Clinical Year: Pediatrics


There are a couple of rumors that go around about pediatric rotations.  I heard them multiple times, and I've heard them from students in all different programs.  

  1. The parents are the worst part of working in pediatrics.  
  2. You will definitely get sick while on this rotation.  

Unfortunately there is some truth to these rumors.  Most of the time parents are fine, but every once in a while, there will be one that is very difficult to deal with, but they weren't that bad.  And I definitely got sick because kids don't even try to not cough or sneeze in your face.  I felt kind of bad for the last week of my rotation, so after multiple negative strep tests, I went to the student health clinic. Just a mild case of pneumonia, but that was resolved with some steroids and antibiotics.  And I learned my lesson and decided I should probably go to the doctor if I'm feeling bad for a week or so and it's not getting any better.  

My pediatrics rotation was at a small clinic in town.  All of the staff and the physician are hispanic, so about half of our patients were mostly Spanish-speaking.  I took some Spanish in high school and college, but I am in no sense fluent.  I can understand some things and carry on a very basic conversation.  So that was a challenge, but I tried!   And everyone was really nice and understanding about my lack of ability to communicate.  

My preceptor was a great teacher.  He had been practicing for years, and had seen some tough cases.  He liked to pimp me, whether we were in the room with patients or during lunch, and his questions were extremely specific.  I rarely knew the answers, but I would always try, and I learned a lot.  He was always nice when I didn't know too.  We had a document as a class with notes of questions he had asked other students in the past, so I tried to study that, and it helped me to get a few right.  There are so many strange congenital defects and diseases that it's impossible to feel prepared to know them all coming out of PA school.  We learn the basics.  

Kids can be tough.  If they're sick, then they are already upset and really don't want you messing with them.  I think its's hard for them to realize that you just want to help.  Some kids will automatically start sobbing when you come in the room.  I learned to look for tears because otherwise they are just putting on a show.  There are a lot of well checks, along with the sick visits.  

One of the interesting things I got to see on this rotation was a child with chicken pox, which my preceptor said he hadn't seen in a few years.  It was a textbook appearance, but it's become very rare to see it in clinic.  The pt was about 2 weeks away from getting her chicken pox vaccine.  I also saw a teenager in sickle cell crisis, which seemed to be very painful.  He had experienced it before and really needed to be at the ER, but it was still a good thing for me to see.  

I enjoyed pediatrics, but it was a little exhausting as well.  My preceptor would just hold kids down if he really needed to, but he was a big guy, and I'm not.  Even now I don't even try to restrain kids while I'm treating them because I usually end up getting kicked or not being able to do what I need to do.  In dermatology (at my practice), I do get to see a good bit of kids.  I think if that's all I saw, I wouldn't like it as much, but I do like getting to see them occasionally.  

Here are some other resources to check out as well:

  • A blog post about a student's experience during pediatrics