Pediatrics

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.

This elective satisfies the sub-internship requirement.  July-November priority will be given to students applying for internships in Pediatrics.

Note:  As of the 2016-2017 academic year, faculty in the Department of Pediatric Emergency Medicine at BMC are no longer able to write a standardized letter of evaluation (SLOE) for an adult emergency residency application.  The current policy from the Association of Emergency Medicine Residency Program Directors is that only faculty of an Emergency Medicine Residency Program may write a SLOE.  Students applying in emergency medicine are, of course, always welcome to take this sub-internship.

 

051.3 Pediatric Inpatient Medicine

Instructor: Sarabeth Broder-Fingert, 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 to 22 years; the sub-intern will work closely on a team with a senior pediatric resident from the Boston Combined Residency Program in Pediatrics (BCRP) and the PICU attending. The sub-I will act as the primary provider for their assigned patients. Major teaching objectives of the rotation are the pathophysiology of childhood critical illness, pediatric advanced life support (PALS), and the various types of intensive care support (i.e. forms of mechanical ventilation, critical care nutrition and coordination of care) 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, including evaluation, documentation, treatment planning, order placement and frequent repeat assessment, under the supervision of the resident and attending physician.

2) The student will perform history taking and physical examinations, complete the history and physical and discuss the differential diagnosis and principles of pathophysiology as applied to the case. Documentation will be reviewed and signed by the PICU resident and attending.

3) The student will suggest and write treatment orders under the supervision of the PICU resident.

4) The student will collect daily objective data, present on morning rounds and write daily progress notes for the patients they follow.  Notes will be reviewed and signed by the appropriate physician.

5) The student will contact consulting services when appropriate, and communicate details of the case to consultants as well as to accepting service teams when the patient is transferred, in consultation with the PICU resident and attending.

6) The student will participate in PICU teaching sessions with the resident and attending focused on common PICU diagnoses and treatment modalities and will be expected to pick a clinical question to perform a literature review for presentation to the rest of the PICU team at some point during the rotation.

Note: This elective satisfies the subinternship requirement

 

053.3  Adolescent Medicine

Instructor: Mandy Coles, M.D., MPH   email: Mandy.Coles@bmc.org

Location: Boston Medical Center – Adolescent Center

Telephone:414-5576     Contact: Therese D’Agostino, Dowling 3 South, Room 3503

Number of Students: One

Period to be offered: Four Weeks (contact Ms. D’Agostino regarding available blocks)

Note: Students who miss more than 5 days from the elective, for whatever reason, are required to make up those days.  This can be done on weekends and official Boston University holidays.

Description of Elective:

The Adolescent Medicine elective will take place at Boston Medical Center’s outpatient Adolescent Center, as well as at a handful of community sites. It will be an opportunity for one 4th year medical student per rotation to gain experience caring for adolescents in the outpatient setting. Students will interview and examine adolescent patients with attending physician supervision, and come up with plans for diagnostic evaluation and treatment. Students are expected to work at least 40 hours per week and have various opportunities to interact with attending physicians, mid-level providers, nurses, social workers, and other community providers. This elective will give medical student valuable exposure to common psychosocial and medical health concerns in adolescents such as sexual and reproductive health, disordered eating, reproductive endocrinology, depression and anxiety, substance use, as well as pubertal growth and development. Students will also attend teaching conferences in the Department of Pediatrics at Boston Medical Center when this does not conflict with clinical experiences. This may include, but is not limited to: Noon Conference, Case of the Week, and Grand Rounds – in addition to adolescent specific education sessions as part of the BCRP Keystone block.

Students will receive timely feedback from providers as well as formative feed back at the mid-clerkship evaluation to assess their progress in developing the below skills. At the end of the elective, the student will be expected to complete an evidence-based presentation as outlined below, and will have gained the following skills:
• To conduct an age and developmentally appropriate interview
• To council adolescents regarding common psychosocial concerns, including but not limited to reproductive health, substance use and mental health
• To come up with appropriate treatment plans for common adolescent concerns.

Student must contact Dr. Coles prior to the first day of the elective to review schedule and arrange for a brief orientation and discussion about issues related to care of the complex adolescent patient.

Adolescent Medicine Elective additional information

 

053.33 Developmental and Behavioral Pediatrics

Instructor: Naomi Steiner, M.D.

Telephone: 617-414-5576      Contact: Therese D’Agostino, Dowling 3 South, Room 3503

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)

 

054.3 Pediatric Gastroenterology

Instructor: Claudio Morera, M.D.

Location: Boston Medical Center

Telephone: 617-414-5576      Contact: Therese D’Agostino, Dowling 3 South, Room 3503

Fax: 617-414-5599

Number of Students: One (One BU 4th year medical student during selected blocks)

Period to be Offered: One month (Block availability is variable and will be announced annually at the beginning of the academic year.  Please email Dr. Morera (claudio.morera@bmc.org) the week prior to the start of the rotation to confirm where and when to meet on the first day of the rotation.)

