Tuesday, August 2, 2011

.paediatric.

inspired by a friend who did a wonderful guideline for orthopaedic postings that i find really helpful, so i came out with this for her instead =)

Introduction
This is a solely random attempt of me as a graduate of 8 weeks paediatric posting of my precious fourth year of medical school in beloved universiti kebangsaan Malaysia. Bear in mind that this is not officially accredited guideline, so do mix and match it up with your preference and daily life activities.

That first day,
My advise to people who not good with children like myself, you might want to start practicing your aegyo (aegyo means cuteness). Stay positive and smile =)) and remember patience is everything when it comes to examining paediatric patients.

Briefing

Where : Seminar room, Paediatric department, level 4 ppukm.
Time : Just be there by 8 c'clock.

Advise again, better walk out from your beloved hostel room early because the department is quite hard to find for first-timers. You have to enter a door just before paediatrics ward 4A’s door. Once you enter the door, you will encounter another 2 more doors, then you will see the sign stated ‘Paediatric Department’. Sound tricky right? Just be there early, so you wont be late even if you get lost.
Briefing will be given by Prof Wong, the posting coordinator and he will ask for volunteer to be the posting leader. When I say volunteer, I mean any responsible people to raise his/her hand and said “I will be the posting leader, prof!” enthusiastically. Otherwise, he will just point out anybody who looks like anwar ibrahim to be one within 2 seconds. Seriously, that exactly what happened to our group.

For all 8 weeks of this posting, you will be sorted and rotated by groups to undergo NICU (2 weeks) – HKL (4/5 weeks) – Kajang Hosp. (1 week)
Each group will have their own supervisor which will be giving teaching for one time every week. And every week also, every group will have their own teaching with any of the external lecturers from HKL or Kajang Hosp.
So sum up, you will be having teaching for at least twice per week.

General Schedule: Monday – Wedsnesday will be allocated for NICU/HKL/Kajang Hosp.
                              Thursday will be for PBL
                              Friday will be for seminar and radiology conferences.


Neonatal ICU (NICU) 
Two weeks rotation. NICU located just opposite the labour room on level 1 ppukm. First thing to do when you enter the NICU, go and wear the blue shirt then wash your hands with aseptic technique. 2 groups will be allocated in NICU for every rotation. Just play osom or what-so-ever-game to determine which group will be under Prof Cheah and the other will be under Prof Rohana. Both of them are equally strict in their own way, so dont be picky. Aseptic technique are super important in paediatric posting, you have to scrub your hand with the alcohol rub everytime you enter a different baby cubicles.

Ward rounds: grand wardrounds will be on teusday with Prof Boo and Thursday with Prof Cheah. Still, everyday wardrounds with respective lecturers are compulsory in the morning and evening. Cover the beds, and please always aware where your patients are, because in a blink they will change cubicle as the staff nurses wish.

Post-natal wardround: this is important as this is the only chance for you to learn how to do neonatal examination. Not to mention you have to fill up your logbook for this section as well. The rounds will be held by the MOs responsible for the day. Usually being done in the morning, whether before or after the wardrounds according to the MOs preference. The tricky part is you don’t know when will be the MOs do it, so my suggestions are either search and ask the MOs responsible for it what time they will be doing it and which OnG ward they wil be doing it. The other solution is just go and wait at any of the OnG wards until the MOs come.

Code pink call: everyday 1 MO and 1 HO will be holding the code pink pagers. Simple, get to know who they are, and when the pager beeps, go follow them to the labour room. You will learn about neonatal resuscitation a lot here.

Institut Paediatrik Hospital Kuala Lumpur.
As I stated before, you will only be here from Monday till Wednesday. Wake up super early and board the bus in front of the staff nurse hostel at 7.15 am. You are suppose to be in IPHKL from 8 am till 5 pm. Go to your allocated ward. UKM students only being allowed to enter ward KK4, KK5, KK6 and KK7. the other wards are for UPM students. Every week only one group will be assigned for each ward. What to do there? Clerk patients, exactly what you do in your internal medicine posting last year.

