Specialty Search: Pediatrics

Well...THIS IS IT! I finally know what I'm going to do with my life! :)

Coming into medical school, pediatrics was what I 100% wanted to do. Even before medical school, I thought that I "knew" that I needed to work with kids. Before I decided on medicine, I thought that maybe I would be a kindergarten teacher, than a high school science teacher, than a pediatric audiologist...Basically, I knew I needed to work with kids. However, once I got to med school, things changed. I realized 1) liking children wasn't enough to make you like the field of pediatrics, and 2) there were so many fields of medicine that I found fascinating. Specifically, the second I realized how much I loved OB/GYN and how much I enjoyed the 80+ y/o population on my internal medicine rotation, I started questioning everything about what I wanted to do with my life. So, once I FINALLY got to my fifth rotation, I couldn't wait to start the rotation that I knew would ultimately decide my future.

If you have been reading my past blogs (OB/GYN and Family Medicine), you might know that this rotation was really the deciding factor. If I absolutely loved Pediatrics, like I hoped I would, then that would be it. If I hated it, than I would do OB/GYN. If I liked Peds the same amount as OB/GYN, I would consider doing family medicine, as this would give me a little exposure to both fields, along with my beloved 80+ year-old crew. Even though I really don't love adult patients, especially the cirrhotic/heart failure/copd/anxiety/depression/substance abuse male population, I thought maybe the ob, gyn, and peds would make up for it. So, you can see how crucial this rotation was for my life decision making process.

The rotation is basically split in 2: 4 weeks outpatient, 4 weeks in-patient. Further, one week of inpatient is newborn nursery and one week of outpatient is "speciality week." I had a less than ideal schedule, because I started with specialty week and ended with the busiest shift (in patient floor), but what can you do?

Week 1: Specialty Week. Since my first day of the clerkship was orientation, I got 4 days in Specialty week. I was able to rotate through Peds Hematrology/Oncology (which I loved), Peds Orthopedic Surgery, Allergy/Immunology, and Peds Emergency Medicine (which I also loved). Overall, I enjoyed the week, but it was a little weird to start with specialities, as I had yet to actually examine a normal healthy child.

Week 2-4: Out-patient pediatrics. Starting this rotation, I thought the part that I would hate about pediatrics would be well-child visits. From my other colleagues, I have heard that the first few were fun, but they got old fast...well, i couldn't disagree more! I loved everything about out-patient pediatrics. I love that your day is split so that (roughly) half your patients are well-visit check ups and half are sick visits. I loved having a conversation with the parents and the children about what was happening in their lives. I loved how excited new parents were bringing their 4 day old child in to the doctor. I loved counseling parents and children about anticipatory guidance and health maintenance. At this point, I became pretty confident that pediatrics would be my chosen field, but I was not ready to commit until I had a little in patient exposure.

Week 5: Newborn Nursery. THE BEST WEEK OF MEDICAL SCHOOL! Seriously. How can anyone rotate through the newborn nursery and NOT want to do pediatrics? Your day is basically split into three. First, you go in, round on your babies - meaning, you go to the parent's room, ask them how the night was, look at some nursing notes to make sure there we no problems, and do newborn exams all morning. Have I convinced you that its awesome yet? No? Ok, let me keep going. The second part of the day is rushing over to L&D for any high risk deliveries. So, you get to still be involved with both vaginal and cesarian deliveries, but once the delivery occurs, you get handed the baby and provide whatever care the only-seconds-old infant needs. Its. so. fun. Have I convinced you yet? No? Ok how about this... the third part of the day is all procedural. Between Circumcisions and Frenulectomies, the number of mini-surgical procedures you do makes the day go by crazy fast. Finally, guess what happens when there is downtime? You go to the nursery, pick up a baby, sit in a rocking chair and cuddle/feed the babies. Yup, pretty awesome. It truly was the perfect combination of fun newborn exams, patient education (with family discharge planning), obstetrics exposure, and procedures. I LOVED IT ALL.

