Pediatric Posting (Pre, Posting and Post)

     Not much to share :) I have never been through Internal Medicine Posting yet, but I heard most of the seniors said that pediatric posting is actually same as internal medicine, just that now we are dealing with the kids! The only additional thing is neotanalogy. In pediatric posting, you are also expected to know some neonatal disorders for example neonatal jaundice and you can find this a lot in HPJ.

     Besides, you may need toys to attract kids. Trust me, communicate well with the kids and you will rewarded with precious opportunities to practice physical examination on them. As for me, I love to perform magic tricks in front of them, some mothers will be entertained as well and this is when you need to grab this chance to take a complete history from the mother. ;) My experience: There was once I entertained the mother with the magic tricks and I got the chance to hear the murmur that her daughter has! So :) pls know how to build the rapport! Equip yourself with TOYS!

1. Pre-posting preparation:

To know what book you might need to use during the pediatric posting, you can visit here. It is a sharing about books for pediatric posting. You can also download ebooks from there. Don't forget to print out or photostat the normal child development assessment table in Malaysia Paediatric Protocol page 12 and 13. You can print it in multiple pages per sheet so that it is smaller and then laminate it. It is very helpful when you take the developmental history of a child. I made a clerking template based on the lecture's notes. You can have it here.

2. Posting:

In HPJ, the rate of discharge is not as fast as Hospital Manjung so if you had already finish clerking your beds (in average each of you will get 2 beds), try to ask permission from your friends and if your friends allow you to clerk their patients, just go ahead. Do not forget, please ask their PERMISSION first before you simply clerk their patients.

In HSM, the rate of discharge is quick fast except those patients in HDU (High Dependency Unit). Those in HDU are under intensive care. Normally you will get interesting cases in HDU, and please share the cases with your friends.

Besides:

• try your best to follow the ward rounds with medical officers, not the specialists. Preferably at night. During the night rounds, they will only go and check some critical cases only. I always followed the night rounds and I met a very good MO, whereby he will always let me auscultate the patients and ask me to present the findings. Also, sometimes, he will ask some questions during his rounds and you need to find out the answer. This is when learning is fun, just ask your lecturers or MO whenever you are not sure of anything.

• On every Tuesday and Thursday, there will be a numbers of kids suffering from thalassaemia who will come to have their regular blood transfusion. Normally they are asymptomatic but grab this opportunity to clerk them as well. However, when there are newly admitted thalassaemia cases in the wards besides Tuesday and Thursday, it means that the kids are admitted to the hospital with several postive signs and symptoms for example like pallor, dizziness and so on. Clerk the patient!!  This is what the HO told me.

• There will be lots of dengue cases in the wards. You can get a very useful reference from WHO here.

3. Post-preparation:

     Basically you will be busy preparing for your end-of-posting clinical exam. What I did was I used In A Page Pediatrics and also Pediatric Protocol (the green book) for my revision. Make sure you really know the common diseases and also the management. Learn the management from the green protocol book. Do the group discussion as group discussion helped me a lot in my theory part after performing the history taking and physical examination during the clinical exam.

p/s: email me at evelyn6757@gmail.com if u want the pdf. copy of Malaysia Paediatric Protocol. I will email it to u, sorry, I haven't repair the broken link.