If you’re in your third year of medical school, or about to be, you may be wondering about rotations, and I want to share with you how to make a good rating in your pediatric clerkship. Our school does things differently because we only have four weeks for each rotation. That’s a short amount of time to learn everything you need to learn, and get a good rating.
If you’re unfamiliar with how medical school works, in your third year of medical school, you begin rotations. This is where you are shadowing doctors, seeing patients, and learning more about each specialty. It’s a pretty fun time (for me) and it really makes you feel like a real doctor.
At the end of each rotation, you take a shelf (MD) or COMAT (DO), exam. The COMAT ranges from 70-130 with a mean score of 100. My school sets a failing grade of 90 and an honors grade of 110, both of which are one standard deviation below and above the average, respectively.
In addition to this score, you also get a score from your preceptor or attending. This reflects how they felt you were as a learner, healthcare team member, etc.
My first rotation was pediatrics, and I scored a 113 on my exam and received a 5 rating. It was a tough four weeks, and the learning curve is steep. But, there are a few things you can do to make a good grade and rating. This post will only be about how to make a rating in your pediatric clerkship and I will write another one about how to get a good grade!
1. General Advice
There are certain things that you need to do in every clerkship to make a good rating. These are the general rules that you should follow across all the rotations.
Be on time
The doctor is always late. And you need to always be there before them, unless they tell you otherwise. It’s a bad look to arrive after the physician, especially when there are patients waiting. You NEVER want to be the one that everyone is waiting on. As a medical student, you are at the bottom of the totem pole, and therefore should never be a problem.
Know things relevant to your clerkship
You are going field many questions that seemingly come out of nowhere. You will genuinely impress your attending if you are able to answer a majority of the questions. Sometimes they like to play the game “Guess what I’m thinking” and the answer isn’t necessarily clear. But overall, if you have a general idea of what is going on, you will demonstrate that you are actively learning the material, which is the goal in these clerkships.
Also, knowing things outside of your clerkship requirements may also come in handy. I freelance for a sleep blog, and shared this information with my preceptor. After demonstrating my knowledge of sleep practices and sleep health, and then he allowed me to speak with all patients who were having sleep difficulties. This was a small responsibility that I got to take on because I demonstrated that I knew what I was talking about so he could trust me to share that information with patients.
Take advantage of opportunities when they present themselves
It’s easy to sit in the background and want to do nothing, especially when it’s not a rotation you enjoy. However, by stepping up when they present you with an opportunity, you show that you are interested in learning, and can be trusted with more responsibilities.
Be a team player
The last thing is to be nice and a team player. Just because you are the medical student, that doesn’t mean that you get to pull the “That is not in my job description card.”
I mean you could, but it won’t get you a good rating. And it won’t make the team like you as much, which is very important. When the medical assistants, nurses, PAs, and other office staff like you, they will help you be successful.
And how do you get them to like you? Help them out with tasks like cleaning up after patients, preparing forms or procedure materials, and any other duties that make their lives easier, and are within the scope of your abilities. However, also keep in mind that sometimes they like things done a certain way, and you don’t want to be in the way trying to be over helpful.
2. Know Growth and Developmental Milestones
The next way to make a good rating in your pediatric clerkship is to know developmental milestones. This is especially important in pediatrics because kids do so much growing and developing. Growth and development are the two most important health indicators in the pediatric population. If at any point, either growth or development is not being met, that could indicate a serious problem. Early detection is vital, as early intervention could prevent progression of the delay, or even put children back on the normal curve.
It may seem impossible to learn all the points of growth and development. But the more children you see, the easier it will be to commit them to memory. The important thing to keep in mind when studying growth and development, is to cluster normal behaviors and skills. There are five major domains in which growth and development are measured:
- Language
- Cognitive
- Social-Emotional
- Gross motor
- Fine motor
Here is a little cheat cheat that you can save to your phone when you begin your pediatric clerkship.
The best part about pediatrics, is that you probably know a kid. Therefore, you can connect the kid you know with the things you’re learning as an easy way to memorize what you’re studying.
3. Know Vaccines, Common Conditions, and Age-Appropriate Anticipatory Guidance
In addition to knowing the developmental milestones, it’s important to know vaccines and age-appropriate anticipatory guidance, in order to make a good rating in your pediatric clerkship.
