Pediatric Clinical Sites

This clinic provides adolescent care, which includes care of eating disorders, mental health concerns, and sexual health. Due to staffing, adolescent medicine M4 elective is currently on hold. Students have the opportunity to spend time in adolescent clinic during the pediatric clerkship general ambulatory week and during ambulatory pediatrics M4 elective.

Ambulatory Pediatrics +/- Bioethics fulfills the M4 ambulatory clerkship requirement. Typically 2 students are scheduled per block with spots being very competitive. Students spend most of the rotation at General Ambulatory Clinic. Students also spend a week at the St. Mary's well baby nursery and might have an opportunity to be scheduled at various specialty ambulatory clinics. During some blocks students have the option of spending two weeks at a community pediatric clinic, Mercy.

This clinic provides consultative health care to children with known or suspected allergic disorders and immunodeficiencies. Students will start as active observers with subsequent levels of patient responsibility as determined by supervising physicians in allergy clinic. Due to patient complexity, students are typically observers for patients with immunodeficiencies. Site is available as an M4 elective, clerkship mini-elective, and career exploration elective.

Inpatient endocrine and heme/onc services. Conference room rounds. Medical students have more limited expectations regarding assessment and plan formulation especially when it comes to primary problems. Excellent for self-motivated learners and those with interest in hematology/oncology and/or endocrinology. Opportunity to participate in consults and observe procedures (bone marrow biopsies, LPs) .

Knowledge about breastfeeding and lactation is a crucial part of caring for a newborn. The overall goal of this rotation is to help students develop the knowledge, skills and confidence to help breastfeeding infants and their mothers. This 2 week elective includes a pre and post-test, several reading assignments and both outpatient and inpatient clinical experiences. This elective would be ideal for those interested in pediatrics, family medicine or obstetrics/gynecology.

This clinic provides consultative ambulatory and hospital based health care to children (fetuses through young adults) with known or suspected cardiac problems. Students will start as active observers with subsequent levels of patient responsibility as determined by supervising physicians. While third year students spend most of their time in clinic, they also have opportunity to observe in other sites including cardiac cath lab, echo and MRI, and fetal heart institute. The site is available as an M4 elective, clerkship "mini-elective," and career exploration elective.

Students will work in foster care clinic and actively participate in the process of preparing child abuse and neglect legal cases: medical record reviews as well as interviews and physical examinations of suspected victims with ample supervision and teaching. The process of detecting and working up possible child abuse and neglect will be emphasized. If court schedules allow, students are also able to listen to experts testify. Students typically provide care alongside the attending. The site is available as a 2w M4 elective and a 1-2w clerkship "mini-elective" and a 1w CE elective/ Students might also spend time in foster care clinic during clerkship general ambulatory pediatrics week and ambulatory pediatrics elective. Since the site "caps" at 1 learner, it is only available to students during weeks residents are not scheduled.

Inpatient service in the pediatric intensive care unit providing care to the most critically ill pediatric patients. The site is available as an M4 acting internship, clerkship mini-elective, and career exploration elective. Given complexity of patients, M3s start as active observers with subsequent levels of patient responsibility (Eg. presentations on rounds, updating notes, etc) determined by the resident and team based on patient acuity/complexity and student’s experience/comfort level. Third years are only scheduled in the PICU after rotating on the general inpatient service and/or emergency medicine. Opportunity to participate in procedures.

This clinic provides general pediatric outpatient care in an ambulatory, community-based setting. Students will take on the role of primary physician for their assigned patients, and will be responsible for all parts of the clinic visit (with attending supervision). This experience is great for students interested in community medicine and those ready for more independence. Students have the opportunity to spend time on this site during ambulatory pediatrics or clerkship "mini-elective." Due to limited spots, the M4 elective is currently on hold

Pediatric dermatology service provides consultative health care to children with known or suspected dermatologic disorders. Students will start as active observers with subsequent levels of patient responsibility as determined by the fellow and attending. The site is available as an M4 elective, clerkship mini-elective, and a career exploration elective. Since the site "caps" at 1 learner, it is only available to students during weeks residents are not scheduled.

