TM
pediatrics tips & tricks
for med students, residents,
and junior doctors
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clinical reference cards set
When studying...
Know the vaccine schedules and antibiotic dosages. Learning how to do the math for dosages
based on weight is very important in peds.
Not only knowing the schedule, but being able to explain the vaccine mechanisms, what
pathogens they provide protection for, and how they do so. Not only may you get asked these
by your physician, but oftentimes you will have to explain these to the parents.
Review developmental milestones to know if the patients are meeting their milestones, and to
know when patients might require additional testing.
Know the differences in physical exams based on age.
The following is a high yield list of topics to be studied up on for clinic and for your shelf exam:
Meningitis Congenital Anomalies
Cystic Fibrosis Immunizations
Acute Otitis Media Hirschsprung disease
Childhood Exanthemas Sickle Cell Anemia
Orthopedics Coarctation of the Aorta
It is very important to know these topics like the back of your hand. That being said, in the clinic, it can be
hard to make decisions on diagnosis and management. The following cards from my Pediatrics
Reference Cards Set encompass a lot of these conditions and provide you with the most important
information to know in the field regarding them.
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clinical reference cards set
before your PEDs rotation
Once you receive onboarding information, feel free to reach out to the physician/resident beforehand.
Let them know who you are and that you will be joining them for the next X weeks. Keep the message
short though, do not try to say too much; just be genuine.
Email is the most professional outlet to do so, but reaching out via cell phone is also widely
accepted nowadays
Practitionet is a program you can look into for assistance with reaching out and getting connected
Once you have your schedule, check the list of patient cases for your week so you can read about
them in advance. If you do this, then you can:
Read up on the basic science and interventions regarding the disease.
Understand any possible implications, next steps in management and more
Know what to look for when you are operating or rounding on the case. This does not only include
what is typical for different diseases, but what may also be irregular presentations of the same
diseases.
Note what to expect in terms of development based on age of presentation
If time allows, head over to the location that you will be rotating at and get a lay of the land
beforehand.
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during your PEDS rotation
Understand your intention with this rotation.
Are you interested in specializing in pediatrics? Perfect! Use this as the opportunity to really
dive in, learn, make connections, and get better at your craft. See as many patients as you can,
ask to practice techniques, etc.
Not sure if you are interested in pediatrics? That’s fine! That is the whole point of the
rotation. Use this time to dive in and really get your full experience. That way you can walk
away from your rotation knowing you for sure want to do surgery, or for sure do not.
No interest in pediatrics at all? Again, totally fine. But, keep this in mind: you have the next X
weeks to have your experience in pediatrics for potentially the rest of your life. Live your
experience to the fullest, and still be eager to learn as you can transfer a lot of your lessons into
other rotations and specialties.
Also keep in mind that your preceptor’s evaluation is still something that residency
programs will see. It is still important to work hard and make a good impression.
Don’t be afraid to speak up and ask to try certain things. Pediatricians love students who show
interest, and more times than not, if you ask if you can try something they will let you. At the very
least, if they cannot, they will show you how to.
The staff and the nurses are resources for you too. Do not just rely on the physician for a bulk of
your learning. Don’t shy away from asking the techs and nurses any questions you may have.
If you see a very unique/interesting case during your time rotating, ask your preceptor if you can
potentially write it up. This is a great chance for you to get published!
Ask your preceptor for feedback. There is always room to improve so be willing to ask and receive
feedback. Now, learn from this and implement the feedback.
Ask questions! As much as pediatricians will pimp you out, it is also okay for you to ask questions.
This shows them that you are here to learn. It is always better to look like an open learner rather
than a know-it-all; trust me, what you think you know, the pediatrician knows 100 times more.
Especially for pediatrics, CONNECT with your patients. Going to the doctor's office is often nerve
wracking for children and teenagers. Take the time to connect with your patient, make some small
talk with them, make them feel comfortable. Take the extra time to chat with them about topics that
are not medicine related (ex. What grade are you in? How are you enjoying that? What
extracurriculars are you involved in?) That way, they will be less anxious and trust sharing
information with you more.
If you go into the room and the patient is smiling and laughing with you when the preceptor
walks in, that looks very good for you not only for your evaluation, but it also shows that you are
personable and able to connect to different people about different things.
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clinical reference cards set
during your peds rotation
For every visit, especially in the earlier years of childhood, 3 things that you have to
be cognizant of are immunizations, milestones and growth.
