Ready to be the savant of clinical clerkships? Thousands of students do it every year with Sketchy as their trusty wingman. SketchyMicro and SketchyPharm are your secret weapons for bugs & drugs, while our clinical courses will help you crush rotations AND Shelf exams. And guess what?! Our SketchyPeds course just got e x p a n d e d! Come check out what we’ve been cookin'!
I am a pediatric hospitalist and I’ve worked with trainees of all levels and experiences - from shadowing premed students, to second year medical students on their first rotation, to senior residents and fellows. My experience is deep in medical education and I am focused on how each level of learner can succeed and grow.
That being said, sometimes as a medical student it is tricky to find your place on the team. The more proactive you are about making yourself a valuable asset, the more and more your team will go to you to give you responsibility and thus amplify your educational experience. In this article, I’ve put together my top 10 keys to being an active member of your peds team so you can be a step ahead on that first day on your rotation.
- Be curious: This is listed as #1 for a reason. I promise if you are feeling bored, you are showing it. If you approach every patient with intellectual curiosity, you will maximize your educational experience and also solidify your engaged role on the team. We know not everyone is going into pediatrics, but there are still lessons to be learned from every patient that will be applicable to your future specialty. Yes, even surgery :).
- As an example: as you are prerounding and see a CXR result for a newborn you may wonder how the radiologist knew that CXR showed respiratory distress syndrome rather than transient tachypnea of the newborn … so be curious! Ask your intern/senior, proactively call and discuss the findings with radiology, look up the Sketchy module on this, read a relevant article … learn as much as you can from each patient’s presentation.
- Take initiative with to-dos: This sounds simple, but offering to follow up on or perform a task will not go unnoticed by your resident team. Just like you, they are learning about their new roles and have more on their plate than they know what to do with. Whether you proactively offer to run that disc down to radiology or call a consultant to follow up on a recommendation, your residents will be very thankful. Whether it is your patient or someone else’s patient, if you have the opportunity, ask to do it! Which takes me to …
- LISTEN on rounds: I remember as a medical student, I had such anxiety about my patient presentation that I would be rehearsing it in my head while other residents or med students were presenting their patients. Don’t be like me! Instead, show your engagement on rounds by actively listening and engaging in the educational conversations. This also allows you to hear when someone casually mentions in their plan that they have a task to do that you think you may be able to take on for them (your residents LOVE this!).
- Read the room: The other edge of the sword of being engaged is being too vocal when the team is clearly overwhelmed. Hence, read the room. Sometimes when you have a complicated educational Q it’s better to hold off. For instance, if your team has 20 patients to round on, you’ve already been rounding for 3 hours…that’s not the time for that long question. Make note of what you wanted to ask, and if you have time, look it up on your own and bring that info to your team later on in the afternoon when things may have calmed down. Or if you notice your intern is drowning in pages but your senior is a little more free, then grab your senior instead.
- Mini-prep for admits: “Hey we have a patient in the ED - this is your turn for an admit!” Don’t panic! Even better, quickly get prepared. Take 5 minutes to come up with a quick differential before heading to do your HPI so you will get a focused, prepared history. For example, if your senior says “We have a kid with fever and a diffuse rash in the ED,” take 5 minutes to read about rashes from your favorite quick reference. Then you’ll be prepared to ask relevant HPI Qs, like “Is it on the palms and soles?” and “Does it blanch?” Your team will be impressed, but more importantly, you’ll deliver better patient care when you’re prepared.
- Put in face time with your patients: This is invaluable for many reasons, but on theme with this list, it is also a huge asset to your team. As a medical student, sometimes you have the luxury of time that your residents often don’t have, as they are covering more patients. So when you are able to, go check in with families & patients throughout the day, as this really can help progress care forward. Some examples of what you can do during an “afternoon rounds” session like this are:
- Assessing respiratory patients – are they ready to wean on oxygen? Albuterol?
- Checking on POing – is your post op appy patient ready to advance their diet?
- Pain checks – is your patient’s current pain regimen working well for them?
- Be your patient’s doctor: This one also may sound obvious, because you are their doctor! But act like it and operate like it. One tangible way to do this is to check in with the nurse for your patient first thing in the morning and (if your team is OK with it), give the nurse your contact info. That way you can practice your triaging skills while also really showing up to the team as your patient’s doctor. The more you do this, the more autonomy and responsibility will come your way!
- Place orders: One skill that you will need to hone for any specialty is placing accurate and timely orders! So use this opportunity to practice, so long as your institution allows it. Many places allow a medical student to place or pend an order, which can then be cosigned by a resident or attending. If you don’t know whether this is allowed, be proactive and ask if you can do that!
- This also applies to admission orders. Admission orders are the set of orders you will use to admit your patient to the hospital (think things like initial labs, imaging, PO status, IV fluids, and antibiotics once you have discussed the plan with the attending).
- Befriend ancillary staff: Collegial and professional behavior with your multidisciplinary staff is paramount, and it lets you leverage their knowledge to help your team. For example, if you have a collegial relationship with nursing and social work, they will be more likely to come to you directly for your patient’s needs. This in turn allows you to be an asset to your team. Being the first to know about important things for your team goes a long way in excelling on your rotation!
- Discharge prep: Seemingly simple things actually can be huge barriers to a timely discharge from the ward or nursery, which is something your teams will focus on. Proactively asking your patient things like: “Who is your pediatrician? Which pharmacy do you prefer your meds go to? Do you need refills on any existing medications prior to discharge?” will all show your team you are actively thinking about your patient’s holistic care from admit to discharge. Families also really appreciate this patient centered care, so they aren’t stuck running to the wrong pharmacy for a med or not having a pediatrician to follow up their hospital care!
Walking into a new rotation can be daunting, so hopefully these tips help you feel a step ahead when it comes to pediatrics. And remember, above all else, intellectual curiosity will take you far and keep you engaged on your team! Enjoy your peds rotation and have fun with those complicated but resilient little humans!
Check out this free pediatrics clerkship guide to get you started on your first day!
