2024-2025 M3/M4 Course Syllabi
Pediatrics
COURSE NUMBER:
16 01 81
TITLE:
PEDIATRIC RHEUMATOLOGY OP -ICE
This elective focuses on providing knowledge of diseases that have not received much attention thus far in your medical school training. The elective will include but is not limited to the principles of musculo-skeletal examination, rheumatologic history, laboratory and X-ray evaluation. An overview of juvenile rheumatoid arthritis, lupus, dermatomyositis, scleroderma and vasculitis in children is presented. Through this elective we hope the student will become familiar with and knowledge of the field of Pediatric Rheumatology. The focus will be on exposure to a variety of Pediatric Rheumatology conditions.
PREREQUISITES:
26961373 (PEDIATRICS CORE CLKSP)

Students must contact Amy Guiot, MD, Medical Student Education Coordinator,
Associate Director, Medical Student Education

Pediatric Hospitalist, Division of Hospital Medicine

Cincinnati Children's Hospital Medical Center

Cell (513) 253-6080
expand all

GENERAL INFORMATION

COURSE YEAR:
M4
CREDIT HOURS:
8
CREDIT WEEKS:
4
DOMESTIC VISITING:
YES
INTERNATIONAL VISITING:
NO
GRADED:
Honors/High Pass/Pass/Fail
COURSE QUALIFICATIONS:
ICE, Outpatient
COURSE TYPE:
Clinical
STATUS:
Full-Time   
OFFERED AS FULL-TIME AND PART-TIME: NO
ALLOWS OVERLAP: NO
COURSE LENGTH:
2 or 4 weeks
DIRECTOR:
Jennifer Huggins, MD
jennifer.huggins@cchmc.org
513-636-8029
, E258
ADMINISTRATIVE SUPPORT PERSON:
Mimi Pence
Mimi.Pence@cchmc.org
636-0339
Kasota Building, 7th Floor at CCHMC, BN7.727
SITE(S):
CCHMC - Cincinnati Children's Hospital
MAX ENROLL:
1 
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:
8:00 a.m. - 5:00 p.m., M-F, (occasionally later)
REPORT 1ST DAY:
Pediatric Rheumatology Clinic Lobby located in Building E level 2 at Cincinnati Children's Hospital Medical Center

INSTRUCTION

LEARNING ACTIVITIES:
  • Case-Based Instruction/Learning
  • Conference
  • Demonstration (description, performance, or explanation of a process, illustrated by examples, observable action, specimens, etc)
  • Discussion-Small Group (Small Group (=12)
  • Independent Learning (Instructor-guided learning activities to be performed by the learner outside of formal educational settings.)
  • Journal Club
  • Lecture
  • Patient Presentation--Faculty
  • Patient Presentation--Learner
  • Problem-Based Learning (PBL)
  • 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:
90% Attending Physician
10% Fellow Physician
FEEDBACK:
ASSESSMENT:
 Participation in Clinic.

ASSESSMENT METHODS:
Clinical Performance Rating/Checklist
Participation
FINAL GRADE:
GRADE ASSIGNED BY: Course director

OBJECTIVES

Curricular Resources :
  1. Petty R and Laxer R, eds.  Textbook of Pediatric Rheumatology, 8th Edition, WB Saunders Co., 2020
  2. Articles provided to all senior students.  (updated periodically based on pertinent new articles)
  3. Murphy K and Weaver C. Janeway's Immunobiology,9th Edition, Garland Science, 2016.
Instructional Methods:
Most of the learning is hands on learning and observation.  There are also several didactic learning sessions.

In the event that in person learning is not possible we have developed a virtual learning course.  Thus, we are always able to offer this course. 
Knowledge/Skills:
The primary objective of this rotation is to familiarize the student with the unique diseases that are seen and treated in Pediatric Rheumatology. To accomplish this objective the student spends most of their time observing and less time obtaining a history and physical on their own.  However, by the end of the rotation the student should be able to:

1. Perform a detailed history and physical examination relevant to patients suspected of having childhood/adolescent rheumatic/ immunologic diseases.
 2. Know the techniques of the common tests used in childhood/adolescent clinical immunology and rheumatology and the interpretation of the results obtained (e.g., ESR, rheumatoid factors, ANA, delayed and immediate skin tests, complement studies, immune complexes, etc.).
3. Be familiar with the fundamentals of the differential diagnosis and management of the major rheumatic conditions/diseases of childhood.                                                                                                  
4. Begin to develop a knowledge base of the basic sciences that relate to immunologic, musculoskeletal and rheumatic diseases.                                                                                                                                 
5. Introduction to the available therapies for the treatment of Pediatric Rheumatic diseases.
Main Course Topics :

1. Rheumatologic history and physical examination
2. Juvenile Rheumatoid Arthritis 
3. Systemic Lupus Erythematosus (SLE)
4. Juvenile Dermatomyositis (JDM)
5. Scleroderma - localized/systemic sclerosis
6. Nonsteroidal anti-inflammatory drugs/methotrexate/corticosteroids - role in treatment/adverse drug reactions.
7. Pediatric Musculoskeletal Pain Syndromes. 
8. Genrealized Hypermobility.                                                                                                                 
9. Vasculitis.                                                                                                                                               
10. Role of Biologics in Pediatric Rheumatic diseases.
11. Uveitis
12. Functional Genomics
13. Auto-inflammatory Syndromes
Procedures:
  1. Know the indications for arthrocentesis and corticosteroid injections.
  2. Display familiarity with utility of musculoskeletal ultrasound.

   No procedures are specifically delegated to the senior students.  The expectation will be that multiple ultrasounds and joint injections will be observed.
Remediation Plan:
 Elective Director's Discretion.

SAMPLE WEEK

Monday:
8:00AM 5:00PM Clinic and Consults
Tuesday:
8:00AM 9:00AM Pediatric Grand Rounds
9:00AM 5:00PM clinic and consults
Wednesday:
8:00AM 9:00AM Clinic and Consults
9:00AM 5:00PM Clinic and Consults
Thursday:
8:00AM 9:00AM Radiology, Immunology or Ultrasound
9:00AM 5:00PM clinic and consults
Friday:
8:00AM 9:00AM Rheumatology Fellows Grand Rounds, 2nd and 4th
9:00AM 12:00PM Clinic and Consults
1:00PM 4:00PM Divisional conferences
4:00PM 5:00PM Sign-out
SCHEDULE NOTE:

Monday

8:00 am - 5:00 pm Rheumatology clinic and inpatient consults

Tuesday

8:00 am - 9:00 am - Pediatric Grand Rounds (Sabin Center 5/3 Aud.)

9:00 am - 5:00 pm - Rheumatology clinic and inpatient consults

Wednesday


8:00 am - 5:00 pm - Rheumatology clinic and inpatient consults


Thursday

8:00 am - 9:00 am - Immunology Class or Musculoskeletal Ultrasound or Radiology Rounds

9:00 am - 5:00 pm - Rheumatology clinic and inpatient consults


Friday

8:00am -9:00 am - Rheumatology Grand Rounds 

9:00 am -12:00 pm - Rheumatology clinic and inpatient consults

1:00 pm - 4:00 pm - Divisional Conferences

4:00 pm - 5:00 pm - Sign-out

 


 

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.




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