Prerequisites: successful completion of 3rd year general pediatrics core clerkship

Description of Elective:

The pediatric gastroenterology elective is an opportunity for students to learn to recognize and manage common gastrointestinal disorders in children (ages birth to 22 years) including: abdominal pain, constipation, chronic diarrhea, recurrent vomiting, hematochezia, hematemesis, failure to thrive, abnormal liver function tests, etc.  The majority of the student’s time will be spent in the outpatient GI clinic.  The student will be assigned to evaluate patients with an attending during a clinic session, with increasing independence after he/she demonstrates competency in obtaining the core elements of the history and physical exam.  Through this experience, students will gain familiarity with both the initial work-up as well as the long-term management of patients with both acute and chronic illnesses as mentioned above.  The student will learn the initial approach for new patients as well as long term management of chronic illnesses.  The student will also attend endoscopy session one or two morning a week, and will learn the indications for procedures, exposure to normal and abnormal findings, and post-operative care.

When there are pediatric GI inpatient consults, the student will be responsible for evaluating and then presenting the new consultations during daily rounds.  The student will follow these patients throughout their admission, writing progress notes, reviewing relevant radiologic imaging and finding related journal articles to augment his/her understanding of each patient’s gastrointestinal disorder.  The student will present relevant journal articles during rounds, communicate consultant recommendations to the floor team and reference applicable material learned in their daily progress notes.

Pediatric Gastroenterology Elective additional information

 

056.3 Pediatric Infectious Diseases

Instructor: Ellen R. Cooper, M.D.

Location: Boston Medical Center

Telephone: 617-414-5576      Contact: Therese D’Agostino, Dowling 3 South, Room 3503

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: Meredith Dixon, M.D.

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:

The student participates in the work-up and care of high risk babies from the time of their delivery on the Maternity Floor through their NICU course.  The Sub-I pre-rounds and examines his/her patients in preparation to present these patients during morning work rounds.  The student formulates a care plan with the NICU staff and carries out that plan.  Sub-I’s participate in procedures, discharge planning and family meetings.  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: Mary Mullen, M.D.

Location: Children’s Hospital, Dept. of Cardiology

Telephone: 617-414-5576      Contact: Therese D’Agostino, Dowling 3 South, Room 3503

Children’s Hospital 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:

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: 617-414-5576      Contact: Therese D’Agostino, Dowling 3 South, Room 3503

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

 

058.3 Pediatric Endocrinology & Metabolism

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

Location:Boston Medical Center

Telephone: 617-414-5576      Contact: Therese D’Agostino, Dowling 3 South, Room 3503

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.

Elective closed for the remaining academic year 2016/2017.

 

059.1 Pediatric Latino Patients: Language, Sensitivity and Cultural Immersion

Instructor: Claudio Morera, M.D.

Location: Boston Medical Center

Pager: 617-414-8000, page number 5618

Email: Claudio.morera@bmc.org

Number of Students: One per block

Period to be Offered: every block except October and December

Description of Elective:

This pediatric-focused elective is an opportunity for students to improve their medical knowledge of pediatric medical issues, deliver pediatric primary, and improve their medical Spanish knowledge in this population. The majority of the student’s time will be spent seeing patients in the outpatient pediatric clinic at BMC with attendings who are Spanish-speaking and/or Spanish-speaking Latino origin that have a significant proportion of patients whose primary language, either for them or their parents, is Spanish.  These clinics may include, but are not limited to the following pediatric settings: Gastroenterology, Neurology, Infectious Disease, Endocrinology, and Primary Care.

The student will learn the initial approach for new patients as well as long-term management of chronic illnesses in the designated clinical settings. Discussions with faculty around patient care will focus both on medical management in general, but also with specific attention to elements of the social and cultural influences that affect the quality of medical services and treatment and that can enhance health outcomes for the patient and family.  As a clinician, the student will develop skills of more culturally sensitive care both through observation of the approach of the experienced physicians and through active practice and feedback.

Complementing the clinic experience and exposure to medical Spanish, the course will have a series of literature discussions developed to cover diverse elements of Spanish-speaking patients and Latino health, cultural awareness and sensitivity, as well as care of patients with limited English proficiency.

Students interested in the elective should have a working proficiency of spoken Spanish with capability of, at a minimum, interviewing the patient, gathering pertinent information and performing a pertinent physical exam.  Students lacking this level of fluency may enroll in the elective, but should have comprehension of spoken Spanish sufficient to follow the interview and interaction in Spanish between the care provider and the patient. For those interested in receiving attestation of their language proficiency to adequately interview patients in Spanish through the Hospital Interpreter Services an evaluation can be arranged beforehand for such attestation

 

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: 414-5576  Contact: Therese D’Agostino, Dowling 3 South, Room 3503

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.