Pediatrics
050.3 Sub I – Pediatric Emergency Medicine
Instructor: Lorrie Edwards, M.D.
Location: Boston Medical Center – Menino Pavilion
Telephone: 414-5514 Contact: Lisa Blake – Vose 5
Number of Students: One
Period to be offered: One month
Description of Elective:
This sub-internship in pediatric emergency medicine will provide students with experience in the direct evaluation and management of pediatric patients, ages 0-21yrs. The rotation will focus on clinical problem solving and will emphasize skills in the differential diagnosis and treatment of acutely ill children. There is no overnight call, but students may elect to have some weekend shifts in addition to weekday shifts to complete the required complement of shifts during the rotation. Approximately half of your shifts will be during the day hours of 8am – 3pm and half will be in the evening hours of 3:30pm – 10:30 pm. Students are allowed to work a limited number of overnights and weekends if they want to. During the four-week block there are 19 required shifts irrespective of excused absences for residency interviews. This rotation is therefore not recommended for students during residency interview months. Attendance at the Department of Pediatrics conferences, weekly resident conferences, and monthly simulation is encouraged. At the end of their rotation, students will be required to present an evidence based medicine session to evaluate their ability to interpret and incorporate the medical literature into their practice. This rotation is designed for one student per block, but depending on staffing and space could potentially accommodate a second student as needed at the discretion of the course director.
This elective satisfies the sub-internship requirement.
Note: Faculty in the Department of Pediatric Emergency Medicine at BMC are no longer able to write a standardized letter of evaluation (SLOE) for an adult emergency residency application. The current policy from the Association of Emergency Medicine Residency Program Directors is that only faculty of an Emergency Medicine Residency Program may write a SLOE. Students applying in emergency medicine are, of course, always welcome to take this sub-internship.
051.3 Sub I – Pediatric Inpatient Medicine
Instructor: Elizabeth Hutton, M.D.
Location:Boston Medical Center – Menino Pavilion
Contact: Carly Werner Email: Carly.Werner@bmc.org
Number of Students: Two
Period to be offered: All blocks except 9
Description of Elective:
Students rotating on the Inpatient Pediatric Sub-internship will function as the primary clinician for 2-4 patients under the direct supervision of the senior resident and the pediatric attending. In this role, students are responsible for all aspects of inpatient management for their patients including serving as the contact point for patients/families, placing orders, completing documentation, communicating with the interdisciplinary care team, placing subspecialty consults as appropriate, and planning for discharge. Students will reference the relevant medical literature and clinical guidelines in developing management plans for patients, and will also communicate key learning points to the wards team in focused teaching sessions.
During this rotation, the student will be exposed to a wide range of general pediatric diagnoses and have the opportunity to serve as the primary clinician for patients aged from birth up to young adulthood. In terms of structure, students will spend two weeks working as part of the day team (11 day shifts) and two weeks working as part of the night team (10 night shifts). This allows students to gain clinical knowledge and experience as a clinician on the day team, while also developing important triage and cross coverage skills as part of working on a night resident team.
Note: This elective satisfies the subinternship requirement
052.3 Sub I – Pediatric Intensive Care Unit
Instructor: Sara Ross, M.D.
Location: Boston Medical Center-Menino Pavilion
Contact: Carly Werner Email: Carly.Werner@bmc.org
Number of Students: One per block
Period to be offered: One Month
Description of Elective:
The PICU is a multidisciplinary four bed unit caring for children and adolescents from newborn to 22 years. The sub-intern will work on a team with a senior pediatric resident from the Boston Combined Residency Program in Pediatrics (BCRP) and the PICU attending. The sub-I will act as the primary provider for their assigned patients. Major teaching objectives of the rotation are the pathophysiology of childhood critical illness, contents of the pediatric advanced life support (PALS) guidelines, and the various types of intensive care support (i.e. forms of mechanical ventilation, critical care nutrition, and coordination of care), as well as psychological and social support for patients and their families.
