Electives - Fairfax Program

ACE - A. I. in Inpatient Pediatrics - Fairfax
Elective Number: 3306 (away)
Rotation Supervisor: Dr. Meredith Carter
Designated Signer:
Evaluation should be given to: attending on service
Duration: 4 weeks
Available: all Rotations
This elective is not available
to visiting students through the University of Virginia
This is considered an away elective and
requires an Application
for Away Electives.
A pager is required and will be supplied by the department.
Report to: Paula Graham
Time to Report: 8:00 am
Place to Report: Dept. of Pediatrics
Typical day: 7:00 am - 4:30 pm
Attendance: A student may not take time off during
an ACE.
Attendance at elective activities is mandatory.
- Anyone who is ill or has a personal or family emergency must contact
Student Affairs and the Attending on Service.
- Students are allowed to take off up to 1 day per week to interview
between November 1 and February 1.
- Specific days missed must be approved by the Attending on Service.
Housing: Housing is not provided
Number of students per rotation: 2
Course Description: The Acting Intern functions as the hospitalized
child's primary care physician. He or she performs the initial comprehensive
history and physical and, with the supervision of the senior resident,
develops the differential diagnosis, determines what lab testing should
be ordered and sets forth a treatment plan. The AI interacts closely with
the patients and his or her family during the entire hospital stay and
sets up an appropriate follow-up upon discharge. The AI functions as the
patient's advocate and tends to the patient's emotional well being in
addition to whatever illness necessitated the hospitalization.
The AI's daily schedule includes Work Rounds with members of his or
her team, Intake Rounds in which the new admissions are presented to
the senior
attending staff, Attending Teaching Rounds, Radiology Rounds, Grand
Rounds and
problem conference. An evidence-based medicine conference is held one
day per month. There will be night call, weekend rounds and weekend call.
The
Inova
Fairfax
Hospital
functions both as a primary care facility and as a major tertiary care
center for Northern Virginia thus enabling the acting interns to take
care of patients with a wide variety of maladies.
Goals: The overall goal of this elective is to introduce fourth year
medical students to the medical care of hospitalized pediatric patients.
The student will work under the supervision of the inpatient attending
physicians.
Specific objectives include:
- To develop competence in patient assessment, analysis of laboratory
data and formulation of therapeutic plans.
- To develop skills necessary to obtain a thorough medical history and
to perform a comprehensive physical examination.
- To develop the ability to recognize disease processes involving all
systems including:
- General: failure to thrive, fever, developmental delay;
- Cardiovascular: rhythm disturbance, murmurs, shock, syncope, hypotension,
chest pain;
- Dermatologic: rashes, petechiae, purpura, urticaria;
- Endocrine: normal and abnormal signs of puberty, diabetes mellitus,
rickets, abnormalities of growth, thyroid disfunction;
- Gastroenterology: fluids and electrolytes, dehydration, abdominal
pain, abdominal masses, vomiting, diarrhea, jaundice, hematemesis,
rectal bleeding;
- GI: urinary tract infection, scrotal masses, dysuria;
- GYN: sexual assault, abnormal vaginal bleeding;
- Hematology/Oncology: hemoglobinaopathies, hepatomegaly, slenomegaly,
masses;
- Musculoskeletal: limp, arthritis, arthralgia;
- Neurologic: seizure, headache, lethargy, ataxia, head trauma,
vertigo, irritability;
- Psychiatric/Psychosocial: suicide attempt, depression, child abuse;
- Renal: oliguria, hematuria, edema;
- Respiratory: tachypnea, wheezing, stridor, hemoptysis, apnea,
respiratory failure dyspnea;
- Infectious Disease: sepsis, viral vs. bacterial infections, AIDS,
meningitis, pneumonia;
- Otolaryngology: otitis media, abnormal speech development;
- Ophthalmology: trauma, conjuctival injection acute visual changes;
- Surgery: pre and post operative care.
- To develop skills in using consultants, non-physician providers of
services, laboratory tests, and diagnostic procedures efficiently,
effectively,
and in the patient's best interest.
- To develop skills in interpretation of tests and imaging studies and
therapeutic options for correction of abnormalities:
- CBC, Platelets, differential, indices; Electrolytes, calcium,
magnesium, glucose;
- Hepatic function tests;
- Renal function tests;
- Drug levels;
- ESR;
- Coagulation studies;
- CSF analysis;
- Urinalysis;
- Gram stain;
- Arterial, capillary, and venous blood gases;
- Stool studies;
- Cultures for bacterial, fungal, viral, AFB cultures;
- Chest x-ray;
- Abdominal film;
- Lateral neck film
- To develop competence in procedural skills and interpretation of monitoring
such as but not limited to:
- arterial, capillary and venipuncture;
- bladder catherization;
- lumbar puncture;
- gastric intubation;
- injection/medication administration;
- respiratory tract medication (nebulizer);
- blood pressure measurement;
- pelvic exam;
- child development screening;
- transillumination of the scrotum;
- pulse oximetry;
- cardiorespiratory monitoring;
- temperature monitoring.
- To develop skills in maintaining accurate, timely and legally appropriate
medical records.
- To develop skills in discharge planning to include but not limited
to:
- appropriate follow-up;
- identifying community resources when appropriate;
- identifying home care needs.
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