Pediatrics was definitely a rotation that surprised me! I was pretty hesitant going into it because I have never really worked around children and wasn’t sure how I would react to some overprotective parents, but I was pleasantly surprised by how fun this rotation ended up being! Many thanks to all the silly and equally entertaining little patients that entered through the doors each day!

I worked at an outpatient Pediatric clinic with multiple doctors and nurses on staff.  The schedule at this Peds clinic was seriously the most laidback that I have had throughout rotations so far! My doc had Wednesdays off and rotated on every couple of weekends. Days were typically 8:30am-5pm, except for Tuesday our late night which usually went until 7:30pm. I was so thankful to have more days off to recover from the illnesses I would acquire throughout my rotation. The staff here was also super friendly and amazing. I felt so at home and welcomed since day 1!

My duties mainly consisted of taking history and physicals and presenting a plan if I was able to come up with the diagnosis. Most of the visits were either acute care sick visits or well child checks! In regards to procedures, I didn’t really get to do any procedures during this rotation because there weren’t many complaints that required procedures. Also, most parents aren’t so keen on you trying something for the first time on their child which is understandable. I was pretty tempted to do some vaccinations, but after watching the nurses do a few, it was pretty hard to watch any more after that. Seeing babies get shots is seriously one of the hardest things to watch!

Another thing about Peds that surprised me was the wide range of patient complaints and types of pathology you encounter. For the most part it’s ear infections and well child checks, but we also had a good amount of interesting cases. And since very young children and infants are not able to express their complaints to you in words, it requires a greater amount of critical thinking to determine the source of the problem!

Resources:

• Objectives: PAEA Pediatrics Topic List, PAEA Pediatrics Exam Blueprint
• Books: 
  • Nelson’s Essentials of Pediatrics: This was a required book for Didactic. Many Pediatricians and Pediatric PAs use the full version of Nelson’s Pediatrics (which is two volumes) so this book is a simplified version. Overall, I though this book was just okay. I mainly disliked the organization and I felt like I had to flip back and forth between sections or conditions were not where I expected them to be.
  • Current Pediatrics: I would choose this book over Nelson’s. It’s more organized. It’s also easy to read and has everything from the objectives. I used this resource along with UpToDate the most. *If you are hesitant to buy an extra book (like myself), I was able to access it free online on AccessMedicine under my school’s library resources. You should definitely check to see if your school offers this too!
  • First Aid for Pediatrics: This book is more of a review/study guide with bullet points. It would be a good resource to add for additional studying, but I still like to read from a book first hand about conditions.
• Websites/Apps: 
  • UpToDate: I used UpToDate SO much during this rotation!
  • OnlineMedEd: I found the videos were extremely helpful especially the Neonatal Jaundice video.
• Podcasts: I didn’t listen to really any Podcasts during this rotation because I had difficulty finding any good ones that would pertain to PA topics. But one that I found Pedscases.com: Pediatrics for Medical Students has some good Podcasts. I didn’t really listen to more than a few, but they seemed pretty good if you want to give it a try!
• Practice Questions: The Point

Additional Recommendations/Tips:

Well Child Examination: Outside of the acute care visits, the Well Child Examination is THE STAPLE of the Pediatrics rotation! I definitely think that it is worthwhile to go into the rotation with a little bit of knowledge about this type of visit.

• Developmental Milestones: The developmental milestones were definitely something that I struggled with during this rotation. Especially, when I was asked to do Well Child Checks by myself! It was good to carry around a quick chart at clinic that I could reference between cases.
  • USMLE Developmental Milestones Chart
  • Developmental Milestones Chart: Here’s a Developmental Milestones chart that I made and carried in my white coat. It doesn’t include everything, but it includes milestones that I feel were the most commonly discussed. (Information from Up To Date).

• Newborn Exam: You’ll be seeing a lot of Newborns in Peds at very frequent intervals during their development. So you’ll have to learn how to do a pretty thorough Newborn Exam. You’ll be able to see how your preceptor does his/her exam which will be helpful, but here’s a few resources for if you’ve never done one before (like myself):
  • Newborn Exam Video 
  • Newborn Exam Printout: Here’s a little printout I made initially just to ensure I hit most of the things to lookout for on a newborn exam.

Otoscope Exam: Looking in little kids ears is possibly one of the most difficult things I have had to do in PA school so far. No JOKE! Props to all the Pediatric providers out there that tackle this challenge on a daily basis. Whenever (on the rare occasion), I was able to see a TM on a patient <1 year of age and accurately diagnose an ear infection, I felt like a million bucks. That being said be prepared to hold children down while simultaneously “trying to hit a moving target”. My preceptor taught me a way to hold the otoscope that stabilizes it against the child’s head, so that the otoscope also moves with their movements instead of lodging into the ear canal deeper. Here’s a video with some good tips: https://www.youtube.com/watch?v=pQbjNyZr0gc

Infection Control PSA: “YOU WILL GET SICK ON THIS ROTATION.” The words I heard so many times, but thought to myself “Hey, I haven’t gotten sick once throughout PA school perhaps I’ll be the lucky one.” WRONG! AND WRONG! Regardless of my religious hand washing/sanitizing on entering and leaving every patient room, I still wasn’t immune! I haven’t been this sick since I was a kid. At first, I had a never-ending cold that lasted 2 weeks. By the time I was starting to feel myself again, I was struck by the most debilitating stomach flu I have had since childhood. This is coming from someone who has had a case of gastroenteritis from Third World Nicaragua! Children carry new germs that you most likely (99% sure) will NOT be immune to. PROPHYLAX. SANITIZE. HAND-WASH. EMERGEN-C. DO WHAT YOU CAN TO SPARE YOURSELF!

…And my rant is over haha!

With all that being said, Peds is super fun and you will most likely enjoy your rotation! Everyone is super friendly in Pediatrics so you really don’t have anything to worry about. If you have an questions or comments, leave them below!