Sub-Interns are expected to stay later into the evening approximately every 4th night (about 7 times a month and including some weekend days) to increase exposure to new admissions to the PICU. The student should stay as late as they feel is safe for their return to their residence, as we do not have a sleep space in the hospital.
Goals:
1) The student will take responsibility for patients, including initial and daily exam, differential diagnosis, admission and daily documentation, treatment planning, and frequent repeat assessment, under the close supervision of the resident and attending physician.
2) The student will suggest and write treatment orders (when appropriate) under the supervision of the PICU resident.
4) The student will contact consulting services and accepting service teams when the patient is transferred, as appropriate, under supervision of the PICU resident or attending.
5) The student will participate in PICU teaching sessions with the resident and attending focused on PICU diagnoses and treatment modalities, and will be expected to pick a clinical question for presentation, including brief literature review, to the PICU team at least once during the rotation.
6) The student will identify all of the attendings and residents who supervise them during the rotation and assign Focus forms to all of those individuals so that comprehensive feedback can be collected for grading.
Note: This elective satisfies the subinternship requirement
053.3 Adolescent Medicine
Instructor: Mandy Coles, M.D., MPH email: Mandy.Coles@bmc.org
Location: Boston Medical Center – Adolescent Center
Contact: Carly Werner Email: Carly.Werner@bmc.org
Number of Students: One
Period to be offered: Four Weeks – Blocks 13, 14 and 15
Note: Students who miss more than 5 days from the elective, for whatever reason, are required to make up those days. This can be done on weekends and official Boston University holidays.
Description of Elective:
The Adolescent Medicine elective will take place at Boston Medical Center’s outpatient Adolescent Center, as well as at a handful of community sites. It will be an opportunity for one 4th year medical student per rotation to gain experience caring for adolescents in the outpatient setting. Students will interview and examine adolescent patients with attending physician supervision, and come up with plans for diagnostic evaluation and treatment. Students are expected to work at least 40 hours per week and have various opportunities to interact with attending physicians, mid-level providers, nurses, social workers, and other community providers. This elective will give medical student valuable exposure to common psychosocial and medical health concerns in adolescents such as sexual and reproductive health, disordered eating, reproductive endocrinology, depression and anxiety, substance use, as well as pubertal growth and development. Students will also attend teaching conferences in the Department of Pediatrics at Boston Medical Center when this does not conflict with clinical experiences. This may include, but is not limited to: Noon Conference, Case of the Week, and Grand Rounds – in addition to adolescent specific education sessions as part of the BCRP Keystone block.
Students will receive timely feedback from providers as well as formative feed back at the mid-clerkship evaluation to assess their progress in developing the below skills. At the end of the elective, the student will be expected to complete an evidence-based presentation as outlined below, and will have gained the following skills:
• To conduct an age and developmentally appropriate interview
• To council adolescents regarding common psychosocial concerns, including but not limited to reproductive health, substance use and mental health
• To come up with appropriate treatment plans for common adolescent concerns.
Student must contact Dr. Coles prior to the first day of the elective to review schedule and arrange for a brief orientation and discussion about issues related to care of the complex adolescent patient.
Adolescent Medicine Elective additional information
053.33 Developmental and Behavioral Pediatrics
Instructor: Audrey Christiansen, M.D.
Contact: Carly Werner Email: Carly.Werner@bmc.org
Number of Students: One
Period to be offered: Blocks 14, 15, 16, 18, 19 and 20
Description of Elective:
The focus of this elective will be on gaining an understanding of normal developmental processes; attachment, autonomy, mother-infant interaction, coping, Piaget’s cognitive theory, temperament. Different types of screening techniques will also be taught; and Denver Developmental Screening Test skills will be practiced.
Structured activities will include supervised consultations, a literature seminar, ongoing child development activities in the Pediatric Department and Division of Developmental and Behavioral Pediatrics and participation in the various clinics.
Flexibility in the elective exists for those who wish to gain some experience with children with specific developmental problems, e.g., learning disabilities, prematurity, and in utero substance exposure.
054.3 Pediatric Gastroenterology
Instructor: Claudio Morera, M.D.
