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 12^th floor every day!) 

A Note About the First Rotation and What is Pharmacy School Like?

Posted by Matthew Lewis at Friday, July 29, 2011

Since this is my first post, let me introduce myself. I'm Matt, I've lived in Michigan my whole life, and got my undergraduate degree here at U of M. Right now, I have a strong interest in infectious disease (ID) pharmacy, as well as transplant pharmacy (mostly because of the ID aspect). I am excited and more than a little nervous about starting my first rotation. I'll be in the pediatric (peds) critical care ward of Mott in the University of Michigan Health System. It's a world renowned system and has all sorts of awards and highest level trauma centers. Basically, if a kid is really sick, they are coming to Mott. Being part of this system and the U of M pharmacy program coupled with the complexity of these patients means I have to bring my A-game. Another part of the difficulty associated with peds is they are not adults. Okay, that is obvious, but practically all of my classwork, all the studies I've read, and all the patients I have seen so far have been adults. Drugs work differently in kids than adults, so I have to make sure I've got pediatric dosing and efficacy in mind when working here and not stuck in "adult mode". It's sort of like being a mechanic for cars, but then switching to planes; everything you learned on one does not just translate to the other. I'm sure you've seen posts from my P4 colleague Jenna, who's crazy for peds, so if you want to learn more about pediatric pharmacy right this instant, (and who doesn't?) go check out her posts.

On another topic, some people have asked me what pharmacy school is like. I think a good analogy, at least for the academic part, is trench warfare. There are periods of digging in, where you just have to keep your head down. You find a close buddy or two who always has your back. There are times where you hear the whistle to go "over the top" and charge for the next trench, which can be the next set of exams or the next year. Oh, and in times of calm we celebrate, lots of celebration. Of course nobody is shooting at us though, so that is a plus.

Outside of the classroom, pharmacy school is incredibly rich and rewarding, and sometimes as educational as our academic portion, since you have the opportunity to meet, shadow, and have personal relationships with some of the superstars of pharmacy. I am not kidding, some of our staff are known around the world, other staff members have created whole new ways to deliver medications in the body, and others still have written chapters for pharmacy textbooks used around America. You also have so many opportunities to get to know your classmates while helping out the community. We have several student organizations such as APhA-ASP, HSP, and the pharmacy fraternity PDC among many others where pharmacy students go out into the area for health fairs and presentations, as well as the occasional purely social get together like the PDC ski trip(members only) or the PharmBash Ball organized by APhA. However, whenever anybody interested in going to pharmacy school asks me, I always end with, "Pharmacy school is what you make of it.", and leading up to the P4 year, I think I've put a lot into this program and it has given me a lot, and will continue to do so this year and beyond.