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Tripler Guide 2013
Tripler Guide 2013

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DEPARTMENT OF PEDIATRICS
INPATIENT PEDIATRIC CLERKSHIP
(Includes: Inpatient Ward; Neonatal Intensive Care Unit; Mother-Baby Unit (Newborn Nursery); Pediatric Intensive Care Unit and Pediatric Sedation Center.)

MAXIMUM NUMBER OF STUDENTS ROTATING ON SERVICE AT ONCE.  Varies depending on the Inpatient Service. Two (2) – Ward; Two (2) – NICU; Two (2) – MBU; One (1) – PICU and One (1) – Sedation Center.

LENGTH OF ROTATIONS.  Two (2) to six (6) weeks.

WILL TAKE STUDENTS FOR TWO WEEKS ONLY?  Yes.

LEVEL OF STUDENTS ACCEPTED  Last quarter of third year (if space available and those considering pediatric residency), entire fourth year.

TIME OF YEAR OFFERRED.  Flexible start dates throughout the year.

PRIOR APPROVAL (FROM DEPARTMENT REQUIRED) AND ELIGIBILITY.

  • Yes.
  • Offered primarily to medical students with an Army obligation (HPSP and USUHS).
  • All students (except USUHS and University of Hawai'i) will apply for a clerkship utilizing the form entitled “ Request for Approval of Clinical Clerkship Training.”
  • USUHS fourth year students will apply using USUHS Form No. 1304 for clerkship request.
  • The TAMC Student Coordinator will obtain permission from the appropriate rotation official upon receipt of the application and will then inform the student of approval/disapproval via e-mail.

OBJECTIVES/DESCRIPTION OF CLERKSHIP.

  • The medical students working on the inpatient pediatric services (Ward, NICU, MBU, PICU, PSC) will assume primary care for children admitted to the various services.
    • The student will be under the supervision of the pediatric residents and pediatric attending physicians.
    • The student will be responsible for evaluating the child, formulating and instituting a plan, coordinating consults, and ensuring the execution of the management plan.
    • The student is expected to write daily notes and participate in the daily rounds.
  • The general inpatient pediatric ward team and the pediatric intensive care unit team are highly integrated and participate in rounds together. Students on this rotation do not follow the PICU patients directly.
  • A NICU rotation is recommended for students planning to train in Pediatrics.
    • The rotation provides an excellent critical care experience.
    • Students are exposed to care of the preterm infant and the critically care infant.
    • The student will develop expertise in systems-based rounds, including ventilator management, fluids and electrolytes, and nutrition.
  • The medical students working on the Mother-Baby Unit/Newborn Nursery service will perform admission and discharge physicals, learn normal variants, attend deliveries, and assist with the well baby clinic.
  • A PICU rotation will provide a well-rounded experience in caring for the critically ill patient and the post-operative patient. Tripler has a 4-bed PICU.
  • A rotation in the Pediatric Sedation Center will allow the student to gain experi-ence with pediatric sedations and airway management. The student will work directly with the Sedation Team, including one of the three Pediatric Intensivists.

FREQUENCY OF CALL. It is recommended that the medical student take call at least once a week, depending on the requirements of the medical school.

  • Call can be taken with either the ward/ER/PICU call team or the NICU/Nursery call team.
  • The student is released from duty at 0900 hour the next morning (after morning report and lecture).

REQUIRED READINGS.

  • Reading assignments will vary depending upon the specific rotation.
  • It is expected that the student will read the current literature and textbooks for details regarding the specific patients that they are caring for.

OTHER REQUIREMENTS.

  • Each student is expected to attend morning report each morning (0730-0800) and morning conference (0800-0900) on Monday through Friday.
  • A lecture series is also scheduled every noon except Wednesday.
  • There is not a requirement for medical students to present a case at morning report; however, this serves as a good training opportunity and exposes the student to the entire Pediatric Department. This presentation should involve a patient that the student admitted to the hospital and assumed care for. The presentation should be coordinated with the appropriate pediatric staff or the inpatient pediatric residents.

HOW ARE STUDENTS EVALUATED?

  • Ongoing feedback should be given throughout the rotation.
  • The final clerkship evaluation will be completed by the appropriate attending physician.
  • The students will be evaluated for general medical knowledge (via direct questioning, quizzes, PREP questions, etc.), patient management skills, professionalism, and interpersonal skills.
  • We use the PRIME evaluation system (professionalism; reporter – interpreter – manager – educator).

ADDITIONAL INFORMATION.

  • Depending upon the number of students at any given time, it is possible to arrange a "split" rotation, meaning that two to three weeks could be spent on one inpatient service and the other two to three weeks on a second inpatient service (or an outpatient service).
  • Likewise, a portion of the rotation may be in an ambulatory pediatric clinic and a portion of the rotation may be in an inpatient discipline. Again, this allows the student to have a greater exposure to different aspects of the program and also allows more members of the department to interact with the medical student.
    • Medical students must confirm with their medical school authorities to determine if this "split" rotation is acceptable.
    • Some medical schools do not authorize "split" rotations, but instead require a full four to six weeks in the same discipline.
  • There is the opportunity to combine clerkship rotations depending on the educational experience desired (i.e. two (2) weeks Ward and two (2) weeks PICU/Pediatric Sedation Center).
  • The 4-week Pediatric Inpatient Sub-Internship is the most requested inpatient rotation from May to September each year.
    • We can accommodate a maximum of two MS4 students at a time.
    • Please schedule the rotation well in advance of planned training dates.

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