Pediatrics Preceptorship

In the second year, we have four pediatrics preceptorships to help us learn to communicate with children and their parents, conduct the well-child exam, and familiarize ourselves with common pediatrics issues. I am working with an attending at the Oakland Children's Hospital ER. It's certainly a very educational environment, quite different from a standard primary care pediatrics office. It's fast paced, very intense, and there's a mix of both acute emergencies and less severe cases. I've learned to deal with the bawling baby, the overprotective parents, the family that speaks only Spanish. I've learned to take the indirect history, plot a growth chart, do a rapid strep test, distract babies, read X-rays. During my first two sessions, I've seen two Down syndrome children (quite unusual), several respiratory distress or asthma patients, a few broken bones and sports injuries, a school-induced pink eye visit.

I love children; they're fun, cute, generally healthy, curious, and excited. Most of the patients I've seen have been elementary school or younger and that demographic is just fantastic (I'm not so sure about teenagers). However, there are aspects to pediatrics (or perhaps peds EM) that I don't appreciate: the difficulty in dealing with parents who insist on antibiotics or resist vaccination, the unruly child who no one can control, the sudden mood swings and immaturity of kids trying to get their way. You also have to watch out for cases of abuse and things like that. The emergency department is interesting; it's not as scary as I would think, but it can get very busy.