Reflection of rotation:
True to form, I liked the pediatric emergency room part of this rotation the best. This is because of the speed at which I like to work and the amount of autonomy. I was able to perform the physical exam, state what tests/medications I think should be ordered, review the tests and images ordered, ending with a diagnosis and discharge or admission. I was able to practice more clinical skills on the pediatric populations such as placing IVs, doing venipuncture, giving shots, performing sutures , place splints and more. The NICU was fascinating, very complex and I enjoyed being an observer in this setting. I spent most of my time looking up diagnoses, treatments and trying to correlate what I was seeing on physical exam with their diagnoses in the computer. My favorite part of NICU was going to the vaginal and C-section deliveries, I have never seen those before, so this was exciting. It was also good experience when the NICU provider would ask me to do the APGAR score on the spot. Pediatric clinic was fun, laid back but did not leave much room for me to practice clinical skills. This part of the rotation was more of a refresher of pediatric knowledge, and it was great to see things in person to cement the medical knowledge. I learn best when I do something so working with the pediatric pulmonologist, listening to lungs, and doing asthma surveys was my favorite part of this week. The pediatric pulmonologist would ask me to examine the patient, ask them questions and then ask me what I heard and what we should do (all in front of the patient) which was a great learning experience for me. I also enjoyed observing the pediatric neurologist and saw the differences between intellectual disability and autism. I also learned about how seizures are a clinical diagnosis and EEG is used more to back up the diagnosis and treat but not necessary for the diagnosis of epilepsy or other seizure disorders.
Site Visit summary:
Site visits were with Professor Maida who is very knowledgeable in pediatrics. My weakest area is my pharmacology knowledge. He can recite adverse reactions on any medication we discussed but I found myself having to refer to my notes. I know this, like many other things, will come with time and discussing the side effects with patients. I challenged myself to pick harder diagnoses to do my H&P’s on. My weakest part of H&P is still ordering all the needed tests to exclude more serious differential diagnoses. This is where “the art of medicine” comes in, where you do not want to order too much due to radiation, cost, and time but you also do not want to miss an important diagnosis. I think this skill will continue to develop for me as my clinical experience continues.
