what is a good Peds elective to take in 4th yr?

[cattyjane]

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I have no intention in doing peds residency. I'd like to do an elective to broaden my knowledge in peds since I felt that I did not have a good peds core rotation, ie short hours, no variety of diseases, mostly outpatient. Is there anything you recommend that I can get see a broad spectrum of peds diseases?

 

[SAvoodoo]

I have no intention in doing peds residency. I'd like to do an elective to broaden my knowledge in peds since I felt that I did not have a good peds core rotation, ie short hours, no variety of diseases, mostly outpatient. Is there anything you recommend that I can get see a broad spectrum of peds diseases?

Ped's ER at a childrens hospital

I'm doing one now and i've seen everything from the basic (rashes, ear infections, sore throats etc) to the more complicated (Bad asthma attacks, DKA etc) to the rare stuff (active TB, multiple hemophilacs, rare congenital stuff). The nice thing about being at a children's hospital is that you get all the transfers of the complex cases from other hospitals but parents also bring all the basic stuff to you becuase the pediatritian clinic is in the same building and they're used to coming there. You won't get much inpatient (obviously) but you get to see the inpatient cases before they go upstairs so you still get exposure to them.

Sorry if my post was confusing or convoluted, trying to type out a response before my shift starts 🙂

 

[BCLumas]

It sounds like the problem was more the specific rotation that you were on rather than the type of pediatrics specialty. I really enjoyed working on General Inpatient Pediatric floors because I got to develop a close relationship with the families and the children. There was a good range of diseases that included FTT, RSV, Asthma, ALL, and more. While on the service, talk to the residents or attendings and see if you cannot shadow them or assist in ER admissions. If you're looking for a subspecialty, I have heard a lot of great things about PICU rotations and people generally get a lot from them. The problem I've seen is that a lot of people feel very saddened by some of the patients, so be careful.

Good luck ^_^

 

[Killer T Cell]

Ped's ER at a childrens hospital

I'm doing one now and i've seen everything from the basic (rashes, ear infections, sore throats etc) to the more complicated (Bad asthma attacks, DKA etc) to the rare stuff (active TB, multiple hemophilacs, rare congenital stuff). The nice thing about being at a children's hospital is that you get all the transfers of the complex cases from other hospitals but parents also bring all the basic stuff to you becuase the pediatritian clinic is in the same building and they're used to coming there. You won't get much inpatient (obviously) but you get to see the inpatient cases before they go upstairs so you still get exposure to them.

Sorry if my post was confusing or convoluted, trying to type out a response before my shift starts 🙂

Completely agree with SAvoodoo!! 👍

 

[J-Rad]

I have no intention in doing peds residency. I'd like to do an elective to broaden my knowledge in peds since I felt that I did not have a good peds core rotation, ie short hours, no variety of diseases, mostly outpatient. Is there anything you recommend that I can get see a broad spectrum of peds diseases?

Can you let us know what you are thinking of doing? My answer to a future urologist would be different than to a future anesthesiologist, OB GYN, or FM doc.

 

[SurfingDoctor]

Can you let us know what you are thinking of doing? My answer to a future urologist would be different than to a future anesthesiologist, OB GYN, or FM doc.

Agree. It doesn't make much sense to do a pediatric rotation unless you plan on doing an adult residency equivalent. You're not going to remember much, if at all, years don't the road from your pediatric elective when you're doing "X" adult residency unless you went into a subspeciality field and did a pediatric subspeciality rotation.

 

[cattyjane]

Thank you guys for your reply.

I intent to do Internal Medicine for residency.
I just would like to see as much as possible as a medical students as we have the options to choose the elective we do. As a resident, I'll never be able to do a peds rotation, or Opthal, etc. Instead of choosing all IM electives, my electives so far are quite broad. I'd like to do a peds elective too, but I do not know what to choose as my core rotation did not expose me to the subspecialties as I was working in ER and clinics.

Doesn't PICU have all the very sick patients? I would think it as adult ICU but with peds population.
I do agree with the above post suggesting ER, but my ER experience was that 95% cases were sore throat, otitis media and asthma.

 

[BCLumas]

Thank you guys for your reply.

I intent to do Internal Medicine for residency.
I just would like to see as much as possible as a medical students as we have the options to choose the elective we do. As a resident, I'll never be able to do a peds rotation, or Opthal, etc. Instead of choosing all IM electives, my electives so far are quite broad. I'd like to do a peds elective too, but I do not know what to choose as my core rotation did not expose me to the subspecialties as I was working in ER and clinics.

Doesn't PICU have all the very sick patients? I would think it as adult ICU but with peds population.
I do agree with the above post suggesting ER, but my ER experience was that 95% cases were sore throat, otitis media and asthma.

Yep! Pediatric Intensive Care Unit. There's also a Neonatal ICU (NICU), but I would think that an OB/GYN student/resident would get more out of that rotation than their IM counterparts. At least with a PICU rotation you can still learn how to manage a ventilator and medications, even though the patients are much tinier. It still has a lot of the same issues that adults have--trauma, sepsis, meningitis, FTT, cancer, etc--but with problem of sadness. I have talked with many people that find the PICU to be an awful place. My opinion differs entirely, but I have spent all of one week in a PICU total, so it may not be valid.

