THIRD YEAR MEDICAL STUDENT ROTATION
Pediatric Surgery
UCLA Medical Center
Students should page the intern (R1) on the Pediatric Surgery service before they begin
the rotation to find out when and where to meet. The name of the intern and pager can
be found on the R1 General Surgery rotation schedule located at the Surgery website:
http://www.surgery.ucla.edu/resident/
Goals:
This clerkship is designed to familiarize the student with the evaluation and treatment of
infants and children with surgical conditions. You will be participating in the daily clinical
activities with the residents and attendings on the service as well as attending didactic
teaching sessions and making a presentation. You will be expected to gain skills in the
following areas:
A.
Comprehensive evaluation of the patient with a pediatric surgical condition.
This skill would include the performance of a comprehensive history and physical
examination followed by the creation of a differential diagnosis and formulation of
a plan of management. Since the types of problems and skills involved are agedependent you should select a newborn, toddler and older child during the
course of your rotation. The exercise should include the collection of the
information and the preparation of a concise write-up to be reviewed and counter
signed by the chief resident on the service. A copy of your write-up should be
photocopied and submitted to the responsible attending for review as well.
B.
Focused Patient Evaluation
This skill can be practiced in either the inpatient, or preferably the outpatient area
with preparation of concise problem oriented history and physical including a
diagnosis and plan of management.
C.
Treatment of Pediatric Surgical Conditions
You should become familiar with the common conditions of the newborn (ie.
tracheo-esophageal fistula / esophageal atresia (TEF/EA), congenital
diaphragmatic hernia (CDH), intestinal atresia, necrotizing enterocolitis (NEC),
pediatric
appendicitis,
hernia,
hydrocele,
undescended
testicle,
gastroesophageal reflux, pyloric stenosis, intussusception, Hirschsprung’s
disease, pectus excavatum, biliary atresia, as well as the major solid tumors of
childhood (Wilms tumor, neuroblastoma, rhabdomyosarcoma). You should also
be familiar with the pre- and post-operative care including parenteral nutrition,
fluid requirements and resuscitation as well as pediatric airway and respiratory
management.
D.
Participation in the Outpatient Clinics and Operating Room
With the current changes in health care, the majority of decisions regarding
patient management have shifted to the outpatient setting. Your participation in
the outpatient area is critical to maximizing the educational benefits of this
clerkship. It is also essential that you participate in the operative care of patients
that you have selected for your comprehensive evaluations as well as observing
as many procedures as possible that have the common conditions listed.
E.
Participation in weekly Pediatric Surgery Conference (Tuesday 4:00-6:00pm in
RRMC 8234) and weekly tutorial conferences with Dr. Fonkalsrud (Tuesday
12:00-1:00pm in CHS 72-130).
F.
Participation in operating room cases for the pediatric surgical service (every
Monday, Wednesday, Thursday, and Friday in the RRUMC main OR and every
Friday in the Ambulatory Surgery Center 6th floor Med Plaza 200 Bldg).
G.
Participation in weekly Department of Surgery Education Conferences every
Wednesday starting at 7:00am and required Core Lecture Series at 9:00am.
H.
Preparation and presentation of a selected pediatric topic of student’s choosing
at the conclusion of the rotation to pediatric surgical attendings and residents (at
the Tues afternoon conference). If you need assistance with topic selection,
please contact the chief resident or the attending pediatric surgeon on service.
Requirements:
1.
2.
3.
At least one comprehensive history and physical per week, preferably two.
Attendance in the outpatient area 1 to 2 days per week.
Selected reading from Principles of Pediatric Surgery, 2nd Edition.by O’Neill,
Grosfeld, Fonkalsrud, Coran (eds.), Mosby 2005 or Pediatric Surgery 4th Edition
by Murphy, Snyder, Holcomb (eds), Saunders 2005.
Summary Sheet
THIRD YEAR MEDICAL STUDENT ROTATION – PEDIATRIC SURGERY – UCLA
Student Name: _________________________________________________
Dates on Service: ________________ to ________________
Complete workups – History and Physical Examination (patient name, diagnosis, date of H & P)
1. ___________________________________________________________________________
2.
___________________________________________________________________________
3.
___________________________________________________________________________
Outpatient Clinic patient evaluations
1. ____________________________________________________________________________
2.
____________________________________________________________________________
3.
____________________________________________________________________________
Pediatric Surgery conferences (these are OBLIGATORY, fill in date).
_______ 1. Weekly Pediatric Surgery Conference
_______ 2.
_______ 3.
_______ 1. Weekly Tutorials
_______ 2.
_______ 3.
_______ 1. Presentation to faculty and residents
We would like you to observe the following INDEX CASES. We recognize that it may not always be possible. Check off if
you were able to do the following.
Index Cases to see
1. Gastroesophageal Fundoplication
2. Inguinal Hernia
3. Newborn anomaly
4. Pectus deformity
5. Intestinal anastomosis
6. Placement of central venous line
7. Peritoneal dialysis catheter
8. Abdominal or thoracic tumor
Observe operation
________
________
________
________
________
________
________
________
Observe NICU
_______
_______
We would like you to develop the following CLINICAL SKILLS. We recognize that it may not always be possible. Check off
if you were able to do the following.
Pediatric Surgical clinical skills (check if completed).
_______ 1. Examine for inguinal hernia
_______ 2. Examine for heart murmur
_______ 3. Auscultation of chest for pneumothorax, atelectosis
_______ 4. Examine abdomen for peritonitis and for intestinal obstruction
_______ 5. Perform a complete exam on a neonate
_______ 6. Perform a rectal exam
_______ 7. Review newborn abdominal x-ray for obstruction or peritonitis
_______ 8. Review intake and output for infant, and child
Comments about rotation:
Please turn in completed form to Iris Mau in Room 72-215 CHS.