Tips for the pediatric rotation

I just finished my pediatric rotation and have a few tips to pass on.

Outpatient

1. Memorize your vaccination schedule and include vaccines in your assessment/plan if the patient is due.

2. Questions you can’t afford to forget when doing a pediatric history: change in appetite/activity? smoke exposure? pets or animals at home? Sick contacts? Always do a good ROS to find out symptoms the patient/parent forgot to mention!

3. Have at least a few reasonable diagnoses for cough, fever, rash, sore throat, vomiting, diarrhea, and poor feeding/failure to thrive.

4. Be comfortable with the descriptive terms for skin lesions and rashes

5. Learn how asthma is diagnosed and treated (the basics–PFTs, controller/rescue meds, etc)

6. Memorize the developmental milestones. At minimum, know at least one gross motor, fine motor, social, and language milestone for each age bracket.

Inpatient

1. Take some time to figure out when and where you are supposed to be places. You will have morning reports, grand rounds, and various other functions. It is easy to miss something if you are not paying close attention.

2. For team D, learn about protein losing enteropathy, short gut syndrome, the hepatitis differential, and intestinal failure associated liver disease. Also learn the differentials for common GI complaints (obviously) like vomiting, abdominal pain, diarrhea, etc. Peds in Review articles are an excellent resource

3. For team A, learn the lupus criteria, Kawasaki criteria, and Jones Criteria. Also read up on diabetes, (especially type 1) and congenital heart disease.

4. For G and B, pick the brain of someone who worked on these teams.

Mock boards

1. Study more during outpatient! You will not have much time for study during the inpatient part of the rotation. Plan on getting through at least 75% of your study during outpatient.

2. Lange Q&A is widely considered high yield. Everyone has to find their own preferred study book/method, however. The best thing to do is to pick a book and study it well. The exact book you choose probably doesn’t matter that much as long as you put in the time and effort.

OSCE

For the live patient OSCE, study the example H&P on the Peds Canvas site. From what I could tell, the biggest chunk of your grade comes from doing a thorough history and physical.