Pediatrics

PEDIATRICS

5

050.3 Pediatric Emergency Medicine

Instructor: Atsuko Koyama, M.D., M.Ph

Location: Boston Medical Center – Menino Pavilion
Telephone: 414-5514 Contact: Lisa Blake – Vose 5

Number of Students: Two
Period to be Offered: One month

Description of Elective:

This sub-internship in pediatric emergency medicine will provide students with experience in the direct evaluation and management of pediatric patients, ages 0-21yrs. The rotation will focus on clinical problem solving, and will emphasize skills in the differential diagnosis and treatment of acutely ill children. There is no mandatory overnight call, but students may elect to have some weekend shifts in addition to weekday shifts to complete the required complement of shifts during the rotation. Approximately half of your shifts will be during the evening hours of 3-10 pm. During a 4-week block there are 19 required shifts and during the 3-week block (block 14) there are 16 required shifts irrespective of excused absences for residency interviews. Attendance at the Department of Pediatrics conferences and twice monthly resident conferences is encouraged. At the end of their rotation, students will be required to present a case-based evidence based medicine session to evaluate their ability to interpret and incorporate the medical literature into their practice.

Note: This elective satisfies the subinternship requirement. In July-November priority will be given to students applying for internships in Pediatrics.

 

051.3 Pediatric Inpatient Medicine

Instructor: Arvin Garg, M.D.

Location:Boston Medical Center – Menino Pavilion
Telephone:414-5576 Contact: Therese D’Agostino,  Dowling 3 South, Room 3503

Number of Students: Two
Period to be Offered: One Month

Description of Elective:

An experience in inpatient pediatric medicine during which the student will have supervised responsibilities on the pediatric ward at a level which the inpatient team judges to be commensurate with an individual student’s abilities.

The student will admit and have responsibility for his/her own patients under the direction of the faculty and house staff on the inpatient service. He/she will be an integral member of the inpatient team participating in all levels of activity.

Note: This elective satisfies the subinternship requirement

052.3 Pediatric Intensive Care Unit

Instructor: Kate Madden, M.D.
Location: Boston Medical Center-Menino Pavilion
Telephone: 414-5576 Contact: Therese D’Agostino,  Dowling 3 South, Room 3503

Number of Students: One per block
Period to be offered: One Month

Description of Elective:

The PICU is a multidisciplinary six bed unit caring for children and adolescents from newborns up to their 22nd birthday; the sub-I will work closely on a team with a PICU senior pediatric resident from the Boston Combined Residency Program in Pediatrics (BCRP) and PICU attending. The sub-I will be the primary provider for all assigned patients. Major teaching objectives of the rotation are the pathophysiology of childhood critical illness, pediatric advanced life support (PALS), and understanding of intensive care support (i.e. mechanical ventilation and hyperalimentation) as well as psychological and social support for patients and their families.
Call is every 4th night including weekends until 10pm

Goals:

1) The student will take responsibility for patients, under the supervision of the resident and attending physician

2) The student will perform appropriate histories and physical examinations, complete and appropriate write ups,    discussion of the differential diagnosis and principles of pathophysiology as applied to the case. These write-ups will be reviewed and signed by the appropriate supervision physician.

3) The student will suggest and write treatment orders under the supervision of the supervising physician

4) The student will write daily progress notes reviewed and signed by the appropriate physician.

5) The student will help with the disposition and transfers of his/her patients and will follow all PICU transfer to the  inpatient unit

Note: This elective satisfies the subinternship requirement

053.0 Pediatric Ward Subinternship at Mass General for Children NSMC

Instructor: Elizabeth Coray, M.D.   contact: ecoray@partners.org

Location: Mass General for Children at NSMC, Salem, MA
Telephone: 978-741-1215
Number of Students: One
Period to be Offered:September to May