Extra tasks for group leaders:

1.  Every time you enter a new ward every Monday, first person that you have to search for is the SISTER (those in blue uniform). Introduce your group to her and they will take you for some brief orientation for every respective ward. This task is SUPER IMPORTANT otherwise you will end up listening to 1 hour motivation lecture especially those in KK7. hahaha.

2. Every Monday, you have to call 2 crucial people for teaching. First, would be your own supervisor and the other one is the external lecturer for that particular week. You will be provided their numbers in handout given to you during the first day briefing in the department.
All the external lecturers are SUPER NICE (dr yong junina, dr wong, dr lim, dr norliza etc.). Learn as much as you can from them as most of them only teach you once only.

Hospital Kajang
What you will be doing here is exactly like what you do in IPHKL. Kajang Hospital only have one paediatric ward and super a lot housemen. They only allow maximum of 6 students to be in the ward at one time, what you can do is divide your group into two, then do some sort of a rotation. You can go to their library situated just above the emergency department, the library is quite nice (to sleep..haha), but don’t sleep there or you will find the librarian will be looking at you sarcastically.

Extra task for group leader:

Do exactly what you do every Monday. For Kajang Hospital, the external lecturer responsible for teaching will be the one and only Dr Baizura. She is super duper nice, ask her anything and everything or else you will regret later!! haha

Seminar and PBL 
Each group will be preparing and presenting according to the topic given in the handout. These will be held at DK2 8am every week.

Extra task for group leaders:

Call the lecturer responsible as early as possible (by right 2 weeks before the presentation) to confirm the topic, time, venue and etc.

Radiology conference 
It will be held at the radiology department conference room every Friday at 11am. Super nice lectures where you will be exposed to the radiological findings for children. And yes, there will be a quiz by 7th week. The lectures are super nice, informative and relaxing but don’t sleep!! There are a lot more to learn for only one hour each week.

Log book
Fill them up.
Trick to fill up the log book:

Parameters measuring – everybody have to do five of these. Instead of doing this in ppukm paediatrics clinic (very hard, have to rebut2, not that many patients if you come late, you wont be in ppukm anyway Monday to Wednesday), do it in HKL clinic instead.
Just go to the clinic by small groups of 3 or 4 students, meet the sister and ask for their permission. The sister are nice, they will let you for sure!
Then, go to BILIK TIMBANG, you will fill up that section of logbook within 5 minutes, trust me!


Clinic
nope2..no clinic session at all unless your lecturer invite you in.


Operation Theater
nope2..no OT.


Case Write up
ONE only, choose your case wisely

Shortcase examination
Exactly alike the internal medicine shortcase exam only that it will be held at paediatric ward 4A or 4B ppukm on the last week of posting. 

Books
sunflower, for some topics you do need nelson for further reference. And the paediatrics protocol.

Yes, there are a lot to learn. Paediatric posting are exactly alike internal medicine posting only with patients from smaller age group. But always remember, whats common is common!

History taking wise, no different from usual history taking, only that you will be talking to the caretaker/parents instead of your actual patients.
Physical examination wise, no different from what you learn in internal medicine posting, only with slight alteration. You will learn it from your lecturers during teachings.
New skills to acquire are neonatal examination and developmental assessment.


.niece.
Lastly, enjoy your paediatric posting!!
=)

.wink.

4 comments:

n a j w a e said...

meh la saya send entry awk kat prof wong.
mesti dia boleh kepilkan sekali dalam guidebook dia hehe

pi la join yam publish kat bba blog!

MyOwNwOrLd said...

haha

Maryam H said...

eeeeeeeeeeep tis entry is for ME? I mean, ME?! hahahaha bangge2. thankyou!!

hurrmm prof wong is a he?dari cite wae ingat kan XY

rse cam nk publish kat bba je...haaa, suh dhira wat yg TRIAD okay dok? & psychiatry sape eeeh

MyOwNwOrLd said...

yup2..prof wong is a he.
psychiatry suh zue la wat..haha