Location: Boston Medical Center
Contact: Carly Werner Email: Carly.Werner@bmc.org
Fax: 617-414-5599
Number of Students: One (One BU 4th year medical student)
Period to be Offered: All blocks except 14 and 16
Please email Dr. Morera (claudio.morera@bmc.org) the week prior to the start of the rotation to confirm where and when to meet on the first day of the rotation.
Prerequisites: successful completion of 3rd year general pediatrics core clerkship
Description of Elective:
The pediatric gastroenterology elective is an opportunity for students to learn to recognize and manage common gastrointestinal disorders in children (ages birth to 22 years) including: abdominal pain, constipation, chronic diarrhea, recurrent vomiting, hematochezia, hematemesis, failure to thrive, abnormal liver function tests, etc. The majority of the student’s time will be spent in the outpatient GI clinic. The student will be assigned to evaluate patients with an attending during a clinic session, with increasing independence after he/she demonstrates competency in obtaining the core elements of the history and physical exam. Through this experience, students will gain familiarity with both the initial work-up as well as the long-term management of patients with both acute and chronic illnesses as mentioned above. The student will learn the initial approach for new patients as well as long term management of chronic illnesses. The student will also attend endoscopy session one or two morning a week, and will learn the indications for procedures, exposure to normal and abnormal findings, and post-operative care.
When there are pediatric GI inpatient consults, the student will be responsible for evaluating and then presenting the new consultations during daily rounds. The student will follow these patients throughout their admission, writing progress notes, reviewing relevant radiologic imaging and finding related journal articles to augment his/her understanding of each patient’s gastrointestinal disorder. The student will present relevant journal articles during rounds, communicate consultant recommendations to the floor team and reference applicable material learned in their daily progress notes.
Pediatric Gastroenterology Elective additional information
056.3 Pediatric Infectious Diseases
Instructor: Ellen R. Cooper, M.D.
Location: Boston Medical Center
Contact: Carly Werner Email: Carly.Werner@bmc.org
Number of Students: Two
Period to be offered: One month- All blocks except 10
Description of Elective:
The course is designed to assist the student in developing expertise in the diagnosis and management of pediatric infectious diseases with emphasis on the clinical pharmacology of antimicrobial agents and newer modalities of diagnostics.
The student will participate in the activities of the pediatric infectious disease group at Boston Medical Center, including in-patient consultation, daily rounds, and conferences. Experiences will include viral, bacterial, and fungal diagnostic labs, as well as Infection Control. Students will have an opportunity to attend Pediatric HIV and International Health Clinics. Students will be evaluated on the basis of their participation in rounds and conferences and one clinical presentation to members of the division at the end of the month
057.3 Sub I – Neonatology
Instructor: Ruby Bartolome, M.D.
Location:Boston Medical Center
Contact: Carly Werner Email: Carly.Werner@bmc.org
Number of Students: Two
Period to be offered: One Month – All blocks
Description of Elective:
The student participates in the work-up and care of high risk babies from the time of their delivery through their NICU course. The Sub-I pre-rounds and examines their patients in preparation to present these patients during morning work rounds. The student formulates a care plan with the NICU staff and carries out that plan. Sub-I’s participate in procedures, discharge planning and family meetings. Time is available for the student to read in depth about perinatal medicine and to participate in seminars with house staff and senior staff.
Note: This elective satisfies the subinternship requirement
058.0 Pediatric Cardiology
Director: Rachel Thompson, M.D.
Location: Children’s Hospital, Dept. of Cardiology
Children’s Hospital Contact: Emily Morabito email: emily.morabito@childrens.harvard.edu
Telephone: 617/355-7655
Number of Students: One
Period to be offered: One Month – All blocks (the student must apply for the elective at least 2 months in advance of the start date)
Description of Elective:
One student will be a member of the cardiology consult team, and will assist in the evaluation, screening and management of patients with known or potential cardiac disease. The student will write initial consult and follow-up notes. Students may explore specialty consult services (e.g., adults with congenital heart disease, cardiac transplantation) for a portion of their rotation. Students are expected to improve ones consultation skills, read pediatric EKG’s, and attend an array of didactic sessions covering a wide range of topics in pediatric cardiology. No call is required.
