Second Year

Pediatric Clerkship

The basic course in pediatrics for all students is a six-week clerkship in the second year. Its principal aim is to provide an exposure to the field of child health. The student has a diverse series of experiences which provide a comprehensive understanding of the underlying concepts of the discipline. Goals of the program include acquiring familiarity and competence with the basic tools of information-gathering (history, physical examination, and laboratory data) and developing an approach to the integration of this material for the solution of problems of health and illness in infancy, childhood, and adolescence. This should be accomplished with continuing reference to the basic principles of pathophysiology encountered in the first-year courses. Those patients to whom the student is assigned provide the focus for case studies.

In addition to the careful history and physical examination which must be recorded, the student is expected to organize an appropriate differential diagnosis and to seek and read pertinent reference material relevant to each patient. The student should learn to present each case verbally in an organized and succinct fashion, to follow the patient's progress, and to interpret all studies which are performed. The student is expected to learn from a number of sources, including Internet accessible multimedia clinical cases (CLIPP cases), standard textbooks and journals, current publications and conferences, and also from people--house staff, faculty, nurses, parents, and all others with whom contact is made in the clinical setting.

Objectives include an understanding of the roles played in pediatrics by other members of the health care team, both in the ambulatory and hospital settings. Patient care may involve nurse, social worker, recreation therapist, psychologist, physiotherapist, dietitian, and others. The six weeks are divided to include time in several of the following settings: (a) Duke outpatient clinics and emergency room, (b) Duke inpatient, (c) Durham Regional Hospital, (d) Duke nursery, and (e) Lincoln Community Health Center. This course is not available for students from other institutions. If you have any questions about the clerkship, please contact the Director of Pediatric Student Education, Robert Drucker, MD.

Selectives (2-week courses)

These two week-courses are available to second year students following their pediatric or obstetric/gynecology clerkships. NOTE: Not all selectives are available every term.

Clinical Genetics and Metabolism

Child Abuse and Family Violence

Overview of Pediatric Hematology/Oncology

Pediatric Intensive Care Unit

Developmental Care of Sick Newborns – Importance of Teamwork

Electives (4-week courses)

These courses are available to second-year students during the elective period in May. All courses require completion of the basic pediatric clerkship prior to enrollment.

Advanced Pediatrics (Includes opportunities in the pediatric emergency department, gastroenterology, pulmonary, rheumatology, or sports medicine.)

Pediatric Infectious Diseases

Allergy and Clinical Immunology

Clinical Genetics and Metabolism

Pediatric Hematology and Oncology

Clinical Pediatric Cardiology

Endocrine Disorders in Children

Pediatric Neurology

Pediatric Intensive Care Unit

Pediatric Nephrology

More about Second Year Selectives

PEDS-220C. CLINICAL GENETICS AND METABOLISM. The students will join the clinical genetics and metabolism service for DUMC and participate in all the activities of the team - outpatient clinics, inpatient consults, case conferences and didactic presentations. They will perform history-taking, pedigree construction, physical examination (including dysmorphology assessment) and construct a differential diagnosis using reading materials, internet resources and databases. They will observe genetic counseling sessions. Course director: Marie McDonald ^ Up

PEDS-221C. CHILD ABUSE AND FAMILY VIOLENCE. This selective provides students the opportunity to learn about child abuse and family violence, the effect of these issues on individual health needs of patients, the impact of these issues on public health, and the role of the physician to address these issues. Students will participate in the evaluation of patients in an outpatient medical child abuse clinic, observe inpatient child abuse consults, observe family based interventions, observe court proceedings, and participate in mental health didactics. Students will choose a topic in child abuse or family violence for further study and present their findings to the Child Abuse Consult team. This selective is appropriate for all students interested in learning more about family violence in adult or pediatric clinical medicine and/or public health. Course directors: Aditee Pradhan Narayan and Karen St. Claire ^ Up

