I spent my 5 weeks at Dr. Hurwitz’s pediatrics office. During these 5 weeks I was able to see many patients ranging from a few days old up until 28 years old. This patient population was different from my previous rotations, because often the source of information wasn’t the patient themselves, but rather a parent or caregiver. Due to the limited history often available, my differential for sick visits had to be larger for more broad complaints such as a fever. Another difficult aspect was completing a physical exam. It was often difficult to do because children often don’t sit still for exams and don’t always follow simple asks such as opening their mouth or standing still on the scale, so I had to develop techniques to combat these issues.

The importance of identifying critical cases/if the patient was well appearing was instilled upon me very early in the rotation. After presenting a case, Dr. Hurwitz would often ask me if I thought the patient was “going to make it,” indicating whether or not this is a more serious case. Another important aspect I learned about was growth and development. Since I had to plot the growth chart for every patient, I was often asked what percentile they were in, so I was able to learn how to interpret the growth curve. I was also exposed to vaccine schedules very often and I would check to see if the patient is UTD on vaccinations before presenting the case. Using paper charts took some time to get used to, however it was interesting to not have a computer system to rely on for many of these things such as vaccinations.

I especially enjoyed doing well visits. On teenage girls I was able to do the entire well visit myself and discuss any problems or concerns they had. I would then let Dr. Hurwitz know if I found anything or if anything concerned me. I enjoyed getting to know the patients and was often told that they enjoyed having a female to speak to in regard to their health. Another thing I enjoyed about this rotation was the weekly research assignments because I was able to familiarize with myself how to work up common complaints such as fever, diarrhea or abdominal pain in this age group. I was also given some topics that I had never heard of. I also enjoyed hearing about the unique cases in the office, such as seeing a young infant during a follow up for septic arthritis.

One thing that was lacking in this rotation was the availability of procedures. The main procedure offered, which was offered in only specific cases was the ability to perform rapid strep/throat cultures. Students never performed injections, however I had a lot of experience with injections from previous rotations so I think that made up for this. Due to being in a primary care setting, bloodwork was never performed, however I do have experience doing bloodwork on children as young as 4 years old from my family medicine rotation earlier this year. I would’ve enjoyed having more procedures to perform.

For my next rotation in internal medicine, I hope to learn more about the inpatient process, since most of my rotations thus far have been an outpatient setting. I also am looking forward to seeing a variety of different diagnoses and also to the week on the stroke team since I think neurology is a weakness of mine.