058.1 Advanced Pediatric Nutrition
Instructors: Carine Lenders, M.D., M.S.,Sc.D.; Kate Donovan, M.S., R.D., L.D.N.; Sarah Gurney, R.D., L.D.N.
Lauren Berard, RD, LDN; Kara Choiniere, RD; Catherine Fanning, MS, RD, LDN; Latchman Hiralall, DTR; Bernadette Levesque, MD; Mary Mitchell, RD; Jessica Perelli, RD; Emily Sylvester, MS, RD, LDN, IBCLC; Margot Tang, MD; Ilene Torchia, RD; Elizabeth Yellen, MD
Location: BMC-Department of Pediatrics
Contact: Carly Werner Email: Carly.Werner@bmc.org
Number of Students: One per block
Period to be offered: Blocks 10, 13, 14, 15, 16, 19, 20 and 21 (the student must apply for the elective at least 1 month in advance of the start date)
Description of Elective:
The U.S. Preventive Services Task Force recommends that physicians provide nutrition counseling and referral as a standard part of their practice and as a strategy for primary prevention of disease. The Pediatric Department at Boston Medical Center serves a diverse and underserved inner city population with high rates of nutritional related diseases including vitamin D and iron deficiencies, failure to thrive, failure to initiate or continue breastfeeding, and overweight / obesity. The purpose of this evidence-based elective is to increase the nutrition knowledge, attitudes and counseling skills of medical students through hands-on, case-based training in pediatric nutrition and weight management, as well as participation in pediatric nutrition conferences and projects.
Students will have the opportunity to work with dietitians, physicians, mental health providers, and lactation consultants, individually and within multidisciplinary teams. They will be exposed to the nutritional management of patients who are enrolled in a variety of programs including the Pediatric Nutrition Support Service, the Nutrition and Fitness for Life (NFL) program, the Grow clinic, Baby Steps, the Pediatric Preventive Cardiology clinic, the Pediatric Endocrine clinic and the Pediatric GI clinic. Students will also have access to other programs based on their specific interests including the Baby Cafe, the Preventive Food Pantry, and the Teaching Kitchen.
While a majority of their time will be spent in clinic, students will also have outside reading and web-based modules, complete a project, receive 1-on-1 lectures based on their interests, and attend case series, grand rounds and nutrition seminars.
Objectives of the elective:
1.To take an appropriate patient medical and nutritional history and to conduct an appropriate physical exam which includes assessment of growth and development and signs of nutritional deficiency and excess
2. To evaluate the patient’s diet and lifestyle behaviors
3. To summarize recommendations from medical societies and national guidelines for breastfeeding, healthy nutrition, vitamin D and iron supplementation
4. To order appropriate tests to assess and manage the patient nutritional status
5. To identify nutritional treatment and lifestyle modifications needed in both health and disease states
6. To counsel patients and families using techniques that are literacy and culturally competent and take into account level of motivation and readiness to change
7. To refer to appropriate specialists including physicians, registered dietitians, behaviorists, and other healthcare professionals as well as to community programming as appropriate
8. To learn how to collect and interpret nutritional data
059.0 Pediatric Complex Care
Course Directors: Kathleen Huth, MD, MMSc (Course Co-Director, On-site Director Boston Children’s Hospital), Rachel Thompson, MD (Course Co-Director, BMC)
Location: Boston Children’s Hospital
Contact:
For Onboarding at BCH:
Emily Morabito (onboarding)
Administrative Associate II, Boston Children’s Hospital
Tel: 617-355-8635 | Fax: 617-730-0469
Emily.Morabito@childrens.harvard.edu
For Course Registration at CAMED:
Contact: Carly Werner Email: Carly.Werner@bmc.org
Number of Students: This course can enroll one student per block.