Description of Elective:
I. Goals:
1. To gain experience and skills in caring for pediatric patients on a general pediatric inpatient unit.
2. Manage, under resident supervision, a variety of acute medical conditions
on the inpatient unit.
3. Appreciate the role of the primary care physician regarding the hospitalized pediatric patient in the community.
4. Gain experience in communicating with primary care physicians, hospital physician and nursing staff, housestaff, and subspecialists regarding the care of the hospitalized pediatric patient.
5. Participate in the evaluation and care of acute pediatric conditions in a community hospital emergency department.
6. Appreciate decision-making strategies for pediatric transfers for tertiary care.
7. Contribute to the teaching of the third year medical students on the pediatric team.
II. Responsibilities
Inpatient Unit
A. History physical examination and admission note on admissions
B. Daily progress notes.
C. All admission notes, progress notes, and orders must be cosigned by the Pediatric resident/facluty.
D. Coordinate patient care along with the attending and resident.
E. Participate in the teaching of medical students
F. Student may be asked to give informal educational talks
Pediatric Emergency Department
A. Students may be assigned to the Pediatric Emergency Department for shifts and will work up patients under the supervision of the Pedi ED attending.
Night Call
A. The subintern will be on call one in four nights, including weekends, with the MGH inpatient resident

Contact Person: Dr. Ed Bailey
Office: 978-741-1215 #2815

Note: This elective satisfies the subinternship requirement

053.33 Developmental and Behavioral Pediatrics

Instructor: L. Kari Hironaka, M.D.

Location: Boston Medical Center, Vose Hall
Telephone: (617) 414-7941
email: lynn.hironaka@bmc.org

Number of Students: One
Period to be Offered: One Month (excluding July)

Description of Elective:

The focus of this elective will be on gaining an understanding of normal developmental processes; attachment, autonomy, mother-infant interaction, coping, Piaget’s cognitive theory, temperament. Different types of screening techniques will also be taught; and Denver Developmental Screening Test skills will be practiced.

Structured activities will include supervised consultations, a literature seminar, ongoing child development activities in the Pediatric Department and Division of Developmental and Behavioral Pediatrics and participation in the various clinics.

Flexibility in the elective exists for those who wish to gain some experience with children with specific developmental problems, e.g., learning disabilities, prematurity, and in utero substance exposure.

053.7 Developmental Pediatrics

Instructor: Doreen Karoll, M.D.

Location:Franciscan Children’s Hospital, 30 Warren St.,
Brighton,MA 02135
Telephone:254-3800, Ext. 7549

Number of Students: One
Period to be Offered: One to two months

Prerequisite: Completion of a clinical clerkship in Pediatrics

Description of Elective:

An introduction to normal and abnormal child development with an emphasis on examination, diagnosis, treatment, and long-term management of developmental problems. The student will participate in diagnostic evaluations, staff evaluation conferences and treatment clinics.

(offered to 4th year Boston University School of Medicine students only)

054.7 Pediatric Anesthesiology-(not offered academic year 2013-2014: 6/2013-5/2014)

Instructors: E. Catherine Miller,M.D., and
Charles T. Kendrick,M.D.

Location: Franciscan Children’s Hospital
Telephone:254-3800, Ext. 2970

Number of Students: One
Period to be Offered: One month

Description of Elective:

During the one month elective the student will function as a member of the Franciscan Children’s anesthesia care team. The student will participate in preoperative evaluation, intraoperative care, and post anesthesia care for pediatric patients, with a variety of underlying medical and surgical problems. The student will participate in informal departmental meetings and hospital conferences focusing on many topics pertinent to the care of the pediatric patient. The student should have ample opportunity to develop skills in preoperative physical assessment and assessment of anesthetic risk, intraoperative anesthetic management (along with the pharmacology of anesthetic drugs), and the important aspects of post anesthesia care.

(offered to 4th year Boston University School of Medicine students only)

 

056.3 Pediatric Infectious Diseases

Instructor: Ellen R. Cooper, M.D.