PEDS-222C. OVERVIEW OF PEDIATRIC HEMATOLOGY-ONCOLOGY. This selective will be offered through the Division of Pediatric Hematology-Oncology within the Department of Pediatrics. During the two week course, students will experience an overview of pediatric hematology-oncology. Students will be expected to round on the in-patient service and to participate in outpatient care provided in the Children's Health Center. Students also will be asked to attend conferences, including patient care conferences, psychosocial rounds, and didactic conferences. In addition, students will meet with individual faculty and staff members for an hour three times a week to discuss specific topics including: sickle cell disease, anemia, leukemia, lymphoma, solid tumors and disorders of the coagulation system as well as psychosocial and ethical issues. Course director: Thomas R. Kinney ^ Up

PEDS-223C. PEDIATRIC INTENSIVE CARE UNIT. This advanced course is designed to allow students a two-week experience in the Pediatric Intensive Care Unit (PICU). Under the supervision of faculty attendings, fellows, and residents, students participate in the care of critically ill children admitted to the PICU for multidisciplinary care. Emphasis is placed on the development of the pathophysiologic approach to the diagnosis and treatment of a broad spectrum of pediatric illnesses as they present in acute care settings. Advanced concepts in pediatric critical care are emphasized. Students are expected to take night call with pediatric house staff. Course directors: Cheifetz, Kern, Meliones, Schulman, Turi, and Weldon ^ Up

PEDS-224C. DEVELOPMENTAL CARE OF SICK NEWBORNS-IMPORTANCE OF TEAMWORK. This selective will introduce the student to the more "general pediatric" aspect of neonatology, namely developmental care, as well as promote the importance of teamwork in caring for premature and sick babies. Students will gain an appreciation of the importance of early intervention, both in the hospital and after discharge for high-risk infants. They will participate in the activities of the developmental team in the intensive care and transitional care nurseries and learn the important role played by psychologists, therapists and social workers in caring for these infants and their families. They will attend developmental rounds, Special Infant Care Clinic and shadow Dr. Goldstein and other members of the developmental team. Course director: Ricki Goldstein ^ Up

More about Second Year Electives

PEDS-290C. ADVANCED PEDIATRICS. This course permits the student to elect an in-depth experience within pediatrics. Each student has a specific faculty preceptor who develops and implements the curriculum tailored to the individual's needs. Listed below are the faculty representatives to contact. Arrangements for the elective must be made with these individuals prior to enrolling in the course. The name of the preceptor with whom a student is working must be designated during web registration. Drucker and selected departmental representatives. Division Faculty Telephone: Emergency Department Karen Frush, M.D. 684-5537* Gastroenterology Martin Ulshen, M.D. 681-4841 Pulmonary Richard Kravitz, M.D. 684-2289 Rheumatology Egla Rabinovich, M.D. 684-6575 Sports Medicine Deborah Squire, M.D. 477-4297 * In the Emergency Department, the student participates in the initial evaluation, stabilization and management of pediatric medical and surgical patients. Special emphasis is placed on the approach to the pediatric trauma victim. Weekly didactic lectures and case review conferences are offered. The student is expected to research a relevant topic of his/her interest and lead a brief discussion with faculty and house staff during the elective. The student is evaluated by the ED Attending staff and receives ongoing feedback throughout the rotation as well as a formal exit interview. Course director: Dr. Drucker ^Up

PEDS-251C. PEDIATRIC INFECTIOUS DISEASES. This course provides experience in the clinical and laboratory diagnosis of infectious diseases and in their therapy. The student works closely with the infectious disease fellow and participates actively in evaluation of patients. Daily rounds in microbiology laboratory. Course faculty: Cunningham, Katz, Drucker, McGann, McKinney, Jhaveri, Seed, St. Geme, Steinbach and Benjamin ^Up

PEDS-253C. ALLERGY AND CLINICAL IMMUNOLOGY. Clinical evaluation and practice in use of methods of diagnosis and treatment of allergic and immunologic disorders including the atopic diseases, immunologic deficiency states, and bone marrow transplantation. Scope: in-depth seminars, history, physical examination, skin testing, a variety of clinical immunologic tests, and Clinical Research Unit experience. Course faculty: Burks, Markert, Williams, Roberts, Frank, Buckley and Mankad ^Up

