Written by: Henry He c2023 McMaster Medical School, Hamilton Campus Where was your placement and what specialty was it in?
4-week clerkship core in Pediatrics at Southlake Regional Hospital in Newmarket How did you get to the core? My parents live about a 15-minute drive from Newmarket, so I stayed with them for the month and commuted by car (no MacCare). Parking is reasonable, about 60-80 dollars for a month depending on which lot you prefer. I parked in the visitor lot for the first day and the parking office gave me a ticket to get out when I purchased the parking pass. Describe a typical day at your core. The paediatric service in Newmarket is split between 3 paediatricians—the on-call paediatrician (sees patients in the urgent care clinic and neonates at risk for hyperbilirubinemia in the daytime, sees new consults from the emergency department, and attends deliveries), hospitalist paediatrician (responsible for the inpatients and newborns), and NICU paediatrician (responsible for the NICU). I alternated each week between working with the on-call paediatrician and hospitalist paediatrician. Each week, I would typically arrive around 8:00 am to meet my preceptor, who would receive handover from the paediatrician on call overnight. Working with on-call paediatrician: 8:00-8:30 am – handover 8:30-12:30 pm – see clinic patients (either in-person or over the phone) and neonates (always in person for clinical assessment and if treatment is required) 12:30-12:45 pm – lunch 12:45-5:00 pm – continue to see clinic patients, neonates, or see any consults in the ED Working with hospitalist paediatrician: 8:00-8:30 am – handover 8:30-9:00 am – review overnight labs and imaging 9:00-9:30 am – rounds with nursing and allied health 9:30 am-5 pm – see inpatients and newborns, with 15-30 minutes in between for lunch Depending on the on-call and hospitalist patient load, even if I was assigned to work with the on-call paediatrician for the week I could be asked to see hospitalist patients and vice-versa. What level of responsibility/exposure did you have as a medical student? I was given a lot of independence and was asked to see patients on my own, then present my findings and suggest a plan to my preceptor. My preceptor would then see the patient and I would complete the note. However, my preceptor could always be reached in-person or through text if I was concerned about the patient or had any questions. I was not required to attend deliveries or C-sections with the on-call paediatrician, although you are welcome to attend whenever you want to if that is something you are interested in! I was asked to complete four 24-hour call shifts. My call experience varied depending on the night and the number of consults we were asked to see in the ED. I was not called to many of the overnight deliveries as the call rooms are quite far from the birthing unit and they told me would be likely to miss most of the delivery even if I was called. What are some things to review about before this core? Pneumonia, bronchiolitis, asthma, neonatal jaundice, newborn exams, SSHADESS history, failure to thrive. What is your most memorable experience from this? My most memorable experience had to be completing my first newborn exam! The resident who I was working with had walked me through the exam and I was able to watch 1-2 exams before I completed one independently. It was a great experience being able to listen to questions and concerns from the parents, see the newborns, and provide reassurance! What was one thing you didn’t like? I completed this rotation during the COVID-19 pandemic, and so many of the urgent care clinic visits were temporarily shifted to phone call follow-ups if the paediatrician on-call felt that an in-person assessment was not necessary at the time. The history and management plan could get quite repetitive for many of the patients. It also reduced the number of patients I could see in person to practice my physical exam skills. However, I had the opportunity to complete plenty of comprehensive histories and physical exams when seeing consults or inpatients. Other than that, no complaints about the rotation! Do you have any recommendations for things to do/explore/eat in the local area? Fairy Lake is a 5-minute drive/20-minute walk from the hospital and is a beautiful outdoor space! Main Street and Upper Canada Mall are close by if you want to get some shopping done, and there are a lot of golf courses within driving distance if you are on the rotation during the summer months. What’s one piece of advice you have for students doing a placement here in the future? Get a call room early! The hospital only has 3 call rooms that are available to sign out, so they run out of call rooms very early in the morning! I suggest going before handover or at least before 10 am to ensure you get one. Would you recommend this core to current students? I would recommend this core to all students who want to gain exposure to common paediatric presentations. As I mentioned previously, I mainly worked with the on-call and hospitalist paediatrician, and there was a separate paediatrician managing the NICU. If you are looking for exposure to the NICU this may not be the paediatrics core for you, although I am sure they would be willing to give you more NICU experience if you asked! Anything else you would like to add about the experience? If you feel that you want to gain more exposure to something specific (e.g., newborn exams, ED consults, specific presentations), just ask! All the preceptors I worked with are very invested in your learning, happy to answer any questions you have about paediatrics, and will do their best to give you as many unique patient presentations to see as possible.
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Southlake Regional Hospital, background credit: yorkregion.com
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