Wednesday, October 9, 2013

Pediatric General Medicine: A Whole New World

Posted by Silu at Wednesday, October 09, 2013

Hi everyone. Rotation 4 has ended and so has 50% of P4 year. Siri tells me there are 199 days from today until graduation! Ah!

For this rotation, I was at UMHS Mott Children’s Hospital for pediatric general medicine. This is considered the “Inpatient A – Generalist” rotation that all UM students have to complete at a UM hospital, having the choice of either adult (University Hospital) or peds (Mott Hospital). I had no prior interest in pediatrics, and, up until a few weeks before the rotation started, I had no intention to choose peds. After some consideration, I changed my mind for the following reasons: 1) several of my rotations were adult internal medicine/general medicine-related, and I wanted to add some variety 2) quite a few residencies programs I looked at had mandatory pediatric rotations, 3) this was my last chance to learn about a special population of patients as a student!

The Mott General Medicine rotation has three main components: 1) rounding with a pediatric general medical team, 2) monitoring total parental nutrition (TPN), and 3) medication reconciliation. A typical day began between 7 and 7:30am, when I would arrive before rounds to work up my patients. This was followed by rounds (usually 1.5-2 hours) and TPN monitoring. In the afternoon, we often had topic discussions with the preceptor or would meet with the other Mott pharmacists and P4 students for presentations and discussions. In between, we would follow up with tasks and questions from rounds and complete med recs for newly admitted patients.

In the beginning, I felt like I entered another world. I Googled and Up-to-Dated every other disease state and wrote down everything I didn’t have time to look up to research later…which was always more than I expected. In the end, I enjoyed this rotation much more than I thought and learned a great deal, not only in terms of therapeutic knowledge, but also of unique challenges in pediatrics for which pharmacists can intervene. For example, since most young children cannot swallow pills, their medications must be in liquid form. It is up to the pharmacist to ensure the patient is able to obtain the liquid medication after discharge by confirming its commercial availability or notifying the team if certain medications need to be specially compounded.

Overall, I enjoyed this rotation for the continuity of seeing patients day-to-day, being a valued part of an interdisciplinary team and the challenge of using creativity and critical thinking to resolve special issues related to pediatrics. The hardest part of the rotation was balancing a full patient load with several other responsibilities, but it was a good learning experience in time management and productivity. In the end, I am glad I chose to experience pediatric pharmacy and feel more confident in working with kids. I’d recommend choosing Mott for the generalist rotation to anyone who is remotely thinking about it…you won’t regret it!  (Bonus? Beautiful view of Ann Arbor from the 12th floor every day!) 

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