Tips for a Pediatrics Rotation

Written by Rand Hashim

Welcome to the pediatrics rotation.

My first big piece of advice is to interact with the parents of the children. They are often the best advocates for their children and are truly so appreciative of everything you do. Pediatrics is not just smaller adults. The diseases that you encounter in pediatrics are often much different than ones you see in the adult world. With that said, you will succeed if you approach your pediatrics rotation in a similar format as your medicine rotations with some small tweaks.

Your inpatient rotation will be similar to your adult medicine rotation in terms of pre-rounding, rounding, admissions, and bedside teaching. However, one difference I’ve noted is that often we try to let the kiddos sleep when they can. That just means trying to check in on them either closer to the time of rounds or go in at the same time as your resident.

Some hospitals may do “family-centered rounds” where they invite the parents (and sometimes the patients) to join on rounds. This provides a good opportunity to learn how to both communicate using medical language, and then break down the information for your patients/their families. Additionally, a big (and obvious) difference between pediatrics and medicine is often you will be talking to the parents of children! Remember that this is a vulnerable time for parents as they are terrified that their kid is in the hospital. Try to approach the parents with understanding and kindness.

Always ask about:

·       Birth history: were they premature? Any pregnancy complications? Any prolonged NICU stay?

·       Immunizations: are they up to date on their vaccinations?

·       Developmental: are they meeting milestones? Any concerns from parents?

·       Environment: who lives at home? Smoke/pet exposure?

·       School: are they in daycare/what grade? What is their behavior like at school and with peers?

·       If an infant: are they breast or bottle-fed? What type of formula? How many wet diapers a day?

·       If a child: how is their diet? Are they getting enough milk/calcium?

·       Always look at the growth charts!

Additional clinical tips:

·       Carrying around stickers can be a great distraction for kids

·       If there is a toy or stuffed animal with them, do the physical exam on the toy first!

·       Start with the heart & lungs—this is something they’re used to and the least invasive!

·       Always try to talk to the kid directly and at their level! Telling them everything that you’re going to do is always good practice.

Shelf exam resources:

·       OnlineMedEd

·       Anki for Step 2

·       UWorld/Comquest/Amboss

·       Divine Intervention Podcasts

·       BRS Pediatrics

·       Know your vaccine schedule and developmental milestones

A few PICU tips:

·       LearnPICU is a great (slightly outdated) resource with common PICU diseases

·       Review treatment protocols for common pathologies like bronchiolitis, post-op care, sepsis, etc

·       Don’t be afraid to ask how you can be involved and participate in procedures—this is an awesome opportunity to learn

·       Always “be there” no matter what the procedure/code/event is—you will be surprised by how much you learn by observing

·       Participate in ways you can—keeping time, giving gowns/gloves, answering questions, talking to the parents, etc

·       Learn the specific protocols for your hospital in terms of trying to transfer a child to the floor and when it would be appropriate to do so

All in all, pediatrics is a great field filled with tons of learning opportunities. Kids are cute and will surprise you with their humor and resilience. Always remember that sick kids are still kids and it’s important to walk into every encounter with a smile, some humility, and a great attitude.