INTRODUCTION TO ATTACHMENT IN PAEDIATRICS & CHILD HEALTH IN NHS FIFE
Welcome to NHS Fife’s Department of Paediatrics and Child Health. We hope you enjoy your stay with
us and make the most of it. This attachment in Fife offers you exposure to wide variety of paediatric
problems with lots of opportunities for hands on clinical experience.
Your clinical attachment in Paediatrics and Child Health lasts three or four weeks and is based in:
 Mainly Victoria Hospital, Kirkcaldy (VHK).
 Queen Margaret Hospital, Dunfermline (QMH) to attend OPD some Clinics. (optional only)
During this you will have various teaching opportunities and allocations:
 Paediatric Ward: clinical teaching, working with children, ward rounds, Grand Rounds
 Paediatric Ambulatory Unit: new cases and follow up reviews.
 Day case and special tests unit
 Neonatal Unit & Postnatal Wards
 General & Special Paediatric Clinics.
 On Call Commitment: where you see & clerk fresh cases, once weekly and one day at
weekends
You will meet with our team of Paediatricians & Paediatric Nurses
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Consultants & Senior Paediatricians:
Dr CR Steer
General Paediatrics and Neurology and ADHD
Dr R Humphreys
Paediatric Orthopaedic Physician
Dr M Thanoon
Neonatology & Cardiology
Dr E Menzies
General Paediatrics and Renal Medicine
Dr A Ainine
General Paediatrics and Diabetes, Endocrine & Education
Dr K Aniruddhan
General Paediatrics and Respiratory Medicine
Dr L Pieterse
General Paediatrics and Allergy and ADHD
Dr J Morrice
G. Paediatrics, Gastroenterology and International Child Health
Dr Khalil
Neonatology & cardiology
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Senior Nurses (shadowing):
Linda Robertson: Paediatric Diabetes Liaison Specialist Nurse
Anne McKean:
Paediatric Outpatient Specialist Nurse (Asthma, Allergy & Endocrine)
Fiona Burt
In Charge of Paediatric Ambulatory Care Unit
Jeana Summers
Charge Nurse Special Care Baby Unit
Angela Toruntay
Endocrine & Growth
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INFORMATION FOR CHILD LIFE & HEALTH
We hope to offer you the opportunity for direct involvement with patients and parents. You will be
encouraged to participate in the clerking process and we hope you will be able to learn some practical
techniques during your stay in Fife. The accent is therefore more on the “nuts and bolts” or “hands-on”
experiential learning in addition to formal tutorial or lecture-type teaching.
The trend in Paediatrics is towards quick turnover and lower bed occupancy and as a result there are
sometimes relatively few patients in the Ward at any one time. This means that Consultant ward rounds
tend to be less formal and perhaps more discursive and we would encourage you to ask questions and
participate in such discussions. There is a working ward round each morning at 9am, simultaneously
Paediatrics and Neonates. These ward rounds deal with every patient under the care of the unit
irrespective of which Consultant is involved and informal teaching may occur on an ad-hoc basis on such
rounds although this is not at the expense of other pressing nursing and medical commitments. On
Monday’s & Tuesday’s 08:30 to 10:00am there is a grand round in Paediatrics and Neonates.
On the other hand, the number of patients attending the Ward on an ambulatory basis has increased and
the numbers are about equivalent to those referred for actual admission. Between these two sources
there ought to be a good supply of clinical material from which to learn.
Your attachment is busy with tutorials, therefore, try to see as many clinical cases as you can in the
ambulatory unit and after 5pm (when on call).
Please liaise with the consultants, as early as possible in the first week, to arrange to take cases to
prepare to how to examine the major systems:
 Respiratory,
 Cardiovascular,
 Abdominal,
 Neurology
AND prepare 2 MiniCEx cases every day to be presented to the consultant at 12-1pm. Sometimes it
would be hard to find 2 cases of one system, only then take one case of another system. Try to get one
case with normal examination of the system and another with some abnormality, if feasible.
There will be bedside teaching of the four main body systems for an hour each, at lunchtime. Students
are required to find two suitable cases on the morning and prepare a MiniCEx on each. Frequently, it
might be difficult to find 2 CVS cases, for example; then one case could be another system. It is meant to
have one normal comprehensive system examination and then few cases over the weeks with
abnormalities if possible. Each student is required to present 4 MiniCEx cases, so this will be used as an
opportunity to teach you by senior staff, and to assess students on their last weeks presentations.
