Day in the Life: Outpatient Pediatrics

Happy Monday, and welcome to Medical Mondays! Ready to hear about my first rotation as a senior resident/second-year family medicine resident?! Well, even if you’re not, it’s happening, so here we go (hello, outpatient pediatrics!)!

I should preface that I always feel a tad soul-less whenever I’m on pediatrics/obstetrics rotations. If ever there was a rotation where I had to “fake it til I make it,” it’d definitely be OB, but inpatient pediatrics definitely gave it a run for its money.

The thought that run through my head most often?

I am so, so glad I don’t have kids.

Day in the Life: Outpatient Pediatrics

My outpatient pediatrics rotation was located at a Federally Qualified Health Center down the street from my office, and since I generally walk everywhere I can, this was no different! I would usually be scheduled at my own office in the mornings and here in the afternoons, although it did flip every now and then.

7:40am-1pm

I’d see my own patients during this chunk o’ time! We’ve shuffled our desks around and I share mine with one of the interns now. I’ve stocked my shelf with snacks so our after-hours note-writing parties (I make them sound so fun–they’re really not) are more bearable.

On Wednesday and Friday mornings, the schedule changes a bit in the sense that I have my usual morning report (lectures) at the Medical Education Building before going to the office to see patients.

As I mentioned before in the last coffee date, we’ve had our patient load increased in order to get us closer to “real world” status of seeing 10-15(?) patients in a half-day session. I’m strongly hoping that I end up in a practice somewhere where I get to spend a little more time with my patients, but we shall see. ;_;

Cases have been ranging everywhere from pap smears to pre-participation sports physicals to chronic nausea (1.5 years o_o) to hospital follow-ups. And also insomnia. For two weeks straight, I had patients coming in for insomnia requesting medications that were inappropriate/ineffective for them, both of which resulted in me having to call my preceptor into the room.

The first one threatened to assault my preceptor and my nurse, then tried to get my preceptor to leave so he could talk to me alone…and the second one broke down into hysterical tears and I ended up in the room for another hour trying to explain our reasoning/console her. Ah, life!

1pm-5pm

I’d usually try to start walking at 12:55pm but would get stopped up by something/someone every now and then. I made it there on time most days though, and my rotation supervisor + other attendings were very understanding.

Like Family Medicine, Pediatrics is another rotation where people honestly should be pretty darn nice (after all, you’re dealing with a whole ton of kids!), so it was a pleasant work environment–everyone was super friendly, receptive to questions, and would show me great resources that helped me when I saw kids at my office too.

I’d usually work with 1-2 attendings and see half or a little over half their patients, although partway through my month-long rotation, I started feeling somewhat tired (and not gonna lie, also slightly miffed). I thought it was somewhat unfair that I’d be seeing 7/12 patients in one session while the other resident and student split the remaining 5, but I chalked it up to getting more exposure/experience and also slowed down a bit so it got more manageable.

The cases I came across in peds included the following:

• Newborn visit
• Weight checks
• 1 month, 2 month, 4 month, 6 month, 9 month, 12 month, 15 month, 18 month, 24 month, 3yo-17yo well child checks
• Follow-ups on obesity, hospitalizations, UTIs, etc.
• Birth control counseling
• Contact dermatitis, viral rashes, scabies, bug bites
• Unwillingness to toilet train, picky eating, and other behavioral problems

Twas interesting, to say the least, but also rather draining. Over half our patients were Spanish-speaking only, and I unfortunately barely speak any (I cannot hold even the most basic of conversations). Thankfully, we had community interpreters and phone interpretation services, but those visits still took a lot longer. Given my experience as an interpreter in the past, it’s still a little weird to be on the other side of it now, but I try to keep in mind the things that I felt would’ve been helpful when I was an interpreter!

• Do you remember going to your pediatrician when you were little? 
• Check out previous Day in the Life’s!