I’ve been getting a number of messages regarding how useful medfolk found my posts on preparing for Step 1, Taking Step 1 and my IM rotation. I figured if something on here is helpful in some way to even one anxious med student, why stop? So here are my tips for excelling in both your pediatrics and surgery rotations.
Sidebar: These are things I did, or in retrospect wish I had done that I totally felt enhanced my experience and helped me prepare for shelf/NBME testing.
I heard a lot that pediatrics is basically internal medicine for babies and I agree with this. Apart from neonatology and management of toddlers, there are so many similarities. The common diagnoses are of course different; less CHF, more asthma, less diabetes, more bronchiolitis. We did see patients with congenital heart diseases like Tetralogy of Fallot and Chronic Kidney Disease.
Examining little kids obviously requires a bit more skill and experience than it does for adults but it’s also more fun especially when it’s an infant who loves to be touched! Overall, here are my tips:
Be patient, with kids and their parents
Always explain your course of action to the parent; it’s a great way to reassure them and that builds a great rapport with them and makes your job easier.
Don’t judge parents. We saw a lot of people with questionable parenting or people whose kids had gotten into accidents or almost drowned because they were left unsupervised. Still you must approach such parents with empathy even or at least treat them with dignity, even if they’re so obviously incapable to you.
Be prepared. The thing with pediatrics is that everything you knew about medicine changes. The normal values for everything as you knew for adults is different for kids so you need a brain refresh. And then even among the kids, things like normal pulse rate and respiratory rate vary from infancy until the beginning of teenage years.
Come with your silly game! I LOVED playing peek-a-boo with the babies on the ward. Peekaboo works for all kids up to the age of 5 at least haha. There’s going to be a lot of reassuring and tickling and placating so come ready.
Have a good time! I meet a lot of students who are often too nervous to enjoy their rotations. You’ll probably never be in a hospital as a student with barely any responsibilities so you might as well enjoy it, learn as much as you can and make the best of every situation, even if kids aren’t your thing.
What I used:
Nelson’s Essentials of pediatrics: This was my favorite resource, really. It’s not the actual Nelson’s textbook of pediatrics (which is huge and unrealistic to cover) but a smaller sort of “handbook”. It had every single topic in our curriculum. If you need an e-copy, I’d be glad to send one to you this applies to all resources mentioned here. Just shoot me an email using the contact form here)
Bates Guide to Physical Examination & History Taking: I used this only to learn physical examination for littles. I love how Bates teaches physical examination.
Case Files Pediatrics: is great to practice your diagnostic skills.
Uworld Questions: aka the real MVP.
I LOVED my surgery rotation despite the fact that I went in terrified, prepared to hate it and that it was the most physically tasking rotation for me, 4:30am wake up times et al. Surgery is one of those fields that just gives the greatest adrenaline rush and the fact that I’m one of those people who has real trouble doing nothing aka can’t sit still was definitely a plus.
There’s a lot of standing around and watching and a ton of getting your hands dirty as well. I did my first few rectal exams, wound dressings, IV placements, suture/staple removals and debridements. It was awesome and I enjoyed my team tremendously. My top tips for surgery would be:
Stick to a routine. Surgery is hard, even harder when you don’t get enough sleep or eat enough. Get a schedule, so you can get to work on time and have food to eat and time + energy to study.
Be interested. It’s hard when you seem to only be standing and watching all day and sometimes it honestly feels like seeing one procedure=having seen every other one of that procedure performed after.
Make time to study. Refresh, especially your anatomy. Your atlas is your friend. I even downloaded my Frank Netter atlas onto my phone. Saved me a lot of times!
Don’t be afraid to get your hands dirty: do as much stuff as you’re allowed to do. You learn best by trying.
Practice suturing & knot tying. Watch videos if you don’t already know how to do these things.
Enjoy team work!
NMS Surgery Casebook is amazing. It enriched my experience on the wards and I think everyone who’s on a surgery rotation should read it. I’ve heard Pestana’s notes is great as well but I couldn’t get my hands on it.
Surgical Recall is great for quick answers to the most commonly pimped questions. I really love the format of this book and I’d usually look at a related section just before a particular surgery.
Case Files Surgery: I’m a huge fan of the Case Files series and the one for surgery is good!
Uworld Questions, as usual.
I hope you find my tips and resources helpful. If you have any other questions, I’m only an email or comment away (depending on your question). I have e copies of these books and willing to share, so holla if you need em.
Do you have any resources not on this list? Have you completed either of these rotations? How did you like them? Let me know in the comments!
Most of all, enjoy the journey!