Pediatrics
TITLE:
PED GASTRO, HEPATO & NUTRITN -ICE
Students will participate in the assessment and management of pediatric patients with gastrointestinal tract diseases in both in and out-patient settings. The nutrition requirements of healthy and ill infants and children will also be a focus. Relevant diagnostic and therapeutic tests will be discussed.
PREREQUISITES:
26961373 (PEDIATRICS CORE CLKSP)
Students may meet with Dr. Mallon at the beginning of the rotation. Please contact Jackie Sweeney (jacquelyn.sweeney@cchmc.org, 513-636-8015) one month ahead of the start of the rotation to ensure your schedule is created. Students will participate on inpatient Gastroenterology Consult team for at least 1 week, typically 1/2 of the rotation.
To meet ICE requirements, must be taken in one 4 week consecutive block. Cannot take for 8 weeks to fulfill ICE requirements.
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GENERAL INFORMATION
INTERNATIONAL VISITING:
NO
GRADED:
Honors/High Pass/Pass/Fail
COURSE QUALIFICATIONS:
ICE
STATUS:
Full-Time
OFFERED AS FULL-TIME AND PART-TIME:
NO
ALLOWS OVERLAP:
NO
COURSE LENGTH:
2 week or 4 week electives, requiring 40 hours per week
DIRECTOR:
Daniel Mallon, MD
daniel.mallon@cchmc.org
ADMINISTRATIVE SUPPORT PERSON:
Mimi Pence
Mimi.Pence@cchmc.org
513-636-0339
Kasota Building, 7th Floor at CCHMC, BN7.722
SITE(S):
CCHMC - Cincinnati Children's Hospital
CCHMC - Liberty Campus
CCHMC - Mason
ROTATIONS:
Rotation |
Dates |
Max |
1 |
05/06/2024 - 05/17/2024 |
1 |
1 |
05/06/2024 - 05/31/2024 |
1 |
1 |
05/20/2024 - 05/31/2024 |
1 |
2 |
06/03/2024 - 06/14/2024 |
1 |
2 |
06/03/2024 - 06/28/2024 |
1 |
2 |
06/17/2024 - 06/28/2024 |
1 |
3 |
07/01/2024 - 07/12/2024 |
1 |
3 |
07/01/2024 - 07/26/2024 |
1 |
3 |
07/15/2024 - 07/26/2024 |
1 |
4 |
07/29/2024 - 08/09/2024 |
1 |
4 |
07/29/2024 - 08/23/2024 |
1 |
4 |
08/12/2024 - 08/23/2024 |
1 |
5 |
08/26/2024 - 09/06/2024 |
1 |
5 |
08/26/2024 - 09/20/2024 |
1 |
5 |
09/09/2024 - 09/20/2024 |
1 |
6 |
09/23/2024 - 10/04/2024 |
1 |
6 |
09/23/2024 - 10/18/2024 |
1 |
6 |
10/07/2024 - 10/18/2024 |
1 |
7 |
10/21/2024 - 11/01/2024 |
1 |
7 |
10/21/2024 - 11/15/2024 |
1 |
7 |
11/04/2024 - 11/15/2024 |
1 |
8 |
11/18/2024 - 11/29/2024 |
1 |
8 |
11/18/2024 - 12/13/2024 |
1 |
8 |
12/02/2024 - 12/13/2024 |
1 |
9 |
12/16/2024 - 12/27/2024 |
1 |
9 |
12/16/2024 - 01/10/2025 |
1 |
9 |
12/30/2024 - 01/10/2025 |
1 |
10 |
01/13/2025 - 01/24/2025 |
1 |
10 |
01/13/2025 - 02/07/2025 |
1 |
10 |
01/27/2025 - 02/07/2025 |
1 |
11 |
02/10/2025 - 02/21/2025 |
1 |
11 |
02/10/2025 - 03/07/2025 |
1 |
11 |
02/24/2025 - 03/07/2025 |
1 |
12 |
03/10/2025 - 03/21/2025 |
1 |
12 |
03/10/2025 - 04/04/2025 |
1 |
12 |
03/24/2025 - 04/04/2025 |
1 |
13 |
04/07/2025 - 05/02/2025 |
1 |
NOTE: If a rotation is offered in both 2 and 4 week slots, the max capacity is limited to the actual spots offered for the 4 weeks. (ie: the 2 week rotations listed share the max of the 4 week rotation)
WORKING HOURS:
8:00a.m.- 5:00 p.m. Monday - Friday
REPORT 1ST DAY:
You will receive an email with detailed information prior to the elective or contact Jackie Sweeney, 636-8015.
If scheduled on consults, please report to the A4 work room, near the vending machines directly opposite the A elevators on the 4th floor.
If assigned to clinics, please see your schedule to report to the appropriate location (usually C2 multidisciplinary clinic, Mason outpatient (location A), Liberty 3rd floor clinics).
