Written by: Andrew Chen, McMaster Medical School c2023 Hamilton Campus 1. Where was it? What specialty was it in?
4-week core in pediatrics at Brantford General Hospital. 2. How did you get to the core? Did you get any funding from the school (MacCare etc?) I drove to Brantford General Hospital and it took about 30 minutes each way. You would need a car to get to this site. I am currently living in Dundas, Ontario. You can receiving funding for gas reimbursement or if you choose to live in Brantford. 3. Describe a typical day at your core. I try to arrive at 7:45am to get situated and read up on the current patients. The day starts with handover from the overnight pediatrician at 8:00am and usually takes about 10-15 minutes. Shortly after, we begin rounding on the inpatients which can include neonates requiring phototherapy, recovery from status asthmaticus, RSV bronchiolitis, etc. Then, NICU rounds start at 10:00am and goes until about ~10:30-11:00am. Brantford has a bilirubin clinic that runs from 10:30-12:00 where we follow up with neonates that are at risk of developing hyperbilirubinemia and its sequelae. We have a lunch break from 12:00-13:00. After lunch, there is an outpatient clinic on the pediatric wards where we will see patients for follow-up or consults from previous days until the end of the day. Patients in the outpatient clinic can include kids with gastroenteritis, bronchiolitis, new-onset rash, minimal change disease, fever of unknown cause, and more. The day typically ends around 4:30-5:00pm. 4. What level of responsibility/exposure did you have as a medical student? You have a lot of responsibilities as a medical student at Brantford. Often, you will take the lead for most of the day. We round on the inpatients and report back to the pediatrician and discuss any changes to the treatment plans. We will see patients in the bilirubin clinic and help make decisions on need for follow-up or treatment for hyperbilirubinemia. If you are on call, you will be asked to see consults in the ER whenever there is one; even if you are not on call, you may get asked to go see them. You also have the independence to see patients in the outpatient clinic. You will also get exposure to the NICU but usually the pediatric will do most of the work due to the "lingo" that is used in that setting. Throughout the day, if the pediatrician is called to attend a delivery, you will also be exposed to vaginal deliveries and C-sections. If you are on for evening shifts, you may be asked to see newborns (1 day old babies) and perform well-baby check prior to their discharge. Therefore, you get to see a huge range of pediatrics at Brantford General Hospital. 5. What is your most memorable experience? Providing a comprehensive management plan for parents and their kids. This is extremely rewarding! Parents are often very thankful if you demonstrate that you truly care for their children - printing out information sheets, listening attentively, and bringing forth their concerns to your attending physician. I was involved in the care of a 18 month old baby girl who presented with respiratory distress and was diagnosed with status asthmaticus after a prompt workout. I helped provide acute care and upon recovery, I provided a long-term pharmacological management and education for preventing further asthma exacerbations. Seeing how thankful the parents were for the care we provided and the stress/anxiety that we helped to relieve was very memorable. 6. What was one thing you didn’t like? There hasn't been anything that I didn't "like". If you complete this rotation during the winter season, you will see a lot of bronchiolitis (RSV, etc.) Especially because I was there during the resurgence of COVID as well, I saw lots of kids with fever as the chief complaint. In these cases, treatment is often supportive (ensure good hydration and oxygenation) and may be less "exciting" than other diseases. 7. Has this experience influenced your career decisions? If so, how? It has strengthened my decision to pursue a surgical specialty that can work with a pediatric population. 8. Do you have any recommendations for things to do/explore/eat in the local area? Food recommendations: Hudson Public, Robbie's Pizza, CT Shawarma, Sociable. Not sure about places to explore in the local area! 9. What’s one thing you wish you knew before doing this core? Read up on common presenting illnesses: bronchiolitis, hyperbilirubinemia (neonatal jaundice), neonatal abstinence syndrome, asthma, constipation, management of neonatal hypoglycemia, allergic reactions (anaphylaxis), etc. CPS guidelines has all the pertinent information you will need! 10. Would you recommend this to current students? Yes! This was an incredible experience. 11. Anything else you would like to add about the experience? All the pediatricians I have worked with at Brantford are super friendly and eager to teach. There will be learning opportunities with every patient you see.
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