Undergraduate Medical Education

Pediatrics Clerkship at Boston Children’s Hospital

As part of the core clerkship year, the Pediatrics Clerkship at Boston Children’s is intended to give Harvard Medical Students a broad introduction to pediatric medicine, to develop comfort with interacting with pediatric patients and their families, and to build skills in the examination of pediatric patients.

The six-week long clerkship will provide experiences in the outpatient primary care clinic seeing both well children and those presenting for evaluation of an urgent complaint; in the newborn nursery; and on the inpatient wards.

Goals, Objectives and Competencies

Goals:

  1. To use pediatrics as a model to teach the core skills of clinical medicine
  2. To understand the importance of development (e.g. physiologic, psychosocial) as a concept within pediatrics
  3. To develop familiarity with commonly encountered acute and chronic pediatric conditions
  4. To communicate effectively with patients, their families and members of the healthcare team
  5. To understand the importance of providing family-centered care
  6. To foster professional relationships among a healthcare team

Objectives:

PATIENT CARE:

  1. To be able to perform an age-appropriate, focused history and physical exam tailored to the patient.
    1. EPAs 1a, 1b
  2. To be able to articulate a management plan based upon the patient’s presentation, being mindful of chronic conditions and the larger care team.
    1. EPAs 2, 3, 7, 9

CRITICAL THINKING AND INQUIRY:

  1. To be able to formulate differential diagnoses and management plans; this process will include critical evaluation of the primary and secondary literature.
    1. EPAs 1a, 1b, 2, 3, 7

INTERPERSONAL COMMUNICATION:

  1. To be able to effectively and professionally communicate information about the patient, history and physical, diagnosis, and treatment plan to other members of the clinical care team and to the patient/family.
    1. EPAs 5, 6, 9

MEDICAL KNOWLEDGE:

  1. To be able to recognize common pediatric conditions.  Refer to requirements log for additional details.
    1. EPAs 1a, 1b, 2, 3

PROFESSIONALISM:

  1. To demonstrate intellectual curiosity, initiative, responsibility, reliability, and ethical behavior in patient care and self-directed learning.
    1. EPAs 7, 9

ORGANIZATIONAL/SOCIAL DETERMINANTS OF CARE:

  1. To be able to use an understanding of cultural, socioeconomic, gender, age and developmental related issues in patient and family interactions and clinical decision making.
    1. EPAs 1a, 1b, 2, 6
  2. To understand different models of delivering health care in a variety of settings, including the importance of the pediatric medical home.
    1. EPA 9

Competencies:

Competency 1: History taking and physical examination skills (Data gathering)

The student will be able to obtain a complete history and perform a complete physical examination on all patients across all pediatric age groups including newborns, infants, toddlers, children, and adolescents.

Competency 2: Data presentation skills

The student will effectively and professionally communicate information about the patient, history and physical, diagnosis and treatment plan to other caregivers and to the patient/family.

Competency 3: Core knowledge and clinical thought process

The student will be able to recognize common pediatric conditions and formulate differential diagnoses and management plans. When a particular diagnosis is not seen via clinical encounters, additional reading materials including CLIPP cases may be used to augment learning.

Competency 4: Professionalism and interpersonal skills

The student will demonstrate intellectual curiosity, initiative, responsibility, and reliability in patient care and self-directed learning.

Typical Schedule

The HMS core clerkship is 6-week rotation. Though individual schedules vary, the clerkship includes the following elements:

  • two daytime weeks caring for inpatient general pediatric patients
  • one week of admit/evening shifts with the pediatric hospital medicine teams
  • one week of a “selective” either on a sub-specialty inpatient rotation, in the ED, or on a specialty consult service
  • two weeks with a mix of ambulatory pediatrics and newborn medicine

On the Inpatient services (both general pediatric and sub-specialty), hours are typically 6:20am-5:00pm. Admit/night shifts are typically from 3 or 4:45pm until ~11pm. While weekend and holiday responsibilities will be rare, there will be some weekend nights and ED shifts.

The nursery and outpatient weeks are call-free without weekend responsibilities. Clinic sessions may be in the morning, afternoon, or evening. 

The NBME shelf exam is given on the last Friday of the rotation and the weekend after the shelf is off for all students.