INSTRUCTION
LEARNING ACTIVITIES:
- Case-Based Instruction/Learning
- Clinical Experience - Ambulatory
- Clinical Experience - Inpatient
- Conference
- Demonstration (description, performance, or explanation of a process, illustrated by examples, observable action, specimens, etc)
- Patient Presentation--Faculty
- Patient Presentation--Learner
- Research
- Self-Directed Learning (Learners take initiative for their own learning; diagnosing needs; formulating goals; identifying resources; implementing appropriate activities; and evaluating outcomes.)
LEARNING ENVIRONMENT POLICIES:
UCCOM strives to provide medical students with a learning environment that is conducive to their professional growth. All UCCOM and visiting medical students are encouraged to review the Student Handbook.
The Office of Student Affairs and Admissions is available to all UCCOM and visiting medical students to discuss any concerns/questions related to the learning environment. Please call 558-6796 to access faculty/staff that can assist you.
TEACHING:
60% |
Attending Physician |
10% |
Other Allied Health Professional(s) |
30% |
Fellow Physician |
ASSESSMENT:
Students will be assessed through direct observation of clinical skills, communication skills (verbal and written notes), professionalism, engagement and proactive self-directed learning. Students should read review articles, uptodate entries, and other readings following their interest, guided by the patients they are caring for, and share their learning with the team. Students should be seeing new consult patients and staffing with fellow and attending. Students should be seeing clinic patients independently, or shadowing, according to the needs of the patient and schedule. Students should be writing notes on patients they are directly caring for.
ASSESSMENT METHODS:
Clinical Performance Rating/Checklist
FINAL GRADE:
GRADE ASSIGNED BY:
Course director
OBJECTIVES
Curricular Resources :
- Pediatric Gastrointestinal and Liver Disease - Wyllie, Hyams, Kay
-
Liver Disease In Children - Suchy, Sokol and Balistreri
-
Curbside Consultation in Pediatric GI: 49 Clinical Questions - Rosh, Bousvaros
- Pediatric Gastrointestinal Disease - Walker et al
- UpToDate
- Bowel Sounds, the Pediatric GI Podcast
Instructional Methods:
- Students typically will be assigned to 1/2 of the weeks of the rotation on the GI consult service, which consists of a GI fellow and GI attending, and the student will actively engage in patient care, follow patients longitudinally. The other half of the rotation is typically spent in a variety of general gastroenterology clinics and subspecialty clinics like Hepatology/Transplant, IBD, NASH/Obesity, Celiac, Eosinophilic disorders, Intestinal Rehab, etc, or a dedicated 1/2 day in the OR observing procedures.
- Students are encouraged to share individual goals with their fellows and attendings on consult service and ensure they receive goal-informed feedback at the end of each week on consults.
- Students are encouraged to go to procedures (Endoscopies and Radiological tests) with any patient on the consult service, especially those they are following.
- Specialized Lumen Conference take place respectively on Wednesdays at 12:00. GI grand rounds occurs Wednesday mornings at 7:30am. Students should attend either Pediatric Resident Morning Report, Pediatric Noon Conference, or the GI conferences on these days.
- Radiology Rounds take place the first Friday of the month at 07:30 am in the Radiology Conference Room (A building). Student attendance encouraged.
Knowledge/Skills:
1. Demonstrate familiarity with the evaluation (including history & physical exam) and management of pediatric age patients with complaints referable to gastrointestinal tract including diseases of:
a. esophagus
b. stomach
c. small intestine
d. colon
e. liver
f. gall bladder
g. pancreas
2. Know the indications and contraindications for common gastrointestinal procedures.
3. Demonstrate familiarity with nutritional requirements of healthy and ill infants and children and teach methods to attain these goals.
4. Recognize cost containment opportunities.
Main Course Topics :
- · Clinical evaluation of GI
symptoms in children
- · Surgical assessment of
the child’s abdomen
- · Evaluation of liver
disease in the pediatric patient
- · Neonatal cholestasis
- · Clinicopathologic
features of biliary atresia
- · Intrahepatic cholestasis
- · Inherited metabolic
diseases of the liver
- · Viral hepatitis in
children
- · Inflammatory bowel
disease
- · Chronic recurrent
abdominal pain
- · Constipation in children
- · Constipation in infants
and children
- · Evaluation and treatment
of GERD in infants and children
- · Gastritis/Peptic acid
disease
- · Allergic disorders of the
GI tract
- · Ulcers and GER
- · Failure to thrive –
Post-natal onset
- · Management of acute and
chronic infantile diarrhea
- · Treatment of severe
malnutrition
- · The refeeding syndrome: a
review
- · Short gut syndrome
- · Obesity
- · Pancreatitis
- · Career planning for
pediatric residents
Remediation Plan:
Remediation may include self-directed assignments, or referral for additional skills training if available through UCCOM.
