I was initially very skeptical about my abilities in pediatrics rotation because I hadn’t had much experience around younger children, and especially from a health care provider point of view. However, after a few days and over a hundred patients, they quickly became just like any other patient population and I was much more comfortable interacting with both children and parents.

One of the important things I learned about outpatient pediatrics is that it is mostly observational. Young children and adolescents are generally healthy with no medications or morbidities, so they typically do not have much of a medical history to explore. This means that when a child comes in with a complaint, it’s important to have a broad differential for the causative organisms and treatment options that are available. Luckily, in the practice I was rotating at, we had a CBC and urinalysis machine that could be used to try and determine if there were bacterial infections or urinary tract infections without having to refer the patients to outside agencies. Aside from this, we are essentially just using clinical knowledge to determine if patients require further workups or referrals to specialists. Taking a history is also somewhat difficult because the patient cannot explain their symptoms if they are very young, and we must rely on physical signs in order to determine what is ailing them. We also have to rely on their parents for information because they are able to recognize any changes in behavior or bodily functions.

 Pediatrics also underscored the importance of becoming competent at thorough physical exams. Children provide an excellent way to learn chest sounds because their chest walls are thinner, so it is easier to auscultate breaths and cardiac rhythms. This also makes it easier to recognize when there are abnormalities, like lower respiratory infections or determining if a heart murmur is present. When seeing a pediatric patient, we try to perform a general head-to-toe exam in a short amount of time, including skin, eyes, ears, throat, abdomen, genitalia, and limbs. This helped me develop a certain “flow” when seeing patients as the motions became repetitive and routine. This will also help me when seeing adult patient populations, and I am now more confident in doing full body exams relatively quickly. Doing some routine bedside procedures also became second nature, and I can confidently give IM injections and throat and nasal swabs, as many peds patients required vaccinations and screenings for strep throat.

I would like my preceptor and colleagues to see some of the improvements I’ve made clinically. I’ve reviewed a good amount of common antibiotics and topical dermatologic treatments, and I’ve gotten more adept at using my stethoscope and otoscope. I’ve also learned a lot about common pediatric illnesses and potential harmful sequelae if they are not treated, such as rheumatic fever developing from strep pharyngitis. Overall, I enjoyed pediatrics very much, and would like to continue to learn more about the specialty.