Pediatric Critical Care Sub-Internship

Educational objectives: The Pediatric Intensive Care Unit (PICU) sub-internship is structured to familiarize the medical student with recognition, evaluation and management of pediatric patients with critical organ system instability. During the month, the medical student will improve their knowledge in the following areas:

• Recognition and management of isolated and multi-organ system failure and assessment of its reversibility.

• Integration of clinical assessment and laboratory data to formulate therapeutic plans for critically ill children.

• Invasive and noninvasive techniques for monitoring and supporting pulmonary, cardiovascular, cerebral and metabolic functions.

• Pre and post-operative management of surgical patients.

• Communicating with patients and families stressed by the severe illness of their child, including observation of discussions regarding the expected prognosis of the patient and understanding the ethical process involved in decisions on the continuance of life support.

The medical student will be expected to:

• Obtain and document a thorough history and physical on all assigned patients.

• Give clear, organized presentations of their patients during rounds.

• Develop a plan of care in conjunction with the residents and critical care attending.

• Follow-up on all labs and tests ordered.

• Re-evaluate patients and report changes to the resident and attending as they occur.

• Expand knowledge of critical care medicine and basic physiology through teaching rounds and reading of suggested materials.

• Prepare a literature review of a topic pertinent to pediatric critical care medicine and present this topic to the clinical team.

Responsible faculty: Disa Wagner, MD (dfwagner@cmh.edu) 

Administrative contact: Regina Carder (rcarder@cmh.edu), (816) 802-1190

Contact person: Holly Frey (hlfrey@cmh.edu)

Elective duration: One month

Prerequisites: Completion of the Core Pediatric Clerkship with a minimum of four weeks of inpatient pediatrics and at least one rotation at Children's Mercy.

Description: Students electing to rotate through the PICU usually have a strong interest in the basic science of physiology/pathophysiology and a desire to care for critically ill children. Most students find the rotation arduous but are rewarded by the knowledge and confidence they accrue during the month. During this sub-internship, students are allowed to have four days off and are expected to work from morning checkout through evening checkout. There are two didactic sessions in the PICU each week. The medical student is also encouraged to attend Noon conferences and Grand Rounds held at Children's Mercy Hospital. The daily (Mon-Sun) time schedule varies depending on the attending.

Calls: No calls

Criteria for passing: Each attending physician who has worked closely with the student completes an evaluation sent by that student's medical school. Those evaluations are then summarized into a single composite evaluation. A student who demonstrates an adequate acquisition of the above learning objectives and meets the above expectations will earn a passing grade. A final exam is a required component of the final evaluation. A final grade for the rotation will not be submitted until the exam has been completed.

Criteria for honors: An honors grade is reserved for the most exceptional student who has a strong knowledge base, exceeds the expectations of the elective and works at the level of a resident. Less than 10% of students have earned an honors grade during this rotation.