Category Archives: Medical Student

Preparing for Pediatrics ^_^

Assalamu Alaykum! (Peace be upon you all!)

My block’s next rotation starting this month (January) is with the Department of Pediatrics. Yes, the wonderful world of Medicine for the little ones! We will be training in Pedia for a duration of four weeks just like our past rotation (in OB-GYN). It is also among the “Big Four” departments that all medical students must be familiar with in order to, well, pass. But like all other departments that we have been to, what I am really looking forward is learning more about dealing with patients in this department, enjoy my stay in this rotation and see for myself if I will be comfortable with it—you know, for future references.

And with our experiences in Pediatrics for the past two years, whenever I hear the term “Pedia”, the very first thing that would come in mind: There’re too many graphs and charts! This is perhaps the only field of medicine that has so many graphs and charts that one needs to be familiar with in order to survive. Growth charts, weight-for-length chart for boys and girls, BMI-for-age graphs, Childhood immunization schedules, developmental milestones, and they even have a separate BP readings by age!

“Children are not small adults” our professors would always remind us. They are not like adult humans; we cannot treat them the way we treat the adults. They have a lot different physiologic processes that are either absent or are still undergoing maturity compared to an adult human. Thus, taking care of them is pretty much on the more delicate side: we have to look for a lot of danger signs especially in administering medications. Plus, most of them don’t even know yet how to express what they are feeling! (Good luck interviewing a crying 8 month old baby).

Thus, any medical student who will go on training in the field of Pediatrics must really be well-prepared for all these. He must learn how extract information from both the parents and the child if possible. He must be alert and observant in the child’s actions and expressions. He must have a good background of the normal developmental milestones of the child, what is in the normal range and what is not (ha! Good luck to me on that!). And lastly, he must learn how to be child-friendly and don’t scare the hell out of every child he interviews. They say having a toy with you will “make or break” your history-taking. Hmm, now where is that teddy bear of mine? (Just kidding, I don’t own things like that)

Now for the preparations. What an ICC Student must have to prepare for the month long training in Pedia:

1. First in the list is the bible: Nelson’s Pediatrics 19th Edition. 

Nelson Book Pediatrics 19th

It’s up to you if you will buy the book or just get an electronic copy (it’s illegal, isn’t it?). I don’t have the book, so yeah, you already know what I have. You really don’t have to read the book cover to cover (no one have ever done that I am pretty sure). According to the orientation slides I have read, we will only focus on the top 10 Ambulatory Morbidities in the PGH for Pediatrics. On what those are, we will still find out along the way. There will be a lot of Patient preceptorials and SGD’s right after that. So, it is pretty wise to have an electronic copy to sneak in and read some basic concepts on your case while waiting for your preceptor to arrive.

The original book costs around P5,000+ but you can buy it in a cheaper price in Recto (I found one arounf P4100) or in any of the fraternity/sorority book-sales.

Dr. Fe Del Mundo’s Textbook on Pediatrics and Child Health is also another option if you have the luxury of time and money. But it’s pretty hard to find a copy of it. It’s pretty old and I don’t when’s the last time they published a new set of copies. A lot of my friends recommend this though. Don’t expect me to give you a review of this one, haven’t read much on it. 

2. The “Red Book” aka Preventive Pediatric Health Care Handbook 7th Edition (2014) published by the Philippine Pediatric Society. Before our ICC rotations started we were asked if we wanted to purchase these beautiful thing, of course most of us bought their own personal copy. It’s pretty helpful I think, maybe until your own medical career in the future. It costs around P200 (I forgot the original price).

Red book philippine pediatrics 2014
The “Red Book”
Published by the Philippine Pediatric Society

 I have not read all the contents yet. Just scanned through them and I find it very useful because for once all the necessary charts and graphs I have been worried about are attached in the booklet! ^_^ Happiness! I mean, I no longer need to print a separate copy of them all.