Vaccines are an integral part of working in pediatrics. They will consume most well-child visits, therefore it’s a must to know when it’s time for which vaccines. Your preceptor will definitely ask you, and it will absolutely be on your exam. Here is a visual aid to help you learn when certain vaccines are due:
Common childhood conditions
In addition to vaccine schedules, you also need to know common childhood conditions. You will see them over and over again, both in real life, and on exams. Children are different from adults, and they are more susceptible to some infections, over others. If you want to get a good rating, be prepared to answer questions about some common infections, and their etiologies. The most salient ones include:
- Ear infections – Responsible microbiology and treatment
- Sore throat – Diagnosis, microbiology, and treatment
- Rash – Diagnosis, microbiology, and treatment
- Fever – Severity, etiology, and treatment or management
- Runny nose and cough – Viral or bacterial etiology, and subsequent management
- Injuries – Accidental or nonaccidental, and proper aftercare
- Learning disabilities or developmental delays – Identification and proper social services
This list is in no way exhaustive, but these were the most common conditions for which parents brought in their children, and also were prominent on the exam. In-office management may be different than what’s on the exam, so be sure to separate the two so as to not confuse yourself.
Anticipatory Guidance
Understanding anticipatory guidance is another sure fire way to make a good rating in your pediatric clerkship. Anticipatory guidance are age-related risks of which parents and kids should be aware. They change with each age group, and it’s important to talk about them with parents and children at well-child visits. Education is key in primary care settings, and believe it or not, most parents may not be aware of some of the information that you will share with them.
The most common topics covered across all age groups are sleep, food and safety. What you discuss within each of those topics varies depending on the age of the child. So, do your research on what the best guidance is for each age group so you can hopefully be given the responsibility of taking over that part of the visit. Below is another aid that you can save to your phone in case you need a quick review!
4. Be Relatable to Kids and Parents
Not everyone is a kid person, and that is totally understandable. However, in order to make a good rating in your pediatric clerkship, you are going to have to become relatable to both kids and parents. This is harder for some than others, but it’s what really sets great student doctors apart from average student doctors. You can have the knowledge in your head all day long, but if you can’t practice medicine, then you won’t be a very effective clinician.
Working in pediatrics is very different from adult medicine, because kids often don’t want to be there, aren’t feeling their best, and are probably anticipating some type of pain. Therefore, you have to make it as fun as possible. Yes, this does mean talking like a kindergarten teacher all day long, and familiarity with cartoon characters doesn’t hurt either. But, if you have little tricks in your bag, then it makes your day easier.
For example, I had a pen light. It was the most simple tool, not even intended for kids. But it kept their attention long enough to get a heart and lung exam done. Kids also hate getting their ears looked into, so use the parents to hold the kids against them so you can get a good look. You have to be pretty creative in how you perform your exams, so just anticipate that it’s not going to be as straightforward as an adult exam to avoid even more frustration.
5. Be Genuinely Interested in Pediatrics
Again, not everyone wants to be a pediatrician, and that’s fine. But, while you’re in pediatrics, it’s best to throw yourself into the speciality like you are about to be the world’s most renowned kid doctor. Keep an open mind, because if you shut yourself off to pediatrics before you even start, you will hate your experience. Regardless of how much you try, this disinterest will bleed into your attitude and effort.
Attendings aren’t there to pump you up and make you be interested in a specialty. They are there to take care of patients, and teach you if you are willing to be taught. Therefore, walking around with a bad attitude will not make them feel the need to be overly invested in interacting with you. This not only could lead you to a bad rating, but also just a poor experience overall.
If you want to make a good rating in your pediatric clerkship, and make the most out of your time, then it’s time to fake it ’til you make it. And that starts with having a good mindset. Consciously override those negative thoughts about working with kids, until your behavior and mood begin to change as well. It’s only for a short time, so enjoy the learning experience, and don’t be an a**hole.
Key takeaways
Your pediatric clerkship is just as important as any other clerkship, regardless of what specialty you go into. Receiving a good rating in your pediatric clerkship may even clue some program directors into your character and your willingness to be a team player. Enjoy the learning and push yourself beyond your comfort zone. Most importantly, take responsibility of your own knowledge and be ready to display it at a moment’s notice.
If you are a pediatrician, or pediatric resident and have other suggestions or stories, please leave them in the comments! And don’t forget to subscribe for more tips on how to survive medical school.
This was right on target Darian
Thank you!