Period to be offered: All blocks except 9
DESCRIPTION OF ELECTIVE
Medical students will engage in clinical care in the inpatient and outpatient setting at Boston Children’s Hospital. They will gain experience with different models of care delivery for CMC, including consultative care and primary care for children with special healthcare needs, with a focus on preventative care. There will be opportunities to tailor the elective to specific learning goals related to pediatric complex care; including clinical experiences focused on cerebral palsy, spina bifida, home ventilation, palliative care, and enteral tube care. Students will work closely with members of our interprofessional team including nursing, advanced practice providers, and social work. They will receive dedicated precepting and feedback from complex care attendings and will participate in regular teaching sessions and care coordination activities.
Clinical Hours & Assignments: Expected clinical hours on the inpatient service are anticipated to be Monday to Friday 7:30am- 5:00pm inclusive of educational activities. Outpatient schedule will typically be Monday to Friday 8:00am-5:00pm. In addition to learning through clinical care, students will grow their knowledge through assigned readings and free, online OPENPediatrics modules on the care of CMC. Students will Development and delivery of a brief (15-20 minute) presentation on a clinical or advocacy topic related to the care of children with medical complexity and disability, determined in discussion with the education director.
It is expected that by the end of the elective, students will develop the skills necessary for crafting a general approach to the care of children with medical complexity and an appreciation for their professional role in caring for CMC in partnership with the care team, including patients and families. Student attainment of these skills will be assessed through real-time feedback to the student and shared with the course director. Students should aim to see, discuss, or read about the following clinical presentations:
- Spasticity or dystonia
- Sleep difficulty
- Chronic respiratory insufficiency
- Sialorrhea
- Dysphagia
- Gastrostomy or gastrojejunostomy tube dependence
- Chronic constipation
- Low bone mineral density
- Global developmental delay
059.1 Pediatric Latino Patients: Language, Sensitivity and Cultural Immersion
Instructor: Claudio Morera, M.D.
Location: Boston Medical Center
Contact: Carly Werner Email: Carly.Werner@bmc.org
Number of Students: One per block
Period to be Offered: All blocks except 14 and 16
Description of Elective:
This pediatric-focused elective is an opportunity for students to improve their medical knowledge of pediatric medical issues, deliver pediatric primary, and improve their medical Spanish knowledge in this population. The majority of the student’s time will be spent seeing patients in the outpatient pediatric clinic at BMC with attendings who are Spanish-speaking and/or Spanish-speaking Latino origin that have a significant proportion of patients whose primary language, either for them or their parents, is Spanish. These clinics may include, but are not limited to the following pediatric settings: Gastroenterology, Neurology, Infectious Disease, Endocrinology, and Primary Care.
The student will learn the initial approach for new patients as well as long-term management of chronic illnesses in the designated clinical settings. Discussions with faculty around patient care will focus both on medical management in general, but also with specific attention to elements of the social and cultural influences that affect the quality of medical services and treatment and that can enhance health outcomes for the patient and family. As a clinician, the student will develop skills of more culturally sensitive care both through observation of the approach of the experienced physicians and through active practice and feedback.
Complementing the clinic experience and exposure to medical Spanish, the course will have a series of literature discussions developed to cover diverse elements of Spanish-speaking patients and Latino health, cultural awareness and sensitivity, as well as care of patients with limited English proficiency.
Students interested in the elective should have a working proficiency of spoken Spanish with capability of, at a minimum, interviewing the patient, gathering pertinent information and performing a pertinent physical exam. Students lacking this level of fluency may enroll in the elective, but should have comprehension of spoken Spanish sufficient to follow the interview and interaction in Spanish between the care provider and the patient. For those interested in receiving attestation of their language proficiency to adequately interview patients in Spanish through the Hospital Interpreter Services an evaluation can be arranged beforehand for such attestation
059.3 Pediatric Neurology
Course Director: Patrick Mabray, M.D.
