Pediatric and Adolescent Medicine -- Neonatology - Rochester

Description:

Students are assigned to the intensive care nursery at Saint Marys Hospital and take part in the activities of the service. These include morning rounds, followed by a brief didactic session, work on the ward, night call at appropriate intervals with one of the residents, and follow-up clinic on Wednesday and Friday afternoons. Students become familiar with the wide range of newborn services used to handle problem deliveries at Rochester Methodist Hospital. There also is the opportunity to gain an understanding of electrolyte balance, ventilatory support, congenital malformations and the problems of premature delivery.

Specific Goals:

1. Acquire the ability to distinguish a newborn infant who is having difficulty from one who is normal.
2. Gain a basic understanding of the pathophysiology of respiratory disease in the newborn period, including respiratory distress syndrome, pulmonary immaturity, pulmonary hypertension and transient forms of respiratory distress, and have some understanding of the use of conventional mechanical ventilation for the support of these conditions.
3. Learn the fluid electrolyte requirements of small premature and term infants.
4. Understand the temperature and environmental support necessary to sustain small premature and term infants.

Activity Outline:

Duties involve working along with the resident as an assistant resident. For suitably qualified, interested individuals, the specific assignment of patients and presentation of those patients on ward rounds is acceptable. Night call generally involves accompanying a resident during his/her usual rotation, usually every three or four nights.

Students attend the general pediatric conference Thursday at noon, as well as Friday morning Grand Rounds. Conferences within the group are less formally arranged but happen frequently.

There are no specific procedures that students must gain experience with, and it is very difficult to program sufficient clinical material to guarantee that students perform certain specific procedures. However, especially toward the end of the academic year when the junior residents have had a great deal of experience, it is possible to yield some of the available procedures to students. For the most part, a resident is the supervisor for these procedures. No specific papers or presentations are required.

Method of Evaluation:

Students are evaluated based on their competence in the basic elements described above, as well as their interest in the field. Availability and presence in the nursery and the ability to seek and accept responsibility when appropriate is the basis for most of the evaluation.