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Aug 07

Day in the Life: Outpatient Pediatrics

Happy Monday, and welcome to Medical Mondays! Ready to hear about my first rotation as a senior resident/second-year family medicine resident?! Well, even if you’re not, it’s happening, so here we go (hello, outpatient pediatrics!)!

I should preface that I always feel a tad soul-less whenever I’m on pediatrics/obstetrics rotations. If ever there was a rotation where I had to “fake it til I make it,” it’d definitely be OB, but inpatient pediatrics definitely gave it a run for its money.

The thought that run through my head most often?

I am so, so glad I don’t have kids.

Day in the Life: Outpatient Pediatrics

Day in the Life: Outpatient Pediatrics

My outpatient pediatrics rotation was located at a Federally Qualified Health Center down the street from my office, and since I generally walk everywhere I can, this was no different! I would usually be scheduled at my own office in the mornings and here in the afternoons, although it did flip every now and then.

7:40am-1pm

I’d see my own patients during this chunk o’ time! We’ve shuffled our desks around and I share mine with one of the interns now. I’ve stocked my shelf with snacks so our after-hours note-writing parties (I make them sound so fun–they’re really not) are more bearable.

On Wednesday and Friday mornings, the schedule changes a bit in the sense that I have my usual morning report (lectures) at the Medical Education Building before going to the office to see patients.

As I mentioned before in the last coffee date, we’ve had our patient load increased in order to get us closer to “real world” status of seeing 10-15(?) patients in a half-day session. I’m strongly hoping that I end up in a practice somewhere where I get to spend a little more time with my patients, but we shall see. ;_;

Day in the Life: Outpatient Pediatrics

Cases have been ranging everywhere from pap smears to pre-participation sports physicals to chronic nausea (1.5 years o_o) to hospital follow-ups. And also insomnia. For two weeks straight, I had patients coming in for insomnia requesting medications that were inappropriate/ineffective for them, both of which resulted in me having to call my preceptor into the room.

The first one threatened to assault my preceptor and my nurse, then tried to get my preceptor to leave so he could talk to me alone…and the second one broke down into hysterical tears and I ended up in the room for another hour trying to explain our reasoning/console her. Ah, life!

1pm-5pm

I’d usually try to start walking at 12:55pm but would get stopped up by something/someone every now and then. I made it there on time most days though, and my rotation supervisor + other attendings were very understanding.

Like Family Medicine, Pediatrics is another rotation where people honestly should be pretty darn nice (after all, you’re dealing with a whole ton of kids!), so it was a pleasant work environment–everyone was super friendly, receptive to questions, and would show me great resources that helped me when I saw kids at my office too.

tylenoldosing

I’d usually work with 1-2 attendings and see half or a little over half their patients, although partway through my month-long rotation, I started feeling somewhat tired (and not gonna lie, also slightly miffed). I thought it was somewhat unfair that I’d be seeing 7/12 patients in one session while the other resident and student split the remaining 5, but I chalked it up to getting more exposure/experience and also slowed down a bit so it got more manageable.

The cases I came across in peds included the following:

  • Newborn visit
  • Weight checks
  • 1 month, 2 month, 4 month, 6 month, 9 month, 12 month, 15 month, 18 month, 24 month, 3yo-17yo well child checks
  • Follow-ups on obesity, hospitalizations, UTIs, etc.
  • Birth control counseling
  • Contact dermatitis, viral rashes, scabies, bug bites
  • Unwillingness to toilet train, picky eating, and other behavioral problems

Twas interesting, to say the least, but also rather draining. Over half our patients were Spanish-speaking only, and I unfortunately barely speak any (I cannot hold even the most basic of conversations). Thankfully, we had community interpreters and phone interpretation services, but those visits still took a lot longer. Given my experience as an interpreter in the past, it’s still a little weird to be on the other side of it now, but I try to keep in mind the things that I felt would’ve been helpful when I was an interpreter!


  • Do you remember going to your pediatrician when you were little? 
  • Check out previous Day in the Life’s!

Permanent link to this article: http://www.fairyburger.com/day-in-the-life-outpatient-pediatrics/

18 comments

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  1. A.K.

    Ah, dealing with the highly unpredictable, often inconsistent behaviour of kids and teens :p Highlights from my childhood include but are not limited to getting tons of shots, something about choking on a turkey bone during early infancy, being labelled ADHD, breaking a leg and certain other bits. Got to love the transition period from studying to real world application of knowledge. I am starting to read the body language of certain residents with ease, some show classic textbook traits associated with frontal lobe dementia or deterioration while others have very obvious post stroke movement impairments.

    Yeah, still adjusting despite a supervisor’s minor screw up which could’ve resulted in my own hospitalization due to blindly ignoring the quarantine warning posted on some resident’s door. I caught their error(despite being dehydrated) but didn’t enter their room yet got some flack from another staff member who started riding me a lil bit recently. My brain is still learning the way around (having short as well as long term care wings look identical doesn’t help xD)So glad there are no kids or romantic partner in the equation at this point as such would complicate life even further

    My tip for you Farrah is this: Some children are often much more impressionable and hence easier to reach if one knows how.

    1. Farrah

      haha, I remember getting shots as a kid! I think I was very easily placated with lollipops, so my pediatrician didn’t have too much trouble with me.