Students will be attached to the ward, the clinics and the neonatal unit; a week each. Many patients go
through the Outpatient Clinics, and the mix of clinical material is somewhat different, often unusual and
complex disorders which do not tend to come in as inpatients. You should regard attendance at various
outpatient clinics as an obligatory part of the attachment. There are many such Clinics (see attached
timetable for a selection).
The department has students from Edinburgh and Dundee Universities which combined can be up to 10
students.
Ward & Clinic Weeks
Students should attend the Monday morning (8.30am) Paediatrics Grand Round. All consultants attend
the Monday Paediatrics Grand Round, after that you can attend either the ambulatory care or the ward
round.
Neonatal Week
Students should start at the Neonatal Unit. All consultants attend the Tuesday morning (8.30am)
Neonatal Grand Round.
Clinic Weeks
Students should start there, with the Consultant or Registrar, further details on clinics can be found by
contacting Karen Moncrieff, the clinic coordinator.
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WEEKLY TIMETABLE FOR STUDENTS: each student will spend a week at one function area as
follows:
Ward at VHK
Neonates at VHK
Clinics at VHK
Week 1
A, D
B
C
Week 2
B
C, D
A
Week 3
C
A
B, D
The teaching for medical students from Edinburgh University will involve 3 attachments and is meant to
cover the 12 outcomes identified by the university as follows:
Location
Themes
Outcomes
Ward
Examination
Management
1. Biomedical & Clinical Sciences
6. Presentation, Diagnosis & Treatment
7. Clinical Communication
9. clinical pharmacology
Clinics
History
Counselling
2. Psychological Aspects of Medicine
3. Social Science & Public Health
4. Research & Evidence Based Medicine
5. Consultation
Neonatal
Nutrition
Neonatal Problems
(Prematurity, Anomalies)
8. Resuscitation & Emergency
10. Medical Informatics
11. Ethics & Law
12. Personal Professional Development
All students doing Neonates should also take advantage of any opportunities to attend high risk
deliveries, such as instrumental, and resuscitations, which may take place while they are in the Unit.
Each student should accompany the doctor responsible for baby checks; to observe several and to
perform a few baby checks under supervision. The Baby Hip Clinic at 8.30am on Tuesday mornings is a
good opportunity to become familiar with investigation and treatment of Developmental Dysplasia of the
Infant Hip. Students will get an opportunity to practise their examination skills on our training dolls. It is
also a good opportunity to gain experience in normal child development as you will be able to interact with
and examine well babies who are days old, weeks old and months old along with their older siblings.
It is obvious that there are a number of options available at any given time and students ought to coordinate matters so that there are not too many at any one of these functions. Bear in mind however that
in many clinics there is more than one member of staff working and it is possible to distribute students
throughout the clinic in this way. It is worthwhile paying attention to the possibility of covering as many of
the available options as possible within the period of your attachment.
We expect a roster to be made up so that there is always a medical student available, including nights
and weekends, to see and assist with inpatient admissions, etc. This is not usually a very onerous
commitment throughout the whole attachment but students should make their own arrangements with the
SHO or Registrar to be called when there are emergencies or interesting events going on out of normal
hours. There is usually an “out of service” bleep, which can be used, provided you let the Switchboard
know which bleep you are carrying. We feel strongly that insight and experience gained in working in this
way is an invaluable part of your learning experience and of great use later for the Undergraduates. This
roster should not be regarded as exclusive and it is quite acceptable for more than one student to be “oncall” at a time.
When clinical commitments allow, the Registrars will be willing (please arrange early in the week and in
your attachment) to undertake bedside teaching or informal tutorials. Because of the unit staffing these
arrangements frequently have to be altered and postponed when pressing commitments interfere and it
has to be understood that this is the basis on which the attachment runs.
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There will be 4-5 class room teaching sessions per week, on Monday morning and Wednesday afternoon
as shown in the table below. Each consultant might contribute either regularly every week or partly once
or twice every four weeks. It might be difficult to determine topics in advance, with a bit of flexibility,
presenting what the students want might help. Additionally, there will be student’s presentations of
various topics, two students will present each week for 10-15 minutes and discussion is around 15
minutes. Presentations might contribute to your assessments.
As well as the Paediatric Unit Meeting on Thursday afternoons there is a Perinatal Meeting once a
month on the third Tuesday when stillbirths, neonatal deaths and interesting cases and matters of
perinatal practice are discussed.
Students interested in Paediatric Orthopaedics are welcome to join Dr Robert Humphreys in his clinics.
In the VHK, these are:
 Talipes Clinic at 1.30pm in Ambulatory Care on Mondays.