Location: Boston Medical Center, Shapiro 8C
Contact: Carly Werner Email: Carly.Werner@bmc.org
Number of Students: One
Period to be offered: All blocks
Description of Elective:
The student will be immersed fully into the Pediatric Neurology team, constituted by Pediatric Neurology and Adult Neurology residents, rotating Pediatrics residents, and one of the staff physicians. This elective provides an opportunity to participate in all inpatient and outpatient activities of the Division of Pediatric Neurology. Students will obtain histories and examine patients seen in clinics, on the wards and in the nurseries, and will then present the case to staff. The staff will provide “hands on” instruction in neurological examination and in clinical management. Additionally, there are weekly Neuroradiology rounds at which cranial and spinal magnetic resonance imaging, cranial computerized tomography, and cranial ultrasound imaging studies are reviewed. EEG rounds are held bi-weekly. Each Friday, 2 hour-long academic sessions are held. The first portion of these Pediatric Neurology Grand Rounds include, on a rotational basis, Journal club, research topics, didactic presentations, case reviews with attending physicians, and topics in psychopharmacology. A live patient presentation and discussion of the child’s neurological disorder by a member of the Pediatric Neurology Division occurs during the second hour as the case of the week. In the course of the month, the student is expected to identify a topic to research in-depth and to present the topic as a 20 minute presentation near the end of the elective. The elective is ideally suited for the student who is interested in pediatrics. Prior completion of the CAMED rotation in adult neurology is not required.
059.33 Child Abuse Pediatrics Elective
Instructors: Genevieve Preer, M.D., Elizabeth Egan, MSW, MPH and Taneequa Fields, MSW
Location: Yawkey Ambulatory Care Center – 6th Floor
Contact: Carly Werner Email: Carly.Werner@bmc.org
Number of Students: One
Period to be offered: Blocks 14 and 21
contact department regarding availability
Description of Elective:
The Child Abuse Pediatrics Elective is an opportunity for a 4th year medical student to gain exposure to child physical abuse, child sexual abuse, and child neglect in the Emergency Department, Primary Care, and Pediatric Inpatient settings. The elective will take place primarily at Boston Medical Center, but the student will also have various placements throughout Boston and the surrounding areas. Students are expected to work at least 40 hours per week, with most of that time being one-on-one with attending physicians, social workers, and other members of the multidisciplinary team as dictated by case load and availability during the rotation. Students will spend at least 20 hours per week in clinical placements with a minimum of two 8-hour ED shifts and one 4-hour well child clinic per week. Students will learn to communicate effectively with families regarding the sensitive issues surrounding child abuse pediatrics, while maintaining a high ethical standard, compassion, and respect for all members of the family. Students will work directly with CPT staff during 51A filings and during weekly case review so as to educate the student about the information required, the basic ethical and legal frameworks, and the specific process of filling. The student will also attend standing case review and multidisciplinary meetings throughout the month and will participate in other related activities outside Boston Medical Center. It is expected at the conclusion of this elective that the student will have an understanding of the variety of ways in which child maltreatment can present in pediatric settings, and begin to develop a repertoire of skills for approaching clinical situations in which child maltreatment is suspected.
059.4 Pediatric Internship Prep Course
Course Director: Rachel Thompson, M.D.
Location: Boston Medical Center
Contact: Carly Werner Email: Carly.Werner@bmc.org
Length of Elective: 2 weeks
Period to be Offered: first two weeks of Block 19 (3/11/24-3/24/24) academic year 2023-2024; first two weeks of Block 20 (3/10/25-3/23/25) academic year 2024-2025
Description of Elective:
This elective will prepare students who are planning to enter a Pediatric Residency. It is designed to build specific skills and knowledge to facilitate the transition from medical student to intern. Students will participate in small group activities and didactic learning (see the Curriculum section for specifics). These will take place in the Boston Medical Center Simulation Center (for procedural/simulation sessions) and the Boston University Chobanian & Avedisian School of Medicine (for classroom learning sessions). CAMED IV students will be oriented to the elective on the first day of the rotation during a formal orientation session with the course directors.
The expected teaching contact hours will be approximately 9a-5p on weekdays. There will be no weekend activities.
The sessions will include a mixture of case-based, small-group classroom learning, as well as hands-on simulation and procedural sessions led by content-expert faculty members and procedurists. There will be no direct patient contact.