Post by Stella on Dec 25, 2007 17:59:48 GMT -5
LOGISTICS
Subspecialty consists of GI, nephrology, and pulmonology. There is a designated Subspecialty team of residents that you'll be working with - one upper level resident and 2 interns. You will be expected to follow at least 2 patients; it might be a good idea to follow 1 patient from each service. The residents round at 7am, so be sure to have your notes written by then. At 8am, everyone goes to Morning Report. Rounds with attendings starts at 8:30am. Since there are 3 services, that means rounding 3 times with 3 different attendings, and it makes things a little more complicated. Whenever you have some downtime after subspecialty rounds, tag along with the general team on their rounds to get some exposure to general peds - it'll be helpful for the shelf exam.
ATTENDINGS
GI - 2 new attendings just joined the GI service this summer; Dr. Lukacik and Dr. Misra. Dr. Lukacik just finished his fellowship so he's still getting used to the swing of things. He always explains his reasoning for using certain drugs or procedures, and he does not ask very many questions. Take advantage and ask him lots of questions! I did not work with Dr. Misra much but he also seems nice.
NEPH - Dr. Ortiz is AMAZING! Whenever there is extra time after rounding, he will give a mini-lecture on various kidney diseases. These mini-lectures are excellent so be sure not to miss them. He does ask questions but it's not malignant, and he is genuinely interested in helping you learn.
PULM - There are 3 attendings: Dr. Hudson, Dr. Guill, and Dr. McKie (the daughter). They are all very nice and always take time to do a little teaching. Ask Dr. McKie to go over the binder with all the images if there's time - it's a great review for the shelf. Dr. Hudson is big on asking you how your CF patients initially presented before diagnosis so just ask the parents when you do the H&P.
WHAT TO KNOW
GI - I only had 1 GI patient the whole time. It was a case of UC, so the only advice I can give is to read up on IBD.
NEPH - You will see lots of nephrotic syndrome, so know about all the different things that can cause it (minimal change, FSGS, etc) and treatment options. Also read about lupus nephritis, renal tubular acidosis, posterior urethral valves, and cystic kidney diseases.
PULM - Most of the pulm patients will be there for CF exacerbation. Read up on CF and be familiar with how to interpret PFT results.
GENERAL IMPRESSION
I had a great time on Subspecialty. I learned a lot about CF and nephrotic syndrome. It was fairly laid back with a good amount of downtime. The most we ever had was 8 patients at one time; however, I have heard that Subspecialty can get really busy sometimes. The only downside is that you have to make an effort to make sure you learn the general peds stuff, but I don't think it really put me at a significant disadvantage for the shelf.
Subspecialty consists of GI, nephrology, and pulmonology. There is a designated Subspecialty team of residents that you'll be working with - one upper level resident and 2 interns. You will be expected to follow at least 2 patients; it might be a good idea to follow 1 patient from each service. The residents round at 7am, so be sure to have your notes written by then. At 8am, everyone goes to Morning Report. Rounds with attendings starts at 8:30am. Since there are 3 services, that means rounding 3 times with 3 different attendings, and it makes things a little more complicated. Whenever you have some downtime after subspecialty rounds, tag along with the general team on their rounds to get some exposure to general peds - it'll be helpful for the shelf exam.
ATTENDINGS
GI - 2 new attendings just joined the GI service this summer; Dr. Lukacik and Dr. Misra. Dr. Lukacik just finished his fellowship so he's still getting used to the swing of things. He always explains his reasoning for using certain drugs or procedures, and he does not ask very many questions. Take advantage and ask him lots of questions! I did not work with Dr. Misra much but he also seems nice.
NEPH - Dr. Ortiz is AMAZING! Whenever there is extra time after rounding, he will give a mini-lecture on various kidney diseases. These mini-lectures are excellent so be sure not to miss them. He does ask questions but it's not malignant, and he is genuinely interested in helping you learn.
PULM - There are 3 attendings: Dr. Hudson, Dr. Guill, and Dr. McKie (the daughter). They are all very nice and always take time to do a little teaching. Ask Dr. McKie to go over the binder with all the images if there's time - it's a great review for the shelf. Dr. Hudson is big on asking you how your CF patients initially presented before diagnosis so just ask the parents when you do the H&P.
WHAT TO KNOW
GI - I only had 1 GI patient the whole time. It was a case of UC, so the only advice I can give is to read up on IBD.
NEPH - You will see lots of nephrotic syndrome, so know about all the different things that can cause it (minimal change, FSGS, etc) and treatment options. Also read about lupus nephritis, renal tubular acidosis, posterior urethral valves, and cystic kidney diseases.
PULM - Most of the pulm patients will be there for CF exacerbation. Read up on CF and be familiar with how to interpret PFT results.
GENERAL IMPRESSION
I had a great time on Subspecialty. I learned a lot about CF and nephrotic syndrome. It was fairly laid back with a good amount of downtime. The most we ever had was 8 patients at one time; however, I have heard that Subspecialty can get really busy sometimes. The only downside is that you have to make an effort to make sure you learn the general peds stuff, but I don't think it really put me at a significant disadvantage for the shelf.