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Northwestern University Feinberg School of Medicine
MD Education

Pediatric Clerkship

The object of the clerkship is to provide the fundamentals of the care of neonates, infants, children and adolescents.

Clerkship Structure

The clerkship consists of experiences in both the inpatient setting (general pediatrics, subspecialty, urgent care and in the normal newborn nursery) and in ambulatory pediatrics (locations in Chicagoland area).

Third year medical students are an integral part of the medical team and are encouraged to take ownership of their patients. In addition to learning well child care and pathologic states in infants and children, students learn to write orders and perform and write admission history and physical examinations, including their own assessment and plan. Students are expected to take part in all aspects of their patients’ care and to read daily about their patients’ problems.

Didactic Component

The didactic curriculum includes a series of sessions given by attending physicians. Students also have interactive case sessions with the Clerkship Directors, ethics sessions, and simulation sessions. Students are also invited to attend Morning Report, Resident noon conferences, Grand Rounds and FIRM conferences.

 Goals & Objectives

Detailed Goals and Objectives

Download the complete Goals and Objectives document.

 Assessment and EPAs

EPAs

Pediatrics Clerkship CPA form

Mobile Observation Forms (eMerg)

Clerkship assessment and grading policy

Students are responsible for being aware of the following assessment policies:

  • Assessment policy for Phases 2 and 3
  • Examination policy

Section I: Components of the grade

Your clerkship grade will be derived from the following components:

Component

% (or points) towards final grade

Faculty/resident clinical performance assessment

50%

OSCE

15%

NBME

25%

Clinical Reasoning Assessment

5%

Professionalism

5%

 

A. CLINICAL PERFORMANCE AND EVALUATION: (50 points)

Your score will be determined by a weighted average of your clinical evaluations (CPA forms). Outpatient (One collaborative CPA = 21.25 points), Inpatient (2-3 CPAs averaged, from 3rd year resident and ward attendings = 21.25 points), and Urgent Care (2-3 CPAs averaged = 7.5 points). 

  • Professional Activities: professionalism, advocacy, and communication
  • History taking and physical exam
  • Clinical reasoning, differential diagnosis, application of knowledge
  • Written notes
  • Oral presentation of patient
  • Medical decision making and incorporation of the literature
  • Contributes as a member of the team

B.  FINAL EXAM: (25 points)

The final examination for pediatrics is the National Board Subject Examination. This is a multiple-choice exam comprised of 100 questions and accounts for 25% of your grade. The passing score for clerkship purposes is a subject test score that is greater than the 10th percentile of junior students in your national reference group. If a student fails the final examination he/she may repeat the exam provided his/her cumulative point total for the clerkship is in the passing range (> 62 points).

C.   OSCE: (15 points)

At the conclusion of the rotation you will participate in an OSCE. This OSCE will assess your history taking, communication skills, counseling skills, medical knowledge, and clinical reasoning skills – this is very similar to your experience in your first and second year CSA. It will take place in the CEC of the Olson Building. You will receive more information about the OSCE as we near the end of the rotation.

 

D.       CLINICAL REASONING ASSSESSMENT: (5 points)

A 30-minute online assessment will be administered on Mid-Clerkship Day through Canvas.  Material is based on the content of the Clinical Reasoning Workshop and the 10 required Aquifer Cases.



E.       PROFESSIONALISM: (5 points)

Examples of a lack of professionalism include: inappropriate behavior, unexcused absences or tardiness, inappropriate dress, responding poorly to feedback, use of inappropriate language, and failure to complete assignments by the designated deadlines.

 

Section II: Calculation of final grades

Final grades will be determined by the clerkship director and numerical cutoffs will be established and reported to students early in each academic year. Grades will be awarded based on the following guidelines:

 

Honors
Honors-level students receive outstanding evaluations from faculty and residents and are viewed as exceptional learners and teachers! They are typically thought of as the primary caregiver to their patients, practice evidence-based medicine, bring in primary literature that is pertinent to their patients, and are able to formulate excellent assessments and plans.  In addition, they complete all required assignments, pursue varied resources for additional study, and actively participate in all mandatory and optional clerkship activities. They are viewed as indispensable to their teams and are highly engaged, professional, and courteous in all clinical settings. To be eligible to receive a grade of Honors, the subject test score must be greater than the 50th percentile of junior students in your national reference group (usually 76 to 78).

High-Pass
Students receiving “High Pass” receive excellent evaluations from faculty and residents and are viewed as very important members of the medical team. They are clinically astute, able to formulate solid assessments and plans, are hardworking and thorough. They complete all required assignments related to the clerkship, pursue varied resources for additional study, and actively participate in all mandatory and optional clerkship activities. They are highly engaged, professional, and courteous in all clinical settings.

 

 

Pass
Passing students receive good evaluations from faculty and senior residents. They are able to perform a comprehensive history and physical exam on pediatric patients and develop a sound assessment and plan.  There are no concerns about their performance, either clinically or professionally. They complete all required assignments related to the clerkship and attend all mandatory activities. They are highly engaged, professional, and courteous in all clinical settings. Passing students must have a cumulative point total of greater than 62, have completed all required assignments, and have an exam score greater than the 10th percentile of junior students in their national reference group on the NBME shelf exam.

