Overall, this rotation served as a valuable transition from my family medicine rotation, where I previously gained experience evaluating pediatric patients in an outpatient setting. During my pediatrics rotation at QHC, my schedule consisted of 3 weeks in the pediatric emergency department, 1 week in the NICU, and 1 week in the hospital’s pediatric outpatient clinic.

During my time in the pediatric ED, I felt that I had a great level of autonomy as a student. I was typically able to see and evaluate patients independently before presenting my findings and assessment to the attending physician on shift. In this setting, I encountered a wide variety of common pediatric conditions, including acute viral URIs, gastroenteritis, RSV, influenza A/B, croup, reactive airway disease, and others. Through repeated exposure, I became more confident in recognizing and managing these conditions. One limitation of the ED experience was the lack of an inpatient pediatric ward at QHC, which meant that more complex or higher-acuity pediatric cases were often transferred to other hospitals. As a result, some of the cases in the ED became repetitive, and there was less exposure to a variety of pediatric conditions/cases.

During my week in the NICU, I gained valuable exposure to neonatal medicine. I learned about various neonatal and genetic conditions, including congenital adrenal hyperplasia (CAH), as well as important aspects of neonatal care such as fluid management and monitoring trends in bilirubin levels. I also had the opportunity to participate in and observe cesarean sections, which provided additional insight into neonatal care immediately after delivery. I believe the experience I gained in the NICU will be especially beneficial as I transition into my upcoming OB/GYN rotation.

My week in the outpatient pediatric clinic closely resembled my prior family medicine experience, with a focus on follow-up visits, routine physical examinations, and preventive care. I was also given the opportunity to work with pediatric specialists in pulmonology and neurology, where I learned many different modalities of asthma medications + management, as well as rare genetic neurological conditions, dystonia, epilepsy, ADHD, ASD, and seizures. This setting further strengthened my confidence in conducting pediatric wellness visits and managing common outpatient concerns.

One of the most significant areas of growth during this rotation was learning how to approach the evaluation of pediatric patients across different age groups, including neonates, infants, toddlers, children, and adolescents. I learned tips and tricks in pediatric physical exam, such as positioning infants with their parents when performing an otoscopic exam to improve cooperation, and asking children with abdominal pain to jump in order to assess for signs of peritoneal irritation. Because I worked with different preceptors during ED shifts, I was able to learn a variety of clinical approaches and techniques from each of them. These experiences helped me develop a more adaptable and confident approach to evaluating pediatric patients.

Procedurally, I was able to gain hands-on experience with several clinical skills. I frequently performed nasopharyngeal swabs for COVID-19, influenza, and RSV PCR testing, as well as throat swabs for suspected streptococcal infections. I also practiced interpreting chest radiographs prior to reviewing the radiologist’s final report, performed an ear lavage, completed wound repairs using Dermabond, and assisted with an ultrasound-guided IV placement.

Throughout my shifts in the ED, NICU, and outpatient clinic, I received valuable feedback from my preceptors regarding pertinent history-taking, physical exam techniques, and the development of differential diagnoses for pediatric patients. This feedback helped strengthen my clinical reasoning skills and increased my confidence in managing pediatric cases.

Overall, I found this rotation to be both rewarding and educational. I especially enjoyed the ED portion of the rotation due to the increased autonomy and exposure to a variety of acute pediatric presentations. Learning from multiple preceptors allowed me to gain different perspectives and practical tips that will continue to guide my clinical practice. This rotation significantly strengthened my confidence in pediatric patient care, clinical decision-making, and procedural skills.