Location: Boston Medical Center
Telephone: 414-5591 Contact: Nancy Ahonen, 670 Albany St., Room 636

Number of Students: Two
Period to be Offered: One month

Description of Elective:

The course is designed to assist the student in developing expertise in the diagnosis and management of pediatric infectious diseases with emphasis on the clinical pharmacology of antimicrobial agents and newer modalities of diagnostics.
The student will participate in the activities of the pediatric infectious disease group at Boston Medical Center, including in-patient consultation, daily rounds, and conferences. Experiences will include viral, bacterial, and fungal diagnostic labs, as well as Infection Control. Students will have an opportunity to attend Pediatric HIV and International Health Clinics. Students will be evaluated on the basis of their participation in rounds and conferences and one clinical presentation to members of the division at the end of the month

057.3 Neonatology

Instructor: Margaret Parker, M.D., M.P.H.

Location:Boston Medical Center
Telephone: 414-5461 Contact: Faye Taylor, 771 Albany St., Dowling 4N, Room 4101

Number of Students: Two
Period to be Offered: One Month

Description of Elective:

A clinical “subinternship” in which the student participates in the work-up and care of high risk patients from the time of their delivery on the Maternity Floor through their nursery course and follow-up in the clinic. Time is available for the student to read in depth about perinatal medicine and to participate in seminars with house staff and senior staff.

Note: This elective satisfies the subinternship requirement

058.0 Pediatric Cardiology

Instructor:Puja Banka, M.D.

Location: Children’s Hospital, Dept. of Cardiology

Contact:Debi Wilkinson       email:  Debi.Wilkinson@CARDIO.CHBOSTON.ORG
Telephone: 617/355-7655

Number of Students: One
Period to be Offered: One Month

Description of Elective:

Description of Elective:
One student will be a member of the cardiology consult team, and will assist in the evaluation, screening and management of patients with known or potential cardiac disease. The student will write initial consult and follow-up notes. Students may explore specialty consult services (e.g., adults with congenital heart disease, cardiac transplantation) for a portion of their rotation. Students are expected to improve ones consultation skills, read pediatric EKG’s, and attend an array of didactic sessions covering a wide range of topics in pediatric cardiology. No call is required.

058.1 Advanced Pediatric Nutrition

Instructors: Carine Lenders, M.D., M.S.,ScD., Kathy Gorman,  M.S., R.D., L.D.N.,   Anne Merewood, M.P.H., IBCLC, Alan Meyers, M.D., Aimee Lim-Miller, M.S.C., LICSW,  Barbara L. Phillips, B.L.P., M.D., FAAP, FABM, IBCLC, Megan Sandel, M.D., Ben Siegel, M.D., Teresa Strzemienski, R.D., C.N.S.C., Rebecca Zinkowski, R.D.

Location: BMC-Department of Pediatrics
Telephone: 617-414-4557

Number of Students: One
Period to be Offered: One Month (Blocks 11-19)

Description of Elective:

The U.S. Preventive Services Task Force recommends that physicians provide nutrition counseling and referral as a standard part of their practice and as a strategy for primary prevention of disease. The Pediatric Department at the Boston Medical Center serves a diverse and underserved inner city population with high rates of prevalent nutritional related diseases including vitamin D and iron deficiencies, failure to thrive, failure to initiate or continue breastfeeding, and overweight. The objective of this elective is to increase the knowledge and counseling skills of medical students through hands-on, case-based training in pediatric nutrition and overweight management as well as participation in pediatric nutrition conferences and projects.
The student will have the opportunity to work with dietitians, physicians, psychologists and social workers, and be exposed to the nutritional management of patients enrolled in programs such as: The Pediatric Nutrition Support Service (multidisciplinary team providing parenteral and enteral nutrition); The Grow Clinic (multidisciplinary clinic for undernourished children with Failure to Thrive); The Preventive Food Pantry (the only hospital in the nation that gives food to children and parents based on doctors prescription to prevent malnutrition); The Demonstration Kitchen (only one of its kind in the nation to help parents, especially immigrants on food preparation practices); the Nutrition and Fitness for Life program (multidisciplinary team with clinic and community projects to prevent and treat youth overweight); and The Birth Center (first WHO Baby Friendly Hospital in MA).
Objectives of the elective:
1. To take an appropriate patient medical and nutritional history and to conduct an appropriate physical exam which includes assessment of growth and development and signs of nutritional deficiency and excess
2. To evaluate the patient’s diet and lifestyle behaviors
3. To summarize recommendations from medical societies and national guidelines for breastfeeding, healthy nutrition, vitamin D and iron supplementation
4. To order appropriate tests to assess and manage patient nutritional status
5. To identify patients requiring nutritional treatment and lifestyle modification
6. To counsel patient and family using techniques that are literacy and culturally competent and take into account level of motivation and readiness to change
7. To refer to appropriate specialists including physicians, registered dietitians, behaviorists, and other healthcare professionals as well as to community programming as appropriate
8. To learn how to collect and interpret nutritional data

