The philosophy of the Department of Pediatrics with respect to the six week pediatric clerkship is to ensure that all medical students learn the care of neonates, infants, children and adolescents. Clerkship Dress Code
You are expected to behave and dress in a professional manner at all times. You must adhere to CMH standards for personal appearance. When in the clinical setting the following dress code applies: - Men: business casual (ties are optional)
- Women: business casual, closed-toe shoes and appropriate length skirts and tops
- White coats must be kept clean
- Scrubs and clean T-shirts (with appropriate pediatric slogans only) are acceptable for evening on-call hours and post call. Scrubs tend to ride low on your waist; make sure your undergarments and abdomen are not visible.
The clerkship consists of a three week inpatient service and a three week outpatient rotation. INPATIENT Inpatient Ward Service - CMH
There will be 2-5 students assigned to each service. Each service is staffed by an attending physician (Ward attending) one or two supervisory residents and first year residents. You will be assigned to work with a resident and will be responsible for performing a history and physical examination on assigned patients. Discuss at the outset with your resident that you would like to help design the evaluation/management plan and write the initial orders. Set a time on a daily basis to meet with your intern to discuss patient plans for the day and to alert him/her to what your schedule is that day. You are required to submit a minimum of two written H & P's to your senior resident (at CMH) and to your attending at ENH.
Inpatient Ward Service - ENH
There will be 2-4 students assigned to Evanston. Each service is staffed by an attending physician and two second year residents. You will be assigned to work with the resident and will be responsible for performing histories and physicals on assigned patients. The educational program at Evanston Hospital is coordinated by Dr. Monica Joseph. Orders/Workups
All orders must be countersigned by your resident. Your written workup is due to your senior resident the morning following admission. The senior resident will review and critically evaluate your workups and should return them to you within 48 hours of receipt. Feel free to "pick up" and follow patients even though you did not work them up upon admission. You should not follow more than six patients. Procedures
You should also assist the resident in the performing procedures and laboratory tests and following the course of your patients. Your success as an integral part of this process depends, in part, on how you demonstrate your willingness to assume such responsibility and, in part, on the "chemistry" between you and your resident. Difficulties in this area should be reviewed directly with your residents, your attending, and ultimately with the clerkship director. Progress Notes
Progress notes should be written on your patients daily, and they must be countersigned by your resident. As all of your written notes are part of the official medical record, and therefore have distinct medical and legal implications, be both precise and factual. Refrain from expressing conjecture or opinion in place of fact. Develop the habit now of critically evaluating everything you say and/or write for its factual content. Attendings
The ward attending, supervisory resident and teaching attending are responsible for teaching on each ward. The Ward attending is responsible for patient care as well. You will be informed of the specific times for rounds and conferences on each ward by your resident. You will be expected to read about your patients' problems and understand the rationale for the evaluation and management of the patient. OUTPATIENT
Community Pediatricians
Community pediatricians have their own office schedules, which may not coincide with yours. That's OK. Let the clerkship director know and arrangements will be made to cover gaps in your schedule. If your pediatrician is located far from CMH you may not be able to make the case conferences. That is okay as you will benefit much more from seeing patients. However, if you choose not to attend conference for a particular day, you must let Grace Alvarado (galvarado@childrensmemorial.org ) know before the conference takes place. Newborn Assignment
Newborn assignments are at Prentice and, those of you doing your outpatient rotation at the CAC in Evanston, at the Nursery in Evanston Hospital. Consult your schedule for instructions on when to get there. Some community pediatricians will offer to take you on their newborn rounds. This experience can be substituted for the Prentice newborn assignment. Inform the clerkship coordinator (Grace Alvarado) if this is the case in advance of the assigned session. CONFERENCES Core Lectures for Students
Discussions emphasizing core topic in Pediatrics. A schedule will be given to you for these conferences. These are usually held in the R-130 conference room. Case Conferences for Students
These sessions are designed to review core curricular topics in depth. Students are assigned to this conference and will be prepared, with a faculty member, to facilitate the discussion. It is usually held in the R-130 conference room. Monday, Wednesday and Thursday Noon Teaching Conferences
A general teaching conference geared primarily to the residents (R-130 conference room). If you are on the inpatient service at CMH you are required to attend. Pediatric Ground Rounds
This conference is held each Friday at 8:00 AM in Bigler Auditorium. You are required to attend this conference while on the inpatient service at CMH. FIRM Rounds
In-depth discussions of one case by the pediatric faculty. Geared to faculty and senior residents this conference can, nonetheless, be very educational for medical students and is almost always very entertaining. You are required to attend this conference while on the inpatient service at CMH. Student Teaching Sessions
These are for students on the inpatient service at CMH. They are held Tuesdays and Thursdays at 11:00 AM in the Core Conference room Attendance
It is expected that you will be at your assigned location on each day of the clerkship. Exceptions are made if your community pediatrician is far away and/or has a schedule that conflicts with yours, if you are sick or if you have pressing personal reasons. You must contact your senior resident (if you are on the inpatient service), your community pediatrician (if you are on the outpatient rotation), and the Medical Education Office. Failure to inform the appropriate people will result in the loss of all your professionalism points. Interactive Case Conferences
Directly given by medical students to an audience of his/her peers. Each student is assigned to a partner (s). These are designed to review one case in depth. You must attend these conferences!! The only exception is if your community pediatrician is far away and/or her/his schedule conflicts with the conference. Discuss these conflicts with the clerkship director prior to the conference.
Night Call
You will be assigned to a night call schedule, approximately every fourth night, while on your pediatric ward rotations. This is often your best opportunity to be involved with patient care, and also with a great deal of informal learning with the residents that night. In order to be involved, however, you need to be on the ward. It is far preferable for you to bring reading materials to the conference room on the ward and read there, than to bury yourself in the library. Frequently problems come up quickly and answers are needed quickly. If you are there, you are involved. In addition, you are expected to be on call, if assigned, on the weekend between the three week shift. The amount of potential learning that can occur offsets your inability to follow those patients long term, because of moving to a different service. Get into the habit of keeping a “to do” list during sign out rounds and offer to pursue tasks to help the team even if they do not pertain to “your” patients. Also, offer to look up pertinent journal articles. You will quickly be accepted as a valuable member of the ward team. Scrub Suits are available in the laundry until 3:00 pm each weekday. Plan ahead so you have a clean set of scrubs while on call. You will be issued one set during the first week. Subsequent clean pairs can be obtained ONLY by trading in a dirty pair. Propriety of Clinical Conversation
Be discreet in your discussion of clinical material, particularly when such discussions occur in hallways, elevators, or in a cafeteria. Also remember that the shuttle bus is used frequently by patients as well as by students and staff; patients can be justifiably offended by foul language or disrespectful discussions of case material.
Sandy Sanguino, MD
Pediatric Clerkship Director
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