EDIT: An additional Peds rotation will help you out in one way. It will keep the "Pediatrics" stuff on your mind for a little bit longer for Step 3. Sure, you're going to be studying hardcore to cover a lot of the information that you forgot. And yes, you're going to forget a lot of it. That doesn't mean, however, that you won't learn something on one of these Peds rotations that won't help you out on your Step 3 later down the road. Good luck!

 

[Doctorverardoll]

Adolescent medicine might be a good rotation.. mix of purely peds problems and some stuff you might encounter in IM. Plus nothing like working on communication skills by talking with teenagers about the HEADSS assessment.

 

[deleted311769]

Kids with chronic illnesses turn into adults with chronic illnesses. Getting a good foundation in CF, congenital heart disease, sickle cell, long term cancer survivors, developmental disability, etc, etc, etc could be quite useful.

 

[J-Rad]

Mostly agree with above.

Peds cardiology-great for listening to uncommon murmurs and the cardiovascular exam. To reinforce the above: a few years back adults with congenital heart disease overtook children with CHD in numbers-having some familiarity and comfort with this population could be an invaluable (and uncommon) asset for an internist. Lot of overlap in the electrophysiology world and you can brush up on EKG skills as well as broaden your scope of knowledge when it comes to channelopathies and cardiomyopathies. As a future internist I would try to do a rotation with a group that sees a lot of adult CHD.

Peds pulm-Just be aware that an incredible percentage of peds pulm is asthma, but that is a useful knowledge base. I find the field painful, so my bias is to not think it's the most useful.

Peds ID-I could see this one being very useful as there is plenty of overlap and we use the same drugs.

Peds Heme/Onc-you will see plenty of patient with very real disease. Though there is often a great difference in the epidemiology of childhood ca vs. adult, there are common principles (tumor lysis avoidance, for example). An outstanding benefit would be the awareness of how to take care of adult survivors of childhood cancers and the risks that those patients face.

Childe neuro-real disease and great reinforcement of the neuro exam. Similar concepts of treatment amongst similar disease, but some disease that won't be seen amongst adults.

Peds ED-dunno. I loved it as a resident, but for someone going into IM? There is so much non-acute stuff, it might be tedious for you.

Peds Endo could be interesting. Will get very comfy with DKA and general DM managment, but most will be type I (with an increasing proportion of type II)

Adolescent is good for routine gyn care in the young female population (DUB, contraception, pelvic exams, etc.) basic psych stuff (simple depression) and some sports med.

A/I is not peds specific, but is useful for any primary care field.

I do agree that PICU can give good experience with the stuff listed above. Now that ECMO is seen a lot more in the adult world, I don't know if it provides all that much to you though since you'll be doing lots of that in adult land anyway.

Not a peds rotation, but ENT sees a lot of kids in a lot of places. Learning a good otoscopic exam is really valuable and ENT clinic is definitely useful. Watching ENT surgeries can be painful, but, if you can arrange it, try to get the intubations in a T&A room. High turnover cases, so lots of opportunity to bag mask and intubate.

 

[SB100]

As someone who is very interested in critical care, I know I'll be doing a NICU and/or PICU sub-I. I've been told to check out pediatric nephrology and ID from several people, knowing about my interest. Other ideas?

 

[cattyjane]

Kids with chronic illnesses turn into adults with chronic illnesses. Getting a good foundation in CF, congenital heart disease, sickle cell, long term cancer survivors, developmental disability, etc, etc, etc could be quite useful.

Thank you for all the above posts. They are very helpful.

Can you please tell me which rotation would cover these diseases you listed above?

 

[J-Rad]

You would encounter patients with the above in a busy PICU, but your interaction with them will be during periods of critical (or near-critical) illness, not during times that affect their life/health for the remaining majority of their lives/experience. So the PICU isn't going to teach you about the routine healthcare maintenance of the kid/adult with CF, for example. My recommendation would be to pick one or two subspecialty rotations that will interest you with a focus on one's that may provide a unique perspective on disease processes. Due to that I would have a bias toward Peds Heme/Onc (due to the vast difference in epidemiology and for the downstream usefulness) and Peds Cardiology (you are unlikely to significantly interact with the ACHD population even in an adult cardiology rotation, but these patients are out there in increasing numbers and needs IM/FM PCPs who don't shudder every time they walk through the door). No one has mentioned genetics, but that could also be a useful one.

 

[kristing]

Listen - if you're going to do medicine, do something that overlaps - adolescent is great, and honestly, so is pulm. You will see a boat load of asthma and CF in pulm and so many peds pulms are still seeing adults, you could really get a leg up on that.

I was the opposite - I only wanted peds and chose all of my 4th year rotations as such. I do not regret doing as much peds as possible. It made me a better pediatrician and a better resident. There is no crime in saying you don't like kids and learning what you'll need to know for later now. And step 3 is easy. Don't worry about that.