Pediatric Oncology rotation

[allymunro]

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Hi!

I'm going to be doing a ped onc rotation next month at a pretty academic university and was just wondering if anyone had any advice on a) what i can do/read to prepare beforehard and b) what i might actually be doing during the rotation! The description on the med school website is pretty vague and just says that its an 'advanced clerkship in inpatient pediatric oncology'. I'm at a british med school and this will be my first proper american rotation (I did my standard peds rotation here in the UK last year). This will probably be my best opportunity to get a letter of recommendation so I'm really keen to make a good impression from the start!

Thanks for any advice!

 

[ckbuffalo]

Definitely read up on ALL, Hodgkins (not sure if it's just straight onc or hem as well) but if hem then also review sickle cell, hemophilia.

I would say those are the most common issues that you will be dealing with.

 

[J-Rad]

Agree with reading up on ALL, AML, and lymphoma. Know about tumor lysis syndrome (what diseases predispose to it, what is it caused by, what will kill you quickly vs. damage over time, and prevention/treatment). Know the oncologic emergencies (there aren't that many). Treatment of neutropenic fever. On the heme side, definitely brush up on SCD (I remember uptodate having a great review). Review the untoward outcomes of SCD, the general tx of pain and fever crises and acute chest syndrome (again, UTD has some great reviews). Try to also review coagulation disorders (hemophilia and VWD). Obviously this isn't the entirety of Peds H/O, but will cover quite a bit of what is commonly seen.

 

[Stitch]

In terms of studying and knowing what's going on, don't waste your time memorizing specific chemo protocols. They vary and some are made up depending on where you are. For example instead of knowing that ALL is treated with drugs x, y and z, look at each agent the kid is on, know how it works, and have an idea about the possible side effects. If a someone is on vincristine, know that it's an vinca alkaloid that inhibits mitosis. One side effect is CNS effects. Something like that.

Also try and learn about pain management. This is also institution and attending specific, but get comfortable with common morphine, fentanyl, even dilaudid doses. That kind of thing can be very helpful in whatever you end up doing long term.

Good luck!

 

[allymunro]

thanks very much for the replies.

as im currently in subsaharan africa (doing a placement in ped onc here as well) and then will be heading directly to the US in a months time does anyone have any recommendations for any online resources i could access here that might help? i get to america 2 days before starting so plan to buy US pocket pharm, pocket peds and maybe onc books.

its the clinical and logistic sides of things that worry me because things are so different in the UK rather than path etc. things like how an examination or progress note is written up. i just dont want to look like an idiot on the first few days from not knowing the system.

thanks!

 

[bks524]

This is a book that I have used on my rotation in heme/onc. As far as notes, we use a SOAP note (subjective, objective, assessment, plan). I would imagine that to be standard in most western medicine (but maybe not?).


http://www.amazon.com/Childrens-Hospital-Hematology-Oncology-Handbook/dp/0323018610

 

[Freibi]

As far as notes, we use a SOAP note (subjective, objective, assessment, plan). I would imagine that to be standard in most western medicine (but maybe not?).

If you aren't familiar with the SOAP note (and presentation!) style that is used in the U.S. (unlike in Europe - I don't know about the U.K. though), there is a little pocket reference called "Maxwell" that's also useful for common abbreviations, the way Americans jot down lab results, etc.:
http://www.amazon.com/Maxwell-Quic...sr_1_1?ie=UTF8&s=books&qid=1246485411&sr=8-1
It will also be important to get good at presenting patients on rounds - I think it was "First Aid for the Wards" that had some helpful passages on this. But it's never wrong to ask your resident(s) or fellow(s) for feedback on your presentation style (on the contrary, you're showing that you care about learning).
Have fun!