Week 6-8: In-patient pediatrics (1 week night, 2 weeks days).  I really really liked these weeks too! Pediatrics is a really awesome field because you do get to apply the medicine that you learn in the first two years of medical school. I felt like many times when I was on Surgery or OB/GYN, I ignored so much of what I learned in school, because they are surgical specialities and not "medicine" specialties. Even though Pediatrics is still a specialty, the parts of medicine that aren't focused on as much (copd, heart failure, cirrhosis) just happen to be the things in medicine that I don't particularly enjoy anyways. Further, the variety of the patients we saw was quite impressive. From the 6 weaker who was admitted for Failure to Thrive, to the 6 year old with Cardiofasciocutaneous Syndrome, to the 17 year old sickler, to the 4 year old with HSP, the variety of patients we worked with was enough to keep me intrigued and interested, while being able to avoid the adult diagnoses that I don't really care about. Also, although pediatrics is known to be a field with fewer procedures, there was still a good number of caths and LPs that would satisfy some desire in me for procedures, if i do end up choosing the hospital as my chosen area in pedatrics.

So, thats it folks! I am pretty dang excited to finally have a future! Although I have NO clue if i want to do general pediatrics or subspecialize or if i want to work in outpatient or inpatient, at least I know which field i am (hopefully) headed for residency! So, if all goes well, in 1 year, I will be Dr. Van Stavern, MD, Pediatric resident! Cross your fingers!

Pediatrics Research Day

Last Wednesday, my research group had the opportunity to do a poster presentation at the 13th annual Pediatrics Research Day at the Breslin Center in East Lansing, MI. It was a great day, filled with speakers from the NIH, Rainbow Babies Children's Hospital, the University of Iowa and Children's Hospital of Detroit. We had talks on Pediatric Academics in the 21st century, Cardioprotection mechanisms for pediatric cancer treatments, and genetic approaches to restoring CFTR function. We also had 6 wonderful oral presentations by Pediatric residents, an undergraduate researcher, and a veternarian. These oral presentations were fantastic; I especially was intrigued by one resident's work with Serotonin-knock out rats that involved surgical manipulation of the ileum to apply acetic acid and observe wound healing mechanisms with the serotonin knock out v. wild type rats - fascinating! Lastly, there were 62 posters presented at the conference. It was inspiring to be around so many people interested in Pediatrics and conducting new and exciting research to better the field. 

Our project was a collaboration of six students and our research mentor, Dr. Gold. The project is relatively new, as we have only been collecting data for about 8 weeks, but we thought it was still interesting and important enough to make a poster and get our data out there. It was great to talk about our research to attendings, residents and other students and getting feedback about how our next steps should fall with the project. Ultimately, we left with a good idea of where to go and finished the day feeling optimistic about our project's design and future. 

The last portion of the day was the closing remarks and awards ceremony. They would be giving out 1 award for the best oral presentation and five awards for the top poster presentations. They started with oral presentation, awarding the top prize to a deserving resident. Moving on to the posters, they began calling the top 5 names - First was a resident, Second was a a resident, Third was a resident, Fourth was a resident, Fifth....was us! Our group poster had won an award of distinction! It was such an honor, especially with our research having very preliminary data and especially because we were the only students that were recognized with this award. What a great day!

Pediatrics

This semester, our clinical skills class is centered around a set of different experiences with different age groups from a newborn exam to a elderly exam/nursing home visit. The first half of the semester is "pediatrics" focused. Last week, we conducted a newborn physical exam. This week, we have a "young child" experience. The week after that, we do an "adolescent experience." Coming into medical school, Pediatrics was at the top of my list of prospectives specialties. Knowing that most medical students switch what they want to do many times during the course of medical school, I was happy to keep my options open...but boy do I love pediatrics! Out of every lecture we have had during the course of school and every clinical experience we have had so far, I have enjoyed anything with pediatrics so much! I really will be surprised if I don't end up doing peds.

Last weeks newborn exam was my most favorite thing ever! As a group of 5 medical students, we went into the nursery at Sparrow Hospital. We started out with one of the neonatologists going over the different aspects of the newborn exam, then split up and conducted our own exams. I had such an amazing time! Its really exciting that we are actually having real clinical experiences now, interacting with real patients (non-simulated ones) and conducting exams that we will actually be using in our career. I love it. I love peds. I love this semester.