      I’m glad that worked out okay! The hospital I’m at is kinda like a maze too, so I still get a little lost every now and then, especially when there’s been a recent Code Red (fire) and all the doors are closed. (Everything looks so different…)

      I’d definitely agree with that tip! It was a struggle for me during my peds rotations when I was a medical student though (or really, even now)–there’s only so much you can do if their caregivers aren’t willing to (a) admit there is a problem and/or (b) help their children take the steps necessary to fix the problem.
      Farrah recently posted…11 Things You Didn’t KnowMy Profile

  2. Linda

    Wow!

    1. Farrah

      <3!

  3. Linda @ The Fitty

    Hey Farrah, will you be answering some of the questions I tagged you in? 🙂
    Linda @ The Fitty recently posted…Oh, Taylor the Latte Boy… + 99 Other ThingsMy Profile

    1. Farrah

      Hey! I’m on night service right now and have been super swamped with work + studying. It’ll be in tomorrow’s post!
      Farrah recently posted…Day in the Life: Outpatient PediatricsMy Profile

  4. Mary

    Wow, you are a senior resident!!! Now that’s exciting. I’m so glad I don’t have kids also, but I know they will be coming soon. Happy you are stocking up on snacks, sometimes your schedule sounds so crazy there isn’t any time for you to eat. OMG, these insomnia patients are a handful. How scary.

    1. Farrah

      haha, it feels so weird! 😛

      I’ve definitely been keeping my pockets filled with snacks! There’s a liiiiittle more time to eat these days! 😛
      Farrah recently posted…Day in the Life: Outpatient PediatricsMy Profile

  5. Jennifer @ Fit Nana

    Unwillingness to toilet train?! Well, I guess if you’re a frazzled parent….. lol Although, I did have to take my daughter in once because a neighborhood boy picked a thai chili pepper off a neighbor’s plant and gave it a taste and then spit it out REALLY FAST right into my daughter’s face. Yeah, pepper juice + eyeball = not a happy 6 year old. :/ Also, she REFUSED to let me flush it so off to the ER we went. Good times. haha! And that’s just crazy about those insomnia patients! I don’t even know if I could handle that – insomnia OR the patients!

    1. Farrah

      hahaha, yeah. He just wasn’t into it, but hopefully he’ll change his mind soon!?

      Ahh! Your poor daughter! I hope she’s okay now–that definitely does not sound like a pleasant time!

      Yeah, neither of those were all that fun to deal with! x_x

  6. ShootingStarsMag

    Oh gosh, I think working with kids would be rough – even for some of the more “normal” issues like check ups! I love kids, don’t get me wrong, but I don’t think I’d want to be their doctor!

    That’s crazy about the two people with insomnia. I’m sorry to hear you had to deal with all of that!
    ShootingStarsMag recently posted…Making It by Christine D’AboMy Profile

    1. Farrah

      haha, I just like the well-behaved ones. 😛

      It wasn’t fun–I felt bad for my attending for having to deal with that! x_x
      Farrah recently posted…Day in the Life: Outpatient PediatricsMy Profile

  7. Hannah

    I can understand peds not being your favorite – I remember myself being a nightmare patient because I hated going to/was terrified of the pediatrician. Ironically, I went to my pediatrician once when I was 20 (because I waaay procrastinated getting vaccines for going overseas and he was the only one who could see me in time…) and he is probably the least terrifying Dr. you could imagine. Super soft spoken and barely taller than me. Little kid me was a bit dramatic!
    Hannah recently posted…In which nothing happens: week in reviewMy Profile

    1. Farrah

      hahaha, I feel ya! Most pediatricians are really awesome, but I don’t think I’d have it in me to actually be one. That’s why I like family med! I still get to see em’, but they don’t make up the entirety of my patient population! 😛

      I was easily bribed with food as a child so when I saw my brother getting a lollipop for getting his vaccines, I rolled up my sleeves for one too, haha.
      Farrah recently posted…Day in the Life: Outpatient PediatricsMy Profile

  8. Kristy from Southern In Law

    I can only imagine how tiring this rotation would be! I don’t remember ever seeing a pediatrician as a kid – but I know I did see one quite often from birth until I was 3 because of my Erb’s palsy/shoulder dysplasia and all the surgeries and therapies that came with it!
    Kristy from Southern In Law recently posted…Why It’s Okay to NOT Love How You LookMy Profile

    1. Farrah

      Oh man, I can only imagine! I had to go see mine a lot in my pre-teen/teenage state because they thought I had a clotting disorder of some kind, but as far as I know, nothing ever came of it! (I wish they’d bothered to tell me what was going on. >_> )
      Farrah recently posted…Day in the Life: Outpatient PediatricsMy Profile

  9. Tamara

    So interesting to read, Farrah! I applaud your energy and abilities, and I think the reason you get to see more patients than the other residents is that you’re capable of it, and that’s a good thing, makes you a desirable candidate to hire!

    Oh, and you need to spice up your after-hours note-writing parties so they deserve the name “party”. If I lived closer I’d try and make a medical cake for your and your doctor buddies, check them out: https://au.pinterest.com/explore/medical-cake/?lp=true

    1. Farrah

      Aww, thanks so much, Tamara! And who knows, haha. At least I learned a lot from the rotation! 😀

      That would be so awesome! Those cakes are so pretty! <3 I love how creative people have gotten with cakes!
      Farrah recently posted…Truffle Pesto Poached Egg ToastMy Profile

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