How to do well on Pediatrics
Pediatrics is Internal Medicine with the additional benefit—and some may say the detriment—of dealing with all the social issues that intertwine with a patient's medical care. Regardless, children have never smoked, drank, injected heroin, or practiced unsafe behaviors; it only makes it more significant and meaningful to treat the diseases that befall them. Pre-rounds, rounds, conferences, and bedside teaching will be consistent to internal medicine's format; however, given that patients are children, there are many opportunities to make a formative difference in each patient's, and family's, outlook. As a medical student, you'll have so much more time to connect.
Tips for doing well on your Pediatrics rotation/clerkship
Figure out your presentations:
Take a look at our Internal Medicine guide for a guide on how to format your morning to pre-round and present. Pediatrics shares the same format; however, for your overall H&P, there are a few subtle differences apart from the usual HPI, ROS, allergies, medications, PMH, PSH, PFH, and social history that you would normally collect. In addition, for each patient, know the following:
Pregnancy: How the mother's pregnancy went, including number of previous pregnancies, gestational age, and how each patient was delivered. Note any complications, illnesses while pregnant, or any drug/aberrant medication use.
Neonatal history: Any problems which arose during the first weeks of life, including, but not limited to, jaundice, hospitalizations, or feeding difficulties.
Immunizations: If they are up to date on their immunizations.
Developmental history: If they are meeting developmental milestones such as rolling over, sitting up, or crawling.
Environment: Who lives with the child, if there is any smoke exposure at home, how old the house is, etc.
Know your developmental milestones
It'll help for those clinic visits to assess where kids are at and it'll definitely help for your OSCE and Shelf exam.
Study concurrently
While it differs from medical school to medical school, you will likely be in placed in an outpatient and inpatient block, with both blocks demonstrating different aspects of a pediatrician's practice. Paying attention to patient's complaints and the management of those complaints and studying the proper management of those complaints in a good review text and then further testing your knowledge with questions will help lock in your learning. Keep up with UWorld questions and run through a review question book or two.
Keep some goodies on you
Get a silly stuffed animal keychain for your stethoscope so you can distract babies while you listen to their heart and lungs. If you're a guy and not willing to compromise to much of your manliness, keep some of those stickers and lollipops they keep in the clinics in your coat pockets. Promising kids a sticker or treat can drastically help your exam.
Utilize the parent
For otoscope or oral exams, have the parent wrap the child in their arms or hold the child's head. Learn to exam children sitting up in their parent's lap.
Go hang out
After you're done rounding, done with your notes, and done with any floor work that needs to be done, go check in with your patients and talk with them. Play games with them. These children are often alone, by themselves, in a completely foreign setting. Become that positive influence to guide them through their illness. Childhood is such a malleable stage; your words and actions can have a profound influence on each child's future.