Red book pediatrics content growth charts
Colored growth charts for girls
Red book pediatrics content Vaccine immunization child
Childhood Immunzation schedule
Red book pediatrics content
Preventive Pediatric Healthcare recommendations

And look! The book also comes with this Visual Acuity chart for kids 🙂
Wonder if I will be able to use this though

3. The other ICC essentials
We already talked about this in our separate post: The ICC Essentials #link#. Perhaps what would really be useful here are the measuring tapes to measure all those circumferences and lengths of growing limbs and parts of every child patient you meet in the wards.

Tausug pouch medical stuff medstudents
My ICC Pouch ^_^ with a touch of Tausug Piys

medical equipments ICC medstudent
My ICC Stash. Sorry it’s always messy.

 And with the special performance from these two:

4. Pediatric Stethoscope
This one is not really mandatory but very highly encouraged. You’ll, there are things that you can’t hear with your adult stethoscope and a Pedia Steth would really save your day.
Stethoscope for children medstudent
My new Pediatric Stethoscope ^_^

Finally I can use this Pedia Steth my beloved sister gave me 😀 Thanks Inn!

5. Sphyg wit Pedia Cuff
An attachable pedia or infant cuff for your aneroid sphyg will surely be handy. Do not expect to get an accurate BP of your infant patient using your adult cuff! You can buy these awesome things in Bambang (Medical Equipment Center—as I call that place) for about P400 a piece without the aneroid.
BP App, sphyg children pediatric infant
A Child-size Sphyg cuff would really be helpful.

I wonder if I missed anything else? Hmm. For now that would be the things we need in preparation for Pediatrics. Oh yes, I almost forgot this one:

6. An Approachable, child-friendly, non-monstrous face.
Have an approachable smiley faceTry to be as child-friendly as possible. Keep a smiling face whenever you approach a pedia patient. Most of the time they would be shy and scared on your first visit, but when they realized later on that you are harmless and you are there to help them, I am pretty sure the kids will like you and be more comfortable with you. If you are doing well, you would even receive a bonus: a heartfelt smile and “thank you, doc” and a cheerful wave after your stay with them.

Now that we are pretty much “prepared” for the training, what’s next? Simple: Enjoy your learning experience! 🙂

Personal Note: Ahmad, there are a lot of children in Pandami and Siasi and even Jolo who never really had seen any doctors in their whole lives! So you really have to learn a lot from your short stay here so that you can at least give them something in terms of service. And you love kids don’t you? Plus, this rotation will surely be important in your training if you plan on applying for an Off-campus Elective in Pediatrics in Zamboanga (or Sulu). Just do your best. And stop slacking around!

Salam Kasilasa!


The ICC Essentials

Assalamu Alaykum! (Peace be upon you all!)
Heya! Here we go again with the usual “I am sorry it took me so long to post here again” scenario which I believe I should already get rid of (-_-) Starting today! I never even have a “Date published” tags on my posts…so no one would really know how late I am. haha! But kidding aside, I think the dates really doesn’t matter anymore… If I am writing these experiences and maybe some tips for the next ICCs*, the order of each rotation would not matter: for every block (all 8 of them) have different schedules, and perhaps different experiences as well. So I will just write what I have in my journals, keep them short and concise as possible (which I am really poor at by the way), and hopefully pray that someone would stumble on this blog and read it. haha. 
Anyway, continuing our sharing of stories and learning experiences (?) as an ICC student… I see my calendar here that we are now in our 8th week as an ICC student. Cool! It’s December already and we have 2 more weeks to go for the first semester! Yeay!
Which reminds me, I still have a lot of “weeks”, I mean rotations to cover uuggggh! <(-_-)> oh well.
Back to our main topic for today: The ICC essentials. What is different with being an ICC Student or Junior Clerk is that you will now be more exposed to the patients. Most of your days will be spent not in the classrooms, but in the wards monitoring patients’ vital signs; in the Out-patient Department (OPD) interviewing new and follow-up patients; and if lucky or unlucky, you will also be left ALONE to do your directed physical examinations. (I emphasized the word “alone” because the past 2 years we have been used to doing things by group.) And with that big realizations comes the great need to have your own medical equipment and stuffs.
Here are the important MUST HAVES as an ICC Student:
My ICC stuffs (sorry for the quality, just used my phone here)