References:
1. Morrison G and Hark L, Eds. Medical Nutrition and Disease, 3rd edition. Malden, MA: Blackwell Science; 2003.
2. Walker W, Watkins J, Duggan C, Eds. Nutrition in Pediatrics: Basic Science and Clinical Applications, 3rd edition. B.C. Decker Inc; 2003.
3. Hendricks KM and Duggan C, Eds. Manual of Pediatric Nutrition, Fourth Edition, BC Decker, 2005.
4. Apovian C and Lenders C. A Clinical Guide for Management of Overweight and Obese Children and Adults. CRC press. December 2006.
5. Institute of Medicine. Jeffrey P. Koplan, Catharyn T. Liverman, and Vivica A. Kraak, Eds. Preventing Childhood Obesity: Health in the Balance, Committee on Prevention of Obesity in Children and Youth. The National Academies Press, Washington D.C., 2005.
WEB references:
1. Nutrition Curriculum Guide for Training Physicians: Practice behavior skills and attitudes across the curriculum www.nhlbi.nih.gov/funding/training/naa/guide.htm
2. Web site with good classical nutrition references

http://main.uab.edu/ipnec/show.asp?durki=35264

3. Web site with current guidelines on growth measurements standards, lifestyle modification, and good nutrition sites http://www.cdc.org
4. Web site with interactive Dietary Guidelines for American (nutrition and physical activity) http://www.mypyramidtracker.gov/

058.3 Pediatric Endocrinology & Metabolism

Instructor: Suleiman Mustafa-Kutana, MB, Ch.B, MSc.

Location:Boston Medical Center
Telephone:614-414-4503  Fax: 617-414-4251  email: Suleiman.mustafakutana@bmc.org

Number of Students:One per block
Period to be Offered: every monthly block or can be arranged

Description of Elective:

This elective will expose the medical student to the fundamental problems of Pediatric Endocrinology and Metabolism including but not limited to disorders of growth, puberty and diabetes.

The service consists of approximately six clinical sessions a week on Monday, Thursday and Friday and a Tuesday morning block for endocrine stimulation testing. The inpatient service consists mostly of consultations that occur sporadically and as necessary, rounding will take place at 9am. If a new onset diabetes patient is admitted we encourage sitting in on a session with the diabetes nurse educator to understand the initial teaching and hands on training involved with these patients.

Didactic sessions with power point presentations will occur weekly to cover topics like neonatal screening, and congenital endocrine syndromes. The student may identify an endocrine topic or disorder of interest to research in depth and prepare a brief presentation to division faculty during the last week of the rotation.

Students will be evaluated on the basis of their participation in clinic and rounds and their presentation at the end of the month. This elective is well suited for students interested in general pediatrics, endocrine or acute/intensive care.

