The pediatrics rotation was my last one in clinical year. It was an especially challenging rotation, as this was a patient population I had the least experience with. Although I encountered pediatric patients during the OB-GYN, family medicine, and ambulatory care rotations, I was never in a setting focused solely on pediatric diseases and disorders, and never in this great of a capacity. The rotation allowed me to expand my skills and learn so much more than I expected.

Treating pediatric patients was different in every regard. Firstly, only obtaining a secondary perspective from a parent due to the age and development of a child is challenging, as a parent can observe what is happening but don’t truly know what a child feels and what is bothering them the most. Examining a pediatric patient can also be tough, as infants and small children tend to be scared of medical providers, uncomfortable with parts of a physical exam, and easily startled. I tried my best to approach patients with a calm, happy, and approachable demeanor, and figured out ways to examine patients in a way that would not startle them. I learned a lot from watching and imitating my preceptors, as their years of experience shone through their approach and skills. I gained a lot of confidence with my techniques, and by the end of the rotation was able to examine most children completely and thoroughly.

An aspect of this rotation I learned the most from was differentiating disease presentations in pediatric versus adult patients. The typical signs and symptoms tied to adult diagnoses are not always present in pediatric patients, and presentations of mild, vague symptoms may indicate a much greater problem than is readily apparent. Every sign and change in daily routine and habits must be explained, as even small details can indicate an illness. Asking more than just the usual questions pertaining to disease is not enough, as every aspect of a pediatric patient’s life must be investigated to find the cause of illness. I learned about the importance of oral intake, urine output, change in play and sleep, and many other daily functions and how they can point to a diagnosis that would not have been considered otherwise.

The most rewarding part of this rotation was helping parents with aspects of their child’s health that did not directly encompass medicine. I got to interact and work with social workers on providing services pertaining to childcare, learning, occupational therapy, and counseling. I also got to examine and thoroughly interview children who were suspected to be abused at home and identify signs of such abuse on physical exam and in interviews. Educating new parents on signs of illness and what to keep an eye out for was important, as these are not always red flags in a parent’s eyes but may indicate an issue that can be caught early.

This was a challenging rotation but most of all it was extremely rewarding. Pediatric patients are harder to assess, diagnose, and treat, and are much more susceptible to the deleterious effects of some medical problems, making proper diagnosis and treatment all the more important. I can confidently say that I have become more comfortable and much more knowledgeable in pediatric medicine thanks to this rotation, and looking forward to treating pediatric patients in the future.