SAMPLE WEEK
Monday:
8:00AM |
12:00PM |
GI Consults/Procedures OR GI/Liver Outpt clinic |
12:00PM |
1:00PM |
Pediatrics Noon Conference |
1:00PM |
5:00PM |
GI consults/procedures/reading OR GI/Liver clinic OR observe procedures |
Tuesday:
8:00AM |
9:00AM |
Pediatric Grand Rounds |
9:00AM |
12:00PM |
GI Consults/Procedures OR GI/Liver Outpt clinic |
12:00PM |
1:00PM |
Pediatrics Noon Conference |
1:00PM |
5:00PM |
GI consults/procedures/reading OR GI/Liver clinic OR observe procedures |
4:00PM |
5:00PM |
Reading |
Wednesday:
7:30AM |
8:30AM |
GI Grand Rounds |
8:30AM |
12:00PM |
GI Consults/Procedures OR GI/Liver Outpt clinic |
12:00PM |
1:00PM |
Weekly lumen meeting |
1:00PM |
5:00PM |
GI consults/procedures/reading OR GI/Liver clinic OR observe procedures |
4:00PM |
5:00PM |
Reading |
Thursday:
8:00AM |
12:00PM |
GI Consults/Procedures OR GI/Liver Outpt clinic |
12:00PM |
1:00PM |
Pediatrics Noon Conference |
1:00PM |
3:00PM |
GI Consults/Procedures OR GI/Liver clinic |
3:00PM |
5:30PM |
GI Academic Conferences (Fellows' conference, Pathology, Med/Peds) |
Friday:
8:00AM |
12:00PM |
GI Consults/Procedures OR GI/Liver Outpt clinic |
12:00PM |
1:00PM |
Pediatrics Noon Conference |
1:00PM |
5:00PM |
GI consults/procedures/reading OR GI/Liver clinic OR observe procedures |
SCHEDULE NOTE:
- Students typically will be assigned to 1/2 of the weeks of the rotation on the GI consult service, which consists of a GI fellow and GI attending, and the student will actively engage in patient care, follow patients longitudinally. The other half of the rotation is typically spent in a variety of general gastroenterology clinics and subspecialty clinics like Hepatology/Transplant, IBD, NASH/Obesity, Celiac, Eosinophilic disorders, Intestinal Rehab, etc, or a dedicated 1/2 day in the OR observing procedures.
- Students are encouraged to go to procedures (Endoscopies and Radiological tests) with any patient on the consult service, especially those they are following.
-
Specialized Lumen and Liver Conference take place respectively on Wednesdays at 12:00, and Thursday at 11:30, for an hour each. Students are encouraged, but not required to attend
-
Radiology Rounds take place the first Friday of the month at 07:30 am in the Radiology Conference Room (A building). Student attendance encouraged.
ATTENDANCE AND ABSENCE POLICY
Session Attendance for M4 Students
- Students may miss no more than two days of planned excused absences on a four week rotation without being required to make-up the work, at the discretion of the clerkship/elective/course director or his/her designee.
- Non-AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the clerkship director to best align with the site schedule. Students may request to schedule 1 or more of these 4 days for planned absences that fall under 1 of the categories listed below for excused absences during non-AI rotations, in consultation with the course/elective director, who may or may not approve such planned absences.
- AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the course director to best align with the site schedule. Students may request to schedule 1 or 2 of these days for planned absences that fall under 1 of the categories listed below for excused absences during AI rotations, in consultation with the course director, who may or may not approve such planned absences. Students must avoid scheduling Step 2 examinations during an Acting Internship.
- Excused Absences - The following will be considered excused absences:
- Diagnostic, preventative, and therapeutic health services (e.g. doctor appointments, physical therapy, counselling, etc).
- Personal illness, accident or a major catastrophic event
- Death or serious illness of immediate family members. Immediate family members, as defined by UC, are Grandparents, Brother, Sister, Brother-in law, Sister-in-law, Daughter-in-law, Son-in-law, Father, Mother, Mother-in-law, Father-in-law, Step-sister, Step-brother, Step-mother, Step-father, Spouse or domestic partner, Child, Grandchild, legal Guardian or other person who stands in place of parent (in Loco Parentis)
- Whenever possible, planned absences should be requested a minimum of six weeks in advance of the start of the clerkship/elective/course in which the absence will occur; this enables the clerkship/course/elective to help plan for educational event scheduling (e.g. a known appointment could be scheduled around with enough notice and the student might not have any required coursework to make up). Absences requested less than 1 week prior to the planned absence may not be considered for a possible excused absence unless extenuating circumstances prevented the student from providing timely notification per the policy. Students should first submit their request for a planned absence to the clerkship/elective/course director using the online MSSF. All planned/excused absences for any reason should be documented on the MSSF.
- The COM abides by the UC Religious Observance Policy that respects the religious diversity of its students by providing opportunities, where possible, for accommodation in cases where conflicts exist between students’ religious beliefs/practices and educational activities. In clinical settings, such accommodations must honor the primacy of a commitment to patient care and avoid unduly burdening faculty, staff and the general student population involved in the affected educational and/or patient care activity.
- The following items are explained in detail in the Medical Student Handbook:
- Excused/unexcused/unplanned absence, religious holidays, jury duty, and make-up work
See Attendance and Absences Policy, Religious Observance Policy, Medical Student Handbook.