Paediatrics: An Introduction

Paediatrics is one of the most interesting yet challenging posting in Medical life. This is an introduction of what to expect in our Faculty's Paediatric Department.
Before we begin,
1) Paediatric is NOT SPELLED as Peaditrics. Some joker in JPP must really take note of this.
2) A child, is Never a small adult. There are subtle difference that one need to keep in mind.
3) Do not treat a child as you treat an adult. Go down to their level of understanding and playfulness.

So in the 8 weeks Paediatric posting
1) There are 4 place that we will basically be learning from
a) Paediatric Department Seminar room for PBL and Seminars
b) Paediatric Institute in HKL, beside our old Kampus KL
c) Neonatal Intensive care Unit, in front of our beloved Labour room
d) Paediatric Clinics
YM Note: Peds department is on the 4th floor. :)

Learning style is a mixture of Internal Medicine and O&G style. That means, both knowledge and experience is important in Paediatrics.

You will be divided into groups as usual. Each group will have 2 supervisors, 1 from HUKM and another part time lecturer from Paediatric Institute.

There are 4 wards in HKL that is allowed for UKM medical students. They are known as KK4, KK5, KK6 and KK7. You'll have at least 1 week in every ward, and 2 weeks in some ward depending on your luck. NEVER intrude into KK1 and KK2 because those are reserved for UPM students. If their lecturer spot you and complain to our lecturers you'll be in deep shit.

So what to do in the ward? Take the opportunity to examine patients, who might have very good findings. Some findings will never be found in HUKM, for instance, Wilson's disease, Pompe's disease etc. Learn how to take a good Paediatric history. You will have teachings with your supervisors, at least 2 days a week. They might ask you to cover bed and present Ward Round style, depending on supervisor. You will be there from 8am till 5pm everyday. So much time and so many patient to see! Moreover, you can go to the Pathology lab to fill in your logbook for procedures that is to be observed.

You will also be posted at least 1 week in clinic. Its situated just in front of Medical Clinic 2. Go there and do the procedures, like measuring length, taking weight etc. You will also follow the doctors clinic. Normally its up to the doctor, if they want you to examine they'll ask you to. Not so formal, depending on the supervisors. As clinic usually ends at noon, take the opportunity to go to Thalassaemia Ward at 4th floor to observe blood transfusions, bone marrow aspiration biopsy etc. ** No need to go to the Child Psychiatry clinic. You will go there during your Psychiatry posting.

As for PBL and seminars, actually they are similar. You have a separate group for seminar while forPBL you follow your supervisor's group. This PBL is not like what we did in 2nd year. Basically the group will be presenting a real case from the ward, based on the topic given. For example if the group's topic is Nephrotic Syndrome they have to find 1 pt with that condition, clerk, examine, plan management etc and present to the whole posting. Same thing with seminars. PBL and Seminars are usually done every Monday and Friday morning, depending on the lecturer in charge. Find and inform them at least 1 week before your presentation date.

In Neonatal Intensive Care Unit(2 weeks), you'll learn a lot regarding problems in the newborn infants. It is here you will follow the Code Pink, and also go for Neonatal rounds in the O&G wards, examining newborns. There are 2 ward rounds each day, although none of you need to present, you still have to follow them and it can be very boring sometimes. You can arrange for teachings in specific topics like neonatal jaundice, hypoglycaemia, NRDS with the lecturers in NICU. Every Tuesday and Thursday, there will be grand ward round by Prof Dr Boo Nem Yun and Prof Dr Cheah Fook Choe respectively. Just follow and listen closely. Learn whatever is written in the Guidebook.

So what new things you will be learning in Paediatrics? Isn't it the same as Internal Medicine?
Yes, and no.

In paediatric, you must be nosier than you are in Internal medicine because even a small thing can give significant effect to the child. For example, in a child with atopic eczema, you must even enquire about what detergent they use and how many times they rinse the baby's cloth, how they dry it and where they keep it.
Some additional history to be taken include Developmental history, Dietary history and Immunisation history. You will learn as you go on.

In Physical examination, the 4 main systems are of course, must knows. However, there are some difference in techniques. For example, how do you examine the Cranial nerves in a 6 month old baby? Well, ask around, learn.
2 new things that you will learn are Newborn examination and Developmental Assesment(DA). I won't touch anything on Newborn examination, you will learn it. For DA, you really need to practice and more practice. Grasp the principles and apply it, and you will be able to do it. Lots of people complain DA is hard, but with practice it is possible to do. However, don't get obsessed with DA. You need to practice other PEs too.

CPGs are important. The Department will supply you some while you'll have to get others.

Lastly, all the best in your postings! Practice and practice. Paediatric is a very nice posting, with cute kids, nothing feels better than having a baby smile and trust you. Enjoy!^^

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