Contact Person: Dr. Mustafa-Kutana

Office:617-414-4503
Fax 617-414-4251
Page 617-638-5795, #7208
Place to report: Room 23 South, ACC – 4

058.33 Pediatric Hematology

Instructor: Philippa Sprinz, M.D., MSc

Location: Boston Medical Center, Yawkey Building, 4S01
Telephone: 414-5554 Contact: Philippa Sprinz, M.D., MSc  email: Philippa.Sprinz@bmc.org

Number of Students: One
Period to be Offered: One month

Please be in touch with Dr. Sprinz (philippa.sprinz@bmc.org) if you would like to set up a session in pediatric oncology at the Dana Farber Cancer Center during this rotation.

Description of Elective:

The Pediatric Hematology Elective is an opportunity for 4th year medical students to gain exposure to recognize and manage hematologic disorders in patients from birth to the age of 22 years old in both the inpatient and outpatient setting.

Students will participate in daily rounds, write progress notes for admitted patients and present new consultations. They will be responsible for following patients on the consult service throughout their admission, communicating with the Pediatrics floor team and finding related journal articles to augment their understanding of each patient’s hematologic disorder; presenting these journal articles both during rounds and in their daily progress notes. Students will also have the opportunity to see patients in the outpatient clinic, to recognize the long-term management of patients with sickle cell and other hemoglobinopathies including sickle cell related pain plans and prophylactic therapies. During this rotation students will be exposed to a wide spectrum of other hematologic disorders which may include: anemia, thalassemias, spherocytosis, G6PD deficiency, ITP, hemophilia, von Willebrand disease, deep vein thrombosis, pulmonary embolism, anticoagulation therapy and white cell disorders. If desired, students may have the opportunity for exposure to Pediatric Oncology – up to four half day sessions as can be arranged – through the Floating Hospital for Children at Tufts and/or Dana Farber Cancer Institute.  Students will attend Pediatric Grand Rounds and Case of the Week and may also attend ‘Morning Report’ and ‘Noon Conference’ with the pediatric interns and residents.

Students will be evaluated by a faculty observation checklist (please see the Evaluation section below). This elective is well suited for students interested in general pediatrics or hematology. It is expected at the conclusion of this elective that the student will have an appreciation of the acute and chronic management of children and adolescents with hematologic disorders. ”

059.3 Pediatric Neurology

Instructors:Karl C.K. Kuban, M.D., SM Epi, William A. DeBassio, M.D., Ph.D., N. Paul Rosman, M.D.
Laurie Douglass, M.D., Joel Herskowitz, M.D., Rinat Jonas, M.D., and Diana Liacos, NP

Location: Boston Medical Center, Dowling 3 South
Telephone: 414-4536 Contact: Lan Ruan

Number of Students: One
Period to be Offered: One month

Description of Elective:

The student will be immersed fully into the Pediatric Neurology team, constituted by Pediatric Neurology and Adult Neurology residents, rotating Pediatrics residents, and one of the staff physicians. This elective provides an opportunity to participate in all inpatient and outpatient activities of the Division of Pediatric Neurology. Students will obtain histories and examine patients seen in clinics, on the wards and in the nurseries, and will then present the case to staff. The staff will provide “hands on” instruction in neurological examination and in clinical management. Additionally, there are weekly Neuroradiology rounds at which cranial and spinal magnetic resonance imaging, cranial computerized tomography, and cranial ultrasound imaging studies are reviewed. EEG rounds are held bi-weekly. Each Friday, 2 hour-long academic sessions are held. The first portion of these Pediatric Neurology Grand Rounds include, on a rotational basis, Journal club, research topics, didactic presentations, case reviews with attending physicians, and topics in psychopharmacology. A live patient presentation and discussion of the child’s neurological disorder by a member of the Pediatric Neurology Division occurs during the second hour as the case of the week. In the course of the month, the student is expected to identify a topic to research in-depth and to present the topic as a 20 minute presentation near the end of the elective. The elective is ideally suited for the student who is interested in pediatrics. Prior completion of the BUSM rotation in adult neurology is not required.