1) Your own Stethoscope — No need to explain why. You just don’t become a third year medical student without your own stethoscope

2) Aneroid Sphygmomanometer — (we call it “BP App”) Others prefer the digital one. Either way, it is important to have one anytime you go o duty. Just be sure you really know how to use them 🙂 If you are still not sure, better train with your classmates first. Or here’s a tip: ask your patient what’s their last BP before, with that you know where you are supposed to here the Korotkoffs 😉

3) Calculator — You will be asked to do a lot of computations: BMI, Expected Fetal weight, etc. If you are not a math whiz, better bring a calculator where ever you go. Keep it handy (not too big, you are not an accountant! And not too small that you have to use some ultra thin fiber to press on a single number!) These guys are also very helpful during exams.

4) Medical Tapes! (Micropore) — You can’t live in the wards without these! There are expensive ones (P130) and some fake cheap ones (P35) in Bambang. Buy as much as you can. You will eventually see how handy these things are: from taping IV Canulas to labeling your stuffs to even repairing ripped off papers, Micropores will sooner be your favorite thing in the world! (at least in medschool)

5) Measuring Tapes — Ever wonder when is the time that you will use those freebies that your seniors gave you during your freshie days? Well, this is it! Those handy, pull-and-tuck tape measures will surely be put to use in most rotations as OB, Pedia, Orthopedics, even in Ophthalmology!

6) Clipboard! — Same as above, you know you need them.

7) Paper and Pens — Oh come on! don’t tell me I have to explain this one?

OTHERS (you can borrow them from your friends, but it’s better to have one if you can)

1) Thermometer — for the constant monitoring duties. We have digital thermometers now (P50-P75) in Bambang.

2) Penlight — After your Neuro and Ophtha rotation, you are supposed to have your own penlight. But you can always borrow if you forgot to bring them 🙂

3) Neuro Hammer — Don’t forget to bring this one during ROR (Rhemua-Ortho-Rehab), Neuro and even in IM rotations.

4) Tourniquet — You will be asked to extract some blood for laboratories, or insert an IV Canula, or “line” the patient, and a tourniquet is an essential item for that. Yes, you can use your latex gloves if there are really none of these around. But I say it’s better to have one, it’s pretty cheap anyway (P15-20), and makes you look like an IV-lining expert.

5) Pulse Oxymeter — Not really required and it’s kinda expensive. But if you are pretty rich and you feel lazy counting those pulses by the clock, then perhaps this item is for you.

6) Handy Dsinfectants — Be it a 70% solution of Isopropyl Alcohol or a lemon-scented Alcogel, it’s up to you. If not, you can still find a lot of alcohols scattered around the hospital wards (you see them on their alcohol holders attached to the walls). And I am sure there is at least one of your classmates who have one hehe.

NOT REALLY REQUIRED (You can borrow from your friends in other year levels)
  • Ophthalmoscope –during Ophtha rotation, you will be expected to have at least 2 students sharing one Ophthalmoscope. It’s a good investment if you are really planning to proceed to Ophtha.
  • Otoscope — usually comes with the Ophthalmoscope. For ORL duties.
Tadaa! I think those are the essentials that every ICC must have (or at least have an idea of). Being an ICC Student they say is pretty “benign” compared to the Clerks, but I believe this is the year that we should never put to waste. We have to learn as much as we can in preparation for the hellish year we are about to endure next year 🙂 So, get as many patient as you can! Ask as much questions as you can! Learn how to do things in the wards, how things work, which paper to fill in, etc. 

Hmmm Hope this post will serve its purpose 🙂
Salaam! Logging out!
*In case you were wondering what those “ICCs” are… ICC stands for “Integrated Clinical Clerkship” which refers to the group of students in Learning Unit 5 (LU5 or 3rd year proper) of UP College of Medicine. It is the equivalent of “Junior Clerkship” in other Medical schools.