 
Fail
Failing students exhibit performance that is below expectations for a similar student at their level of training. Faculty and resident evaluations may indicate significant concerns about their performance (either clinical or professional). Students who have failed any portion of the clinical rotation (inpatient or outpatient) as determined by their clinical evaluators will fail the rotation. Students who have a cumulative point total of 62 or less will also receive a failing grade for the rotation and will be required to repeat the rotation. If a student receives a failing grade on the National Board Subject Examination (final examination) he/she may repeat the examination if the student’s cumulative point total is greater than 62. If the student fails the re-take twice, he/she will fail the clerkship and be required to repeat the clerkship. Please note: a student’s grade may be lowered or a student may fail the rotation for egregious professional behavior despite academic success.

 

* When a numerical score falls closely between two grades, the clerkship director will evaluate all components of the student’s performance to determine the final grade.



** A clerkship director may decide a student needs additional time on the clerkship to meet the objectives. The amount of time needed will vary. In this case, the grade will be “Pass” and the number of additional weeks needed will be noted on the transcript.

*** A grade of fail will be given in the following circumstances.

·         Failing the NBME shelf exam three times.

·         Being unable to meet the clinical requirements of the clerkship after completing additional time twice.

·         An egregious professionalism issue.

 Required Clerkship Clinical Experiences (Clerklog) and additional tools

Download the Clerkship Clerklog

Access the Clerklog Online(requires NetID)

 

Additional Materials

Students will be provided with a list of articles which cover general pediatric topics. All students my borrow a hard copy of Nelson’s Essentials of Pediatrics textbook while rotating on the Clerkship. Other numerous textbooks students have found helpful include Schwartz's Handbook of Pediatrics and Bernstein's Pediatrics for Medical Students. The AQUIFER are also a wonderful tool to assist with your studying. A great resource for the outpatient portion of the rotation is http://brightfutures.org/. This website goes through each well child care visit and questions that you should consider asking at each visit. We also provide a booklet to general pediatric articles which you should find very useful.

 

 Frequently Asked Questions

What are the daily expectations for a M3 on this clerkship?

Third year medical students are an integral part of the inpatient medical team and are encouraged to take ownership of their patients. In addition to learning well child care and pathologic states in infants and children, students learn to write orders and perform and write admission history and physical examinations, including their own assessment and plan. Students present their patients during rounds on the inpatient units and write daily progress notes on all their patients. Students are expected to take part in all aspects of their patients’ care and to read daily about their patients’ problems.

What is the typical schedule (number of days worked/hours per day) for this clerkship?

The clerkship consists of 4 weeks in the inpatient setting (general pediatrics, subspecialty, urgent care, observation unit, and in the normal newborn nursery) and 2 weeks in the outpatient setting (location in Chicagoland area). Generally, inpatient days are longer than outpatient. Urgent Care and Observation Unit shifts are often in the evenings.

What is pre-rounding? Rounding? Note writing expectations for this particular clerkship?

On the inpatient portion of the clerkship:

Pre-rounding is the expectation that you will review the overnight data (lab values, vital signs, imaging/studies, ins-outs, and notes from consultants) and visit your patients to perform a physical exam when you arrive at the hospital. Pre-rounding is essential to planning your patient’s day and reviewing your ideas with the senior resident prior to attending rounds.

Rounding is considered formal bedside rounds, or family-centered rounds, usually with the attending physician, which will take place later in the morning. You will likely have practiced your presentation and reviewed your plan with your team by this point. You will direct most of your presentation to the family at the bedside and engage in a discussion about the plan with your team.

You are expected to write a new daily note on your patient including an updated/current physical exam, assessment, and plan.

What does “Call” mean on this particular clerkship?

There is not currently an expectation of “call” on this clerkship. You may “sign-out” your pager after you handoff your patients and leave the hospital but are otherwise expected to answer pages and be available during assigned clinical hours.

What do I do if I have a question about my clerkship grade?

If you have a question about your clerkships grade you should discuss this directly with the clerkship director.  

What do I do if I have experienced or witnessed Student Mistreatment during this clerkship?

If you have experienced or witnessed student mistreatment there are many avenues to report this.  You can discuss this with the clerkships director, mentor, any of the deans or Lisa Rone, MD, the ombudsperson

What do I do if I feel burnt out or overwhelmed during this clerkship?

If you feel burnt out or overwhelmed during a clerkship there are a number of people you can speak with.  The clerkship director, your mentor or anyone in the dean’s office are available to talk.   CAPS can also be extremely helpful in this situation.  You can contact CAPS at 847-491-2151.

Who do I contact if I am sick or have a personal appointment?

Please contact the clerkship coordinator and clerkship director who will then direct you as to how best to notify your clinical site.

Any required equipment?

A personal otoscope can be checked out from Galter Library if desired.

Contacts

Alanna Higgins
Alanna Higgins Joyce, MD, MPH
Director

Robyn Bockrath
Robyn Bockrath, MD, M.Ed
Associate Director

Colleen Cirilo-Marchant
Coordinator

Mailing Address

Ann and Robert H. Lurie Children's Hospital of Chicago
225 East Chicago Avenue
Box 18
Chicago, IL 60611