This clinic provides medical care for children with developmental disabilities, such as autism, developmental delay, genetic conditions, ADHD, and intellectual disability. Med students will participate in multidisciplinary, comprehensive assessments of children, will learn developmental testing tools, and will participate in medical follow-up visits. The site is available as an M4 elective, clerkship mini-elective, and a career exploration elective.

The focus of pediatric emergency medicine is care of children with acute illness or injury in the emergency room. Students will work with a variety of attendings and build skills in efficient assessments by giving presentations to attendings directly. Large variety of types of patient encounters and experiences, including opportunity to participate in procedures. Schedule tends to be skewed towards evenings/nights and weekends. M4 students on EM clerkship have the option of spending 2 or 4w on PEM at CG. The site is also available as a clerkship "mini-elective" and a career exploration elective.

Pediatric endocrinology service provides consultative health care to children with known or suspected endocrine disorders. Students will work in a variety of outpatient clinics, including general endocrine, diabetes, lipid management, and Prader Willi. Students will start as active observers with subsequent levels of patient responsibility as determined by the attending. The site is available as an M4 elective, clerkship mini-elective, and a career exploration elective.

Pediatric gastroenterology service provides consultative health care to infants, children, and adolescents with known or suspected GI, liver, and nutritional disorders. Students will start as active observers with subsequent levels of patient responsibility as determined by the supervising physicians. While third year students spend most of their time in clinic, they also have opportunity to observe endoscopies and participate in inpatient consults. The site is available as an M4 elective, clerkship mini-elective, and a career exploration elective.

General pediatric well and acute visits at Danis Pediatric Center, Midtown and/or Cardinal Glennon. Midtown is one of the core pediatric clerkship sites with 4-6 M3s scheduled each week. Fourth year students on ambulatory pediatrics spend most of the rotation at Danis. Thursday evening Danis CG is the site of the pediatric health resource center clinic staffed by pre-clerkship students supervised by general academic pediatrics attendings.

Caring for patients on general inpatient teams hospitalized due to acute problems and/or exacerbations of chronic conditions.

• Orange team: general pediatric and nephrology patients

• Purple team: general pediatric and GI patients

• Yellow team: general pediatric patients only

General inpatient pediatrics is one of the core pediatric clerkship sites with 3-4 M3 students scheduled on orange and purple team for 1-2w blocks. Orange and purple teams are also the sites for the general inpatient acting internship. Fourth year students additionally have the opportunity to experience general inpatient pediatrics during hospital pediatrics elective. Yellow team is the primary site. If a resident is scheduled on yellow team, fourth year elective student is placed on orange or purple team (unless an AI is already scheduled)

The Genetics service provides consultative health care to both children and adults. Patients are typically referred for evaluation of problems related to developmental delay, chromosomal abnormalities, known inherited syndromes, and dysmorphic features. Learners will continue to build knowledge regarding normal child development, as well as common and/or important disease processes and syndromes seen in children with genetic conditions through participation in genetic and metabolic clinics, multidisciplinary care clinics (Marfan and Neurofibromatosis), and inpatient consults. Skill building will focus on working with a genetic counselor to take a history with a special focus on birth history and family history/pedigree, as well as conducting thorough physical exam with focus on measurements of the body and categorizing dysmorphic characteristics. The elective is available to M4 students. Given the subspecialized nature of the experience, clerkship students are scheduled for this site only after discussing their interests with the site director. Per faculty request, this “mini elective” is available only as a 2w or 1.5w block.

Students will work in the Costas Center clinic, where Heme/Onc patients present for referrals, follow ups, medication administration, procedures, and labs prior to scheduled admissions. Medical students can expect to learn all aspects of outpatient management of hematologic diseases and cancer. Given the delicateness and complexity of patients in the clinic, this is primarily an observational experience for third year students, though medical students will be actively involved and may be able to participate directly in some aspects of care. The site is available as an M4 elective, clerkship "mini-elective," and career exploration elective.

The Pediatric Infectious Disease clinical service provides inpatient consultation for patients throughout the hospital as well as clinic follow up visits. The site is available as an M4 elective, clerkship "mini-elective," and career exploration elective.