PEDS-254C. CLINICAL GENETICS AND METABOLISM. The student becomes familiar with evaluation and management of various genetic disorders including malformation syndromes and biochemical disorders. History-taking, pedigree construction and analysis, specialized aspects of the dysmorphological physical examination, diagnostic techniques, routine and specialized laboratory methods (cytogenetic, biochemical, molecular), and reference materials (texts and computer programs) are covered. Students participate in weekly teaching and clinical conferences. Course director: McDonald ^Up

PEDS-257C. PEDIATRIC HEMATOLOGY AND ONCOLOGY. Includes all aspects of clinical and laboratory hematology as well as the diagnostic evaluation, care, and treatment of patients with malignant diseases. Emphasis is placed on fundamental concepts. Students will accompany the inpatient team on the ward rounds for 2 weeks of the rotation with the remaining time spent in the clinic evaluating new patients and seeing established patients. Students also are expected to attend divisional teaching conferences. Students will be asked to research a specific topic and present a short presentation at the end of their rotation. Course directors: Kinney, Chung ^Up

PEDS-261C. CLINICAL PEDIATRIC CARDIOLOGY. This Medical Student rotation provides an intensive learning experience in the clinical diagnosis and management of childhood heart disease. Emphasis is placed upon inpatient and outpatient management. The inpatient section includes a pre and post operative management of children with heart disease via a step-down/Ward environment. The outpatient section includes exposure to cardiovascular procedures including interventional techniques and echocardiography as well as management of children referred for a cardiology evaluation or follow-up via clinic or consultation. The Medical Student also is exposed to pediatric acute care medicine and the modalities available to maintain cardiovascular function in the extremely ill child. Scope: history, physical examination, and special diagnostic techniques (echocardiography, electrocardiography, cardiac catheterization and cineangiography). Students participate on daily ward rounds, out-patient clinics four days per week, and all clinical and didactic teaching conferences of the division. Course faculty: Rhodes, Armstrong, Herlong, Kanter, Camitta, Barker, Delaney and Carboni ^Up

PEDS-265C. ENDOCRINE DISORDERS IN CHILDREN. Students attend in the Pediatric Endocrine, Diabetes, and Insulin Resistance/Obesity Clinics and assume active roles in the evaluation and management of in-patients admitted to the Endocrine Service. Emphasis is placed upon the evaluation of growth and sexual development as indices of endocrine status during childhood. Students also participate in a monthly endocrine journal club and in weekly intra- and interdepartmental endocrine clinical and research conferences. Students will make a presentation to the endocrine group at the end of the rotation. Course director: Freemark ^Up

PEDS-266C. PEDIATRIC NEUROLOGY. Students will partake in the evaluation and management of both hospitalized and ambulatory pediatric patients with neurological disorders. Emphasis is placed on the neurodevelopmental history, neurological examination, the use of laboratory tests and radiological tools and pharmacotherapy in the diagnosis and management of childhood neurological disorders. Course director: Lewis ^Up

PEDS-270C. INTRODUCTION TO THE PEDIATRIC INTENSIVE CARE UNIT. This course is designed for second year medical students to allow students a four-week experience in the Pediatric Intensive Care Unit. Under supervision of faculty attendings, fellows, and residents, students participate in the care of critically ill children admitted to the Pediatric Intensive Care Unit. Emphasis is placed on the development of the pathophysiologic approach to the diagnosis and therapy of a broad spectrum of pediatric illnesses as they present in acute care settings. Advanced concepts in pediatric critical care are emphasized. Students are expected to take night call with pediatric house staff. Course faculty: Cheifetz, Kern, Meliones, Schulman, Turi, and Weldon ^Up

PEDS-271C. PEDIATRIC NEPHROLOGY. The course is designed to provide experience in diagnosis, interpretations of laboratory tests, natural history, and treatment of acute and chronic disorders of the kidney in children. The student also is exposed to the management of fluid and electrolyte disorders in infants and children. Course faculty: Foreman and Wigfall ^Up

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