Written by: Keerthana Pasumarthi McMaster Medical School c2023, Hamilton Campus Where was your placement and what specialty was it in?
Oakville-Trafalgar Memorial Hospital (OTMH) - Pediatrics Core [as a cc2] How did you get there? My family lived in Oakville, about a 5-10 minute drive from the hospital so I stayed with them for the month. However, the commute to Oakville from Hamilton isn't too bad, especially if you get a 407 pass. The buses around the hospital in Oakville are quite infrequent as it's a newer area so it can take a while to wait for the bus. Totally doable if you plan out your schedule accordingly though. I didn't get any MacCare funding Describe a typical day at your core. At Oakville-Trafalgar, you are with a brand new preceptor every week so your day-to-day varies depending on who is on service for that week. As well, there is only one pediatrician on call everyday at this hospital, so you are pretty much seeing everything from in-patients to clinic visits to deliveries and ER consults. Generally, my days usually started at 7 AM with rounding on all the in-patients and writing notes. After seeing all my assigned patients, I would review with my staff and we would aim to finish rounding by around 9 AM. After this, on most days I went with my staff to the Special Care Nursery (NICU) to round on the newborns. Bilirubin Clinic opens at 9 AM and you may receive consults from this clinic in the morning, mostly following up on babies with jaundice and new mothers. I usually got around 15-20 minutes of lunch, followed by Post-Emergency Pediatric Clinic from 12 PM - 4 PM with follow-ups of kids presenting to the Emergency Department. My day usually ended at around 4-5:30 PM depending on how much work I had to catch up on at the end of the day. We also received consults from the Emerg and other services in the hospital throughout the entire day in addition to the tasks I've mentioned above. Pediatrics at this hospital is also consulted for any deliveries that may require special neonatal care or admission to the NICU so you are present for these as well. Depending on how many consults and deliveries there are, your days can be very different. What level of responsibility/exposure did you have as a medical student? The amount of responsibility and exposure I had varied week to week as some staff let me have more freedom and independence. Generally, I was able to round by myself on the in-patient admits, do any Emerg consults that came up, and do clinic visits as well. I was also able to round in the NICU a few days and do lots of newborn exams! Some weeks (depending on the preceptor), I ended up not being able to see as many patients alone as I would have liked. It can be a really busy service as there is only one pediatrician on call for the entire hospital and it's quicker for the staff to see patients sometimes than letting you see first and then reviewing. There is no call on this rotation at Oakville but it is still an incredibly busy service regardless (as not much happens overnight). What are some things to review about before this core? And do you have any resource suggestions? Having an approach or structure to Pediatric consults is very important. The Green Book (found on Medportal) was very helpful for this to ensure you don't miss anything. Consults in Pediatrics can be different than adult medicine as there are specific questions that can be important to ask. Also review SSHADESS history! In terms of common conditions, I was able to see a lot of bread and butter cases. Since I did this core in January, there was so much RSV and Covid (though this might vary depending on what season you are doing your core in.) You also see plenty of constipation, neonatal jaundice, asthma, prematurity, failure to thrive, seizures, eating disorders. There is a good variety of cases you see. What is your most memorable experience from this core? The hospital is absolutely beautiful - it is the most beautiful hospital I've ever seen or worked in. Apart from that, I think my most memorable experience was definitely being able to connect with the kids and make them feel more safe in a scary environment like the hospital. As the age and development age of patients you see is so wide, one technique you try to bond with a 5-year old probably won't work with a 17-year old. It was very rewarding to be able to soothe a crying newborn baby and then immediately afterwards, try to relate to a teenager over high school life. What was one thing you didn’t like? As there is only one pediatrician on call at this hospital during the day, it can get quite busy. If you are a new clerk starting off with a Pediatric rotation at this hospital, it may be very daunting to juggle the rounding, all the clinics, and consults. It is just you and the pediatrician for the most part (since there is no residents or other learners), so it's quite difficult to ask anyone for help. MacDOTS are very difficult to complete at this location because of the sheer volume of patients there is to see. Staff may also not be familiar with the expected level of a clerk since they may not be used to seeing medical students. As well, some of the staff like teaching and others don't. There may be some weeks where you are simply designated to writing notes and discharge summaries, depending on the attending. OTMH also uses a brand new EMR (Meditech Expanse) which can be annoying to use sometimes. What’s one thing you wish you knew before starting this placement? Community Pediatrics at Oakville can be very challenging if it is your first clerkship core. It can also be hard to get to know staff as there is a new doctor on service every week and the days are so busy you don't get to talk with them too much. This can be a great rotation to get exposure to bread and butter Pediatric cases but because you are the only learner (with staff who may not enjoy teaching and who are not familiar with the level of a clerk) and there is so much to do in a day, this rotation can be incredibly difficult. Would you recommend this core to current students? Yes! This can be a great rotation if you are interested in Pediatrics as you get a lot of exposure to a wide variety of presentations. As it is a community hospital, it was also very nice to see kids who are relatively healthy and have a good prognosis. The nurses and allied health at this hospital are all very sweet, welcoming, and supportive! If you are looking for a letter from this core to apply to Pediatrics however, it may be difficult to get to know the staff very well due to the fast-paced environment and high volume of patients to see. Do you have any recommendations for things to do/explore/eat in the local area? The neighbourhood around the hospital is quite new so there isn't too much to explore closer to the hospital, in my opinion. The lakeshore and downtown Oakville can be quite nice to visit during the spring and summer times - they are very picturesque! Anything else you would like to add about the experience? It's very difficult to get lost at this hospital since it's so big and all the hallways look the same. Make sure you pay attention to which way you are going during orientation! Also make friends with all the nurses - they are lovely and will help you so much.
0 Comments
|
Oakville-Trafalgar Memorial Hospital Lobby, image credit: parkin.ca
|