 General Paediatric Orthopaedic Clinic (focus on Cerebral Palsy on 1st and 3rd Wed) at 1.30pm
on Wed afternoon in the Paediatric Clinic.
 General Paediatric Orthopaedic Clinic on Friday mornings at 9am in the Paediatric Clinic.
Finally, it cannot be stressed too strongly that medical students and attached Postgraduates have access
to patient material and records on the understanding that they strictly observe the code of medical
confidentiality. It is too easily forgotten in a busy hospital setting and especially in the Children’s Unit, and
a deliberate effort is sometimes required. Furthermore, students are tactfully reminded that children and
parents must be accorded personal treatment, which takes into account their fears and expectations and
their right to preservation of personal dignity and privacy.
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Paediatric Student Teaching Timetable, updated April 2013
Time
Monday
Tuesday
Wednesday
Thursday
Friday
AM
8:30 – 10 am Ward1
Paediatric
Grand Round
Assessment Room 1or2
8:30 -10 am NNU
Neonatal
Grand Round
8:30 – 9 am
Paediatric teaching by
Ward Consultant
Ward Doctors Office
8:30 – 9 am
Paediatric teaching by
Ward Registrar
Ward Doctors Office
8:30 -9am
Neonatal Teaching,
NNU Doctors Office
Dr Thanoon
Cardiovascular Ex
2 MiniCEx
(Arlyne 21253)
Dr Morrice
Abdominal Ex
2 MiniCEx
Children’s Ward
(Karen 28828)
an hour
anytime
between
12-14
PM
Dr Aniruddhan
Ward teaching
2.30-3.30 pm
Respiratory, 2 MiniCEx
(Ann 28225)
Dr Ainine
2 Students ppt presentns
Education Centre
2 – 3:30 pm
(Arlyne 21253)
Dr Humphreys
Education Centre
4-5 pm
(Susan 21733)
Departmental teaching
Education Centre,
Lecture Theatre
3:30 - 5 pm
Private study
Please confirm with the Teaching Doctors the day before. Or with the secretaries (numbers in (Name xxxxx)) in the morning of your tutorial to see
whether the teaching is happening or not (annual, study or sick leave…etc.)
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CLINICS
am
Mondays
Tuesdays
Wednesdays
Thursdays
Fridays
Dr Ainine –
Growth &
Endocrine
Dr Thanoon –
General
Dr Steer –
ADHD Review
Dr Morrice –
Gastroenterology
(1st, 3rd and 5th)
Dr
Aniruddhan –
General
ADHA Clinics
New – Dr
Steer
Review – Dr
Moaman & Dr
Graham (alt.
weeks)
Dr
Humphreys
–
Orthopaedic
Lyndsey Pert
ADHD
Medicine
Review
Dr Pieterse –
Allergy
Dr Maddox –
Clinical
Psychology
Dr Munro –
Surgical (4
weekly).
Anne
McKean –
Asthma
Education
Laura Harrison
– Dietetic
clinic
Dr Ainine –
Diabetes
(1st,2nd,3rd)
Dr
Aniruddhan –
Respiratory
(monthly)
General
Clinics
Dr Thanoon
Dr Aniruddhan
(alt. weeks)
Dr Claisse (alt.
weeks)
Dr Thanoon –
General
(Week 3)
Dr Aniruddhan
– Asthma
Dr Steer –
Epilepsy
Dr Pieterse –
General
Dr Menzies –
Constipation (1st,
3rd, 4th and 5th)
Dr Humphreys
– Orthopaedic
ENT Pre-op
Assess
Dr burns –
Cardiology (1st
and 5th)
Third
Thursday of
every month
2pm
Paediatric
Outpatient
Specialist
Nurse
Session
(Asthma,
Allergy
&Endocrine)
(Education
Centre – Anne
McKean)
Dr Maddox –
Clinical
Psychology
pm
Dr Morrice –
Enteral
Feeding
Clinics (week
2)
Dr Morrice –
Weight
managements
(week 4)
Dr Ainine –
Diabetes
(1st,2nd,3rd)
Dr Gibson –
Rheumatology
(2nd)
Dr Lam –
Genetics
(week 2 and 4)
Dr Morrice General
Dr Pieterse
– ADHD
Lyndsey
Pert – Sleep
Clinic
PRIVATE
STUDY
Activities run every week unless otherwise indicated
Session starts at 9.15am to give students opportunity to attend Ward handover meeting at
9am.
All ward rounds are consultant-led and therefore represent valuable learning opportunities.
Students assigned to Ward should attend as much of the ward round as possible
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