Friday, August 14, 2009

Peds

Hey y'all, I hope this isn't too late for those of you starting Pediatrics on Monday but here's the skinny on what's it's like (at least was like for me).
They feed you well here. You'll have a light breakfast (juice, coffe, fruit, donuts, bagels) most weekday mornings and every weekday there's a noon conference with good food. Don't be late to these things 'cause occasionaly they run out of food and some attendings/seniors use attendance as part of your eval. If you're at PCMC there's a resident lounge that always has food in it (literally always).

3-weeks In-Patient:
Glasgow or Ward team. I did Glasgow and loved it. You actually play doctor and have some responisblity (i.e. you make the care plan, call consults, etc, by your lonesome; you also have to get your notes done 'casue there's no intern to pick up your slack). That means you'll be speding more time there though. Forget the usual q4 call schedule. You work 6-6ish every day. On your call day (every 4th day) you carry the team pager. That means any problem with any patient your team has comes to you first. You then have to punt your pard if they're around or fix it yourself. If it is something serious when you call back tell them you're coming and to page the senior as well. This is the cross-cover fun. You'll need to be up on all the patients on the team not just yours so you can handle what may come. On you post-call day you'll until your notes are done after rounds (usually 12-1300ish). It's usually pretty fast-paced but you won't regret doing Glasgow over the ward teams--if you're on a ward team you'll still have fun, I think. You are supposed to average one day off per week which means more cross-covering for all.
One important note about the in-patient gig: use all your money on the meal card. Kristin takes it back at the end of in-patient so don't be skimpy. You get like $14/call shift which is a fortune at the Rainbow Cafe.

Out-Patient weeks:
1 week in the Well Baby Nursury. This week is at the nursey at the U (2nd floor in the new part). You pretty much just play with babies all week with the occasional call to deliveries/c-sections to resuscutate the not-so-well babies. Days are 7-whenever you're done and it's slow. For me that was 6ish since we had a boat-load of kids. Others got out regularly by 3-4. You're supposed to do a weekend day as well. you actually get a grade for this part which is different from the other out-patient weeks which are pass/fail. There is a newborn OCSE that you'll have to get done at some point but that's easy to do. One bonus thing to do: bring your senior lunch back from noon conference.
1 week in Out-Patient Clinic. For most of you this'll be clinic 6 at the U. The attendings are pretty chill. You go see patients first. Afterward you present them to the attending (this is brief, some only want your diagnosis), suggest a plan which you carry out with them. It's pretty cool if you know what the kid has because you diagnose it and decide how to treat it. The attending is only there to sign the prescription form in those cases. The schedule for this week is 9-5 with weekends/holidays off. Usually you'll be out before 5 depending on patients. You're supposed to still go to morning report and noon conference at PCMC.
1 week of Sub-Specialty. I did the PICU so I can only speak to that. It was pretty cool. Don't pick this one if you have a hard time with really sick kids. Days were 6-5ish and I think you're supposed to do a weekend day (I had this last so I didn't do the weekend). You'll need to be somewhat proactive here. Since it's pass/fail and they don't always have students there they don't "expect" you to know/do anything. Feel free to take as many patients as you like (I only followed one for the whole week because we didn't have many to go around). Like most things the more you do the more you'll learn.
One note on the out-patient weeks: Try to get your CLIPP cases done during this time. In-patient is pretty busy and you won't want to do them then, especially on Glasgow.

Enjoy the happy-land of peds where people don't pimp you to make you feel stupid and all things are made of butterflies and bubbles.

Psych at 5 West (U of U)

The psych rotation is pretty straightforward. Everyone is really nice - my attending, residents and the rest of the team were all awesome. The hours aren't quite as nice as UNI (my hours averaged 8-6). The patients are mostly nice and you have a lot of time to get to know and talk with them so it is really rewarding. Once in a while a patient keeps it real by telling the attending he is going to "stick a nuke up [his] a**" or providing other such delightful repartee +/- antics.

The only advice I really have is for the shelf - don't ignore which kind of psychotherapy you use for which diagnosis like I did (e.g. what is Cog-Behavioral therapy indicated for vs. Insight-oriented). For the shelf, First Aid that the department lends you was the most useful.