It is important to track immunization records to ensure that the child is keeping
up to date. Note that there will be parents who are anti-vaccinators. Remember,
your job is to advocate for child health and educate. At the end of the day the
patient and parents have the autonomy to make any decision they wish. Before
you head into the patient room, take a quick glance at your pediatric
reference card to see what immunizations they are scheduled to be up to
date with.
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clinical reference cards set
during your peds rotation
Similar to immunizations, keeping an eye on
milestones based on age is an important way to
monitor development of children. Before you
head into the patient room, take a quick glance
at your pediatric reference card to see what
milestones they are expected to be developing
at their respective age.
Finally, it is also essential that you are monitoring
the growth of your kiddos.. Before you head into
the patient room, take a quick glance at your
pediatric reference card to see respective
growth charts and compare the percentiles that
your kiddo is in.
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clinical reference cards set
during your peds rotation
There is a good chance you will get sick on your peds rotations, especially in the winter. Wear a mask
if you need to.
If you are examining an infant, NEVER TURN YOUR BACK ON THEM COMPLETELY.
For example, if you have to grab your stethoscope, keep one hand on the patient. You never
know when that baby may decide they can roll over for the first time.
Peds patients come in with a flood of ongoing or new issues. Don't dismiss anything parents or family
report, listen attentively. But when talking to your preceptor, pick out the most important fix for that
singular visit, diagnosis and plan. The other things can be managed at later visits on a priority ranked
basis.
Education for parents and patients is key. Don't leave an interaction without educating them on
what prompted their visit that day.
If an infant is crying, talk to the mother and create rapport while gathering history. The child will be
watching the mom’s reaction to you and will mimic that after some time. Exam their ears last when
possible.
Even if the patient is older than 6 months, be sure to go back and inquire about the pregnancy and
neonatal period.
For example, there are a lot of conditions that are more prevalent in premature babies. Just
knowing that your patient was premature can help you with your differentials.
Keep some goodies on you! Have a small toy on your badge chain; maybe keep some stickers with
you. Something small and fun that can distract the babies while you are performing physical
examinations can allow an easier time for you to perform them, and less anxiety for the patient.
Utilize the parent. For carrying out physical exams, have the parent wrap the child in their arms or
hold the child's head if it will be helpful for you.
Don’t be afraid to hang out with the children! After you're done rounding, done with your notes,
and done with any floor work that needs to be done, go check in with your patients and talk with
them. Play games with them. These children are often alone, by themselves, in a completely foreign
setting. Become that positive influence to guide them through their illness.
Remember, it is mandatory that you REPORT any indication of child abuse/neglect. If you have any
suspicion, make sure to bring it up with your attending.
Useful apps to use while you are in clinic
Hospitalist Handbook helps you quickly learn how to approach different diseases or conditions
that are common in the hospital setting.
Epocrates helps get you clinical decision support, and saves time with prescribing. This not only
helps with choosing medications, but also with dosing.
MDCalc is a free app that allows you to calculate different risk/score calculations.
UpToDate helps you find the most up-to-date information in medicine regarding diagnoses,
management, and treatment.
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clinical reference cards set
after your peds rotation
Consider leaving a thank you note for the pediatrician on your last day. If possible, even
a thoughtful little gift (ex. Their favorite candy, etc.). Physicians really appreciate knowing
that you took something away from their rotation and so showing that gratitude goes
miles. Seeing that you even took the time to write out a note over texting/emailing them
also shows them how thoughtful you are.
If this is the field you want to pursue, definitely try to maintain a long term relationship
with this physician. Write a follow up letter 2 weeks after your rotation has ended. Talk
about what the experience meant to you. Let them know you appreciated their
mentorship and would be happy to work together in the future in some medium. Maybe
even setting up some further shadowing.
If this is the field you want to pursue, consider them for a letter of recommendation. An
important thing to consider for an LOR is one that would have an institution's letterhead.
Click or scan here to get the pediatrics TM
clinical reference cards set
Other Great resources
Blueprints Pediatrics: Great book to give an
overview of pediatrics while hitting important
topics more in depth.
Case Files Pediatrics: A consolidation of patient
cases specific to the pediatric setting.
Shelf Life Pediatrics: A pocket-sized question
book with 500 high-quality questions and answers,
is designed to solidify your understanding and
concepts related to pediatrics.
First Aid for the Pediatrics Clerkship: This is one
of the greatest resources for a pediatric clerkship,
written by Latha Ganti and Matthew S. Kaufman. It
covers hundreds of topics that you need to know
to perform well on your shelf exams and wards.
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clinical reference cards set
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