Thursday- you are excused from all patient care activities that day- please see the student day section for details. NIGHT CALL Inpatient night call averages every fourth night, unless other arrangements are made with the consent of the students and staff. This translates into 7 call nights for the first half of the rotation and 6 nights for the second half. Students should take at least one Saturday and one Sunday as part of their required inpatient call. Weekend call is 8 am. - 8 am. There will be no assigned night call on most ambulatory rotations but this may be dependent on the specific rotation. Students are expected to contact the senior resident or attending on service if they are unable to keep their night call commitment. On night call, students will be expected to get up with the PL'1 and help problem solve issues that involve patients on their ward. Ideally, residents will be seeking student input on how to address problems at hand. Students should be thinking through problems even if not asked by the residents. The purpose of this exercise is to make the students more active learners while on . STUDENTS SHOULD NOT T ATKE CALL THE NIGHT BEFORE POM3; THE FINAL EXAM OR THE LAST WEEKEND OF THE ROTATION. ON CALL ROOMS There are no specific call rooms reserved for students and it is expected that students will share a room with the resident with whom they rotate. Problems should be communicated to the senior in house residents. Students on call for inpatient rotations at Children's will have access to a beeper and a key to their on-call room. They will be responsible for these items and will be required to pay in full for their replacement if they are lost. Failure to do so will result in an incomplete grade for the rotation. ATTENDANCE All students are expected to carry out their assignments maturely and responsibly and are to notify a member of the resident staff faculty or Office of Medical Education if they are unable to do so. Patient care and family issues always comes first. Unless you are needed on the ward or outpatient areas, you are expected to attend rounds and lectures, especially those on Wednesday Student Day. In case of illness, you must notify your ward resident or outpatient attending in a timely fashion. Repeated, unexcused absences could result in disciplinary action. INSTRUCTIONS FOR HISTORY AND PHYSICAL EXAMINATIONS It is essential that all medical records be complete and neatly written, since they are used as the basis of judging the quality of patient care and as such are the primary focus of clinical teaching. References - 2. Algrananti, P The Pediatric Patient: An Approach to History and Physical Exam, Williams & Wilkins, 1992. Patients on the wards will be allocated to you by the senior and junior ward resident or fellow. Patients in ambulatory areas will be allocated to you by an attending. Remember that all of the feelings ascribed to an adult patient exist, sometimes in a more intense fashion, in the parents from whom you take your history. An older child may help with the history and also share with his parents many of the concerns associated with illness and hospitalization. Even a toddler "hears" more than you think. While it is good to take a history in the presence of a child (To let him/her get used to you before your physical examination), sometimes it is prudent to explore more "sensitive parts" of the history, such as parental concerns over developmental retardation, apart from the child. In general, the history should be taken in a relaxed atmosphere and if the child is grossly disturbed at the time, it is better to separate the parents from the child to get a history. During late childhood, and always during adolescence, it is good to take part if not all of the history separately from the parents and patients. PAST HISTORY SHOULD
INCLUDE: FAMILY HISTORY SHOULD
INCLUDE: SOCIAL HISTORY SHOULD INCLUDE: 1. Income. PHYSICAL EXAM1NATION - see curriculum under Physical Exam Skills
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