This is my second post about doing well in your pediatric rotation. You can check out my first few posts here and here.. In this post, I will talk about the tips that really made the difference in my rotation.
Keep in mind that this was my first clinical rotation ever. Still, I was still combined in teams which included both more experienced third and fourth-year medical students. Even though we were told we wouldn’t be compared to upperclassmen, it’s a hard thing to separate out for the attending. Thus I had to learn very fast and faked it till I made it. Fortunately, I had some great attendings who set their expectations and my evals indicated I had met them.
Here are my tips for the pediatric rotation.
1. Be Playful Before You Play Doctor:
Kids don’t enjoy hospitals. Yes, some have chronic ailments where they become regular visitors to the hospital but they still rather not be there.
To make the most out of your pediatric experience, pretend to be a kid or a teen for a second before you pretend to be a doctor.My most memorable experiences on my rotation were also my most successful patient interactions.
I knew that when all things were done, the patient would receive the care they needed. What I could change was how quickly they became comfortable with the process.
I can still remember my first ever patient on my pediatric rotation. She was in tears prior to me entering the room because of pain.
I could have simply taken my history and done a quick physical exam, but that wouldn’t have done much for her current discomfort. So I took a few moments to find listen to her struggles, find some common interests, pulled out my stickers (they’re magic you guys!) and she calmed down.
The history process was easy from then on out. Also, my future interaction with her was much easier because I took some time to step back and build rapport on my first try.
2. Joke With the Kids:
Sometimes the sickest patients need to laugh the most. Be goofy and silly but be sincere and compassionate.
You may not have all the answers to the questions they and the parents may have (I sure didn’t). Being available is still way more important that being knowledge.
My favorite age group to work with were the teens. Teens are notorious for putting up a bratty or indifferent persona. We all were in their shoes once and were victims to this phase. But as soon as you start cracking some jokes, they let down their shields and return the playful interaction.
I had a patient who fit the bill for a typical teen. He would barely answer my questions, would be texting during my interview, and was vague about everything. As soon as I brought up basketball and playing each other on the Xbox, he put that phone away. I spent two afternoons with him playing video games! Just to go show the change you can bring out of your patients if you take a different approach.
When you connect with your patient you also become more involved and interested in their care. I impressed my attendings more often when I looked up topics because I was interested in my patients and not because I wanted to show off my knowledge.
The times I did look up things to impress rarely produced the opportunity to show it off. So care about your patients and you’ll naturally attract attention from your team members.
3. Learn Something About Your Patients Your History Skills Wouldn’t Disclose:
With electronic medical records, you could go into a room and ask 5-10 yes/no questions and you would be done. The EMR tells you their age, gender, and long medical history. You could learn a lot about your patients by sitting at your computer, but they tend to tell you very little about the actual person.
During my H&P with my kiddos, I found it effective to ask about school, favorite subject, sports, hobbies, movies, and food (food almost always works)! I would use these bits of info to make my patient interaction smoother on future encounters.
4. Study Hard For Your Shelf:
Study often and study early.
The shelf was hard. I’m not going to act like I walked away confident in performance. Maybe that’s just a part of being a new clinical student taking his first shelf. Regardless study hard. Do a lot of questions and do them early.
If you’re a first or second-year medical student wanting guidance on how to succeed in medical school, read my book, The Preclinical Guide. I provide all the tips I wish I knew day one of medical school. Check out the book here.