Let's see...a typical day on Pediatrics. Let me first contrast this with what you may be used to as far as a ped's experience. In my medical school we rotated at a pediatric hospital seeing all the really sick kids with the rare 'boards' diseases. In addition, dehydration assessment, fluid calculations, caloric intake was always a large part of what we performed daily. These were busy rotations, learning a lot of detailed information. However, I learned very little about normal development and was challenged in residency with evaluating otherwise healthy kids with a cough or diarrhea. I had to learn that not everyone has cystic fibrosis or other metabolic diseases.

Here in our pediatric rotation we see a broad spectrum of patients that includes the perfectly healthy infant to the occasional sick kids like the two year old with Ornathine Trascarbamolase (OTC) deficiency. We spend time on the floor with inpatient pediatrics, nursery with predominantly healthy newborns, NICU, and emergency care in the emergency department (not to mention the vast amount of infants in the clinic).

On this particular day I was scheduled in the emergency room from 3p-11p. I was not assigned to round in the morning so had some time to eat breakfast with my family. By midmorning I went into the clinic to catch up on paperwork (since I had taken 2 day's off previously to take the USMLE Step 3). I received a call while at clinic from the OB resident informing me of my clinic patient in the hospital contracting regularly. I told him I was free and would be right up. I took some of my clinic work up to the OB lounge and monitored my patient while doing my work since the OB resident had an emergent twin delivery in the OR.

I attended noon conference which was a discussion on toxicity management in drugs of abuse, and then returned to the OB floor to rupture my patient's membranes. By 1:45, she was feeling a lot of pressure and the urge to push. I called the director on call but baby wasn't waiting, the med student and I delivered a healthy baby boy prior to even getting our gowns on. Delivery went well, newborn care took place in the room and now it was nearly 3pm and time for my scheduled Ped's ED shift.

Initially at 3 pm there were no pediatric patients so I went in on a 57 year old with vaginal bleeding. Once I was out of that room however, I noted another vaginal bleeding in a 4 year old. That turned out to be a labial trauma requiring Ketamine sedation and a repair which I performed before seeing the rest of my evening of peds. Throughout the one evening shift I saw a one month old with continued cough after a pneumonia, one month old with projectile vomiting and possible dehydration, one month old with club feet I had to cut a cast off, 10 year old with a 2 cm laceration on his back, 10 year old with testicular pain, 3 week old with vomiting, a 3 year old with a blood glucose level of 400 and since I was down there I repaired two facial lacerations on an 18 year old and a 4 year old.

These were cases that required a lot of medical decision making. I went home feeling like I had a very fulfilling day, a lot more fulfilling than admitting two or three pediatric patients could bring from my med school peds rotation.

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