Longitudinal peds experience in residency

[DrMcCoyDO]

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Hey all. I’m currently a resident at a newer program with a PD & APD who are very open to resident feedback on the curriculum. Currently, our peds experience is primarily confined to our peds ED blocks, with scattered peds pts in the main ED when there’s nobody staffing the peds ED. I want to talk to my program administration about the possible benefits of adding a longitudinal component to our peds curriculum. Does anybody have any experience with a longitudinal peds curriculum in residency or know of any resources I can use to read up on this further? I’d like to come to them with something more than just my personal belief that it will be beneficial.

 

[RustedFox]

Hey all. I’m currently a resident at a newer program with a PD & APD who are very open to resident feedback on the curriculum. Currently, our peds experience is primarily confined to our peds ED blocks, with scattered peds pts in the main ED when there’s nobody staffing the peds ED. I want to talk to my program administration about the possible benefits of adding a longitudinal component to our peds curriculum. Does anybody have any experience with a longitudinal peds curriculum in residency or know of any resources I can use to read up on this further? I’d like to come to them with something more than just my personal belief that it will be beneficial.

n=1, but I think that your peds EM blocks will be plenty.
In fact, you'll wish you had less of them, because it gets tiresome.

 

[GonnaBeADoc2222]

Where I trained, we had a couple dedicated peds blocks during the first two years and then scattered peds shifts the second two. I liked the scattered shifts as it gave a nice break to the frequently ass-kicking adult shifts.

 

[Rekt]

Hey all. I’m currently a resident at a newer program with a PD & APD who are very open to resident feedback on the curriculum. Currently, our peds experience is primarily confined to our peds ED blocks, with scattered peds pts in the main ED when there’s nobody staffing the peds ED. I want to talk to my program administration about the possible benefits of adding a longitudinal component to our peds curriculum. Does anybody have any experience with a longitudinal peds curriculum in residency or know of any resources I can use to read up on this further? I’d like to come to them with something more than just my personal belief that it will be beneficial.

After just finishing up many interviews on the trail, it seems like most places are moving to longitudinal peds experiences. I personally think it's the way to go. It's something I considered highly when making my rank lists as I don't think 1-2 months is enough (in the places that dedicated peds hospital that sucks all volume from the main ED). Most of the faculty stated they changed due to resident feedback. I don't think it would hurt to bring it up.

 

[namethatsmell]

The value to seeing peds all year long is you 1) keep your peds knowledge towards the front of your mind and can refine it as you progress through training and 2) see the various types of illnesses/problems they come in with during the different seasons of the year.

Another important factor is where you see kids. You do not want to do all your time at a tertiary peds place.

 

[Druggernaut]

n=1, but I think that your peds EM blocks will be plenty.
In fact, you'll wish you had less of them, because it gets tiresome.

This is one of the reasons I was glad we had longitudinal peds after our one month block as interns. 3 shifts a month was tolerable, 18 was painful. As stated above, presentations are seasonal too, so you get some of everything.

 

[GonnaBeADoc2222]

A straight month of presenting to pediatricians is enough to make you want to quit residency.

 

[NurWollen]

A straight month of presenting to pediatricians is enough to make you want to quit residency.

Come on now, what do you mean by that?

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[emergentmd]

Unless you are going to an academic or Pedi ER, One month of Peds ER a year is plenty.

I got very little out of inpatient wards - Well sick (Asthma, obs, newborn fever) or ICU sick (ECMO), etc.

 

[deuist]

A straight month of presenting to pediatricians is enough to make you want to quit residency.

Emergency medicine residents should not present to pediatricians during a pediatric emergency medicine block. According to the RRC, only physicians who are residency trained or board certified in emergency medicine or pediatric emergency medicine can supervise emergency medicine residents while in the emergency department. Unless you are hospital has some weird set up where the adult emergency department is run through emergency medicine and the pediatric emergency department is run through the department of pediatrics, I can't see why there should be any general pediatricians working in the ED.

 

[Rekt]

Emergency medicine residents should not present to pediatricians during a pediatric emergency medicine block. According to the RRC, only physicians who are residency trained or board certified in emergency medicine or pediatric emergency medicine can supervise emergency medicine residents while in the emergency department. Unless you are hospital has some weird set up where the adult emergency department is run through emergency medicine and the pediatric emergency department is run through the department of pediatrics, I can't see why there should be any general pediatricians working in the ED.

I'm assuming he meant Peds to EM trained physicians. There's quite a difference in how they practice and act from my experiences compared to EM to peds.

 

[alpinism]

There's a huge difference in practice between peds and EM trained folks.

Peds attendings by in large are very uncomfotable with anything resembling a sick patient and are quick to consult for even the simplest procedures.

There was a study done by Cincy a few years back that showed that most PEM attendings graduated with less than 10 intubations and even less central lines and chest tubes.

 

[NurWollen]

Emergency medicine residents should not present to pediatricians during a pediatric emergency medicine block. According to the RRC, only physicians who are residency trained or board certified in emergency medicine or pediatric emergency medicine can supervise emergency medicine residents while in the emergency department. Unless you are hospital has some weird set up where the adult emergency department is run through emergency medicine and the pediatric emergency department is run through the department of pediatrics, I can't see why there should be any general pediatricians working in the ED.

Happens in hospitals across the country all the time.

 

[deleted109597]

Nobody ever wishes they saw less kids in residency.
Longitudinal shifts also prepares you for real life, where you'll see them interspersed with your other patients.
Yes, pediatricians do work in pediatric EDs. EM residents cannot staff patients with them. Peds residents can.
Pedi=>Peds EM attendings are frequently more of the peds mindset than the EM one.

 

[NurWollen]

Nobody ever wishes they saw less kids in residency.
Longitudinal shifts also prepares you for real life, where you'll see them interspersed with your other patients.
Yes, pediatricians do work in pediatric EDs. EM residents cannot staff patients with them. Peds residents can.
Pedi=>Peds EM attendings are frequently more of the peds mindset than the EM one.

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[deuist]

Happens in hospitals across the country all the time.

Yes, I know that. I am saying that general pediatricians should not staff the emergency department.

 

[deleted109597]

Yes, I know that. I am saying that general pediatricians should not staff the emergency department.

Neither should IM, FM, or GS.

 

[GaBulldog]

Our program has longitudinal peds shifts throughout all three years. I absolutely dread my 3 or 4 12-hour peds ED shifts each month, but think in the end I will feel fairly comfortable with 95% of situations as an attending. Clearly biased, but I think longitudinal is the way to go.