Students will have the opportunity to rotate in the FACES clinic and participate in home visits. FACES is a comprehensive, culturally and linguistically sensitive clinic dedicated to addressing the physical, developmental, and emotional health care needs of new Americans including newly-arrived refugees, immigrants, international adoptees and their families. Given the delicateness of the clinic, students can expect to work alongside attendings at all times. The site is available as an M4 elective, clerkship "mini-elective," and career exploration elective.

Inpatient service providing care to critically ill infants with prematurity, acute illness, and/or congenital anomalies. Given complexity of patients, students start as active observers with subsequent levels of patient responsibility (Eg. presentations on rounds, updating notes, etc) determined by the team based on patient acuity/complexity and student’s experience/comfort level. Opportunity to participate in procedures. Acting internships are available to M4 students at CG NICU and at St. Mary's NICU. Fourth years also have the opportunity to experience one or both NICUs through the Exploring Neonatology elective. CG NICU is available to third year students as a clerkship mini-elective and a career exploration elective. Third years are scheduled in the NICU only after rotating in the well baby nursery.

Pediatric nephrology service provides consultative health care to children with known or suspected renal disorders. Students will work in a variety of clinics and may be able to participate in inpatient consults. Students will start as active observers with subsequent levels of patient responsibility as determined by the attending. The site is available as an M4 elective, clerkship "mini-elective," and career exploration elective.

Pediatric neuro-oncology service provides consultative health care to children with known or suspected CNS malignancies. The site is available as an M4 elective. Given the subspecialized nature of the experience, clerkshp students are scheduled for this site only after:

• They have already experienced general pediatric hematology-oncology through blue team and/or hematology-oncology clinic

• They briefly discuss their interest with Dr. Navelkele

Pediatric pulmonologists provide inpatient and ambulatory primary and consultative health care to children with known or suspected lung disorders. Students will work in a variety of clinics such as general pulmonology, asthma, cystic fibrosis, and sleep disorder. Students may be able to participate in inpatient consults. The site is available as an M4 elective, clerkship "mini-elective," and career exploration elective.Students will start as active observers with subsequent levels of patient responsibility as determined by the attending.

Inpatient cardiology and pulmonary medicine services. Typically table rounds. Cardiology patients include post-op cardiothoracic surgery patients as well as kids with heart disease admitted for acute illness. Pulmonary medicine patients include those hospitalized due to asthma, cystic fibrosis, or chronic ventilator use.

Pediatric rheumatology service provides consultative health care to children with known or suspected rheumatologic disorders. Students will work in a variety of clinics and may be able to participate in inpatient consults. Students will start as active observers with subsequent levels of patient responsibility as determined by the attending. The site is available as an M4 elective, clerkship "mini-elective," and career exploration elective.

The pediatric sedation service provides anxiolysis and if needed analgesia for radiology studies and procedures. Knowledge building will include levels of sedation and required monitoring, common sedative medications, their indications and their effects on the airway and respiratory drive. Skill building will focus on applying principles of airway anatomy and physiology to patient care through pre-sedation risk assessment, basic airway maneuvers, bag-mask ventilation, as well as recognizing and managing common sedation complications.

As no ferrous (iron) metals allowed in MRI, we ask those with internal metal devices (Eg. orthopedic screws) and/or any learners with questions about MRI safety, contact us to discuss site eligibility. The site is available as an M4 elective (pending), clerkship mini-elective, and a career exploration elective. Since the site "caps" at 1 learner, it is only available to students during weeks residents are not scheduled.

Pediatric sleep medicine physicians provide consultative care to children with known or suspected sleep disorders, such as sleep disordered breathing, insomnia, and sleep related movement disorders. Students will work primarily in clinics and will start as active observers with subsequent levels of patient responsibility as determined by the attending. The site is available as an M4 elective as well as a 2w clerkship mini-elective.

Caring for well newborns at St. Mary’s Hospital. Well baby nursery is one of the core pediatric clerkship sites with 4-6 M3 students scheduled each 1w block. Fourth year students have the opportunity to rotate at the WBN during newborn medicine elective (2-4w) and during one week of their ambulatory pediatrics rotation.