Pediatrics

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M65/801  General Pediatric Sub-Internship- St. Louis Children’s Hospital

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This is the general pediatric sub-internship. The student will be assigned patients on one of two inpatient pediatric floor teams. They will follow patients from initial evaluation and for continuing care until discharge. Students work directly under the supervision of the senior resident and manage their own patients without co-coverage by an intern. Teaching rounds are conducted by the faculty. The elective will provide experience in the management of many pediatric medical conditions (variable depending on floor) and will include the care of patients with various diseases including pulmonary, infectious diseases, gastrointestinal, renal, neurological, endocrine, and rheumatologic issues. Additionally, patients with failure to thrive, asthmatic exacerbations, poisonings, PICU transfers and undiagnosed conditions may be seen.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 100%; Subspecialty Care/General Pediatrics 100%

Major Teaching Responsibility
Attendings and residents

Patients Seen/Weekly
Approximately 12

On Call / Weekend Responsibility
2-3 weekend days, 5 consecutive night shifts

M65/808  Pediatrics

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

In predominantly an outpatient setting, students will evaluate patients with a wide variety of allergic and immunologic disorders including asthma, allergic rhinitis, anaphylaxis, food allergy, atopic dermatitis, urticaria, angioedema and primary immunodeficiency. Rotation goals include: (1) the extension of history-taking skills to include environmental exposures, (2) the recognition of physical findings suggestive of allergic disease, (3) understanding the indications and interpretation of diagnostic testing including skin testing and assessment of pulmonary function, and (4) application of appropriate therapeutic strategies to these disorders. Weekly didactic conferences and inpatient consultations provide additional educational opportunities to the student.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 10%; Outpatient 80%; Conferences/ Lectures 10%; Subspecialty Care 100%

Major Teaching Responsibility
Leonard B. Bacharier, MD, and Caroline Horner, MD

Patients Seen/Weekly
40

On Call / Weekend Responsibility
None

M65/809  Pediatric Pulmonary Sub-Internship

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

On the 7 East Respiratory Unit, the sub-intern is an active member of a multidisciplinary care team, consisting of attending pulmonologist or allergist, advanced practice nurses, second-year pediatric residents, unit nurses, and other care providers and takes responsibility for children with acute and chronic lung diseases admitted to the unit. The student will be co-managed with a senior pediatric resident and the sub-intern will be directly supervised by the pediatric residents and attending physician in the daily care of patients. The rotation is structured to provide students with a primarily clinical experience to allow them to gain exposure to the breadth of lung diseases seen at St. Louis Children’s Hospital.

The volume of patients on the 7 East Respiratory Unit varies with the number of patients covered by the sub-intern at any time, and he or she will typically be responsible for the care of two to six patients at any given time. The student will be exposed to children with wide-ranging lung diseases and breathing disorders, such as asthma, cystic fibrosis, bronchopulmonary dysplasia, bronchiolitis, pneumonia, chronic respiratory insufficiency, and congenital lung anomalies during their clinical rotation. The student will also have the opportunity to participate in tests and procedures essential to the practice of pulmonary and allergy medicine, including pulmonary function studies, flexible fiberoptic bronchoscopy, and overnight polysomnography. Sub-interns do not have evening coverage responsibilities, and weekend responsibilities are limited to two days during the four-week block. They are strongly encouraged to attend departmental and divisional conferences.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 80%; Outpatient 10%; Conferences/ Lectures 10%; Primary Care 30%; Subspecialty Care 70%

Major Teaching Responsibility
Attending Physician

Patients Seen/Weekly
10-15

On Call / Weekend Responsibility
Two weekend days per month

M65/811  Pediatric Critical Care Medicine

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This elective is designed to familiarize the student with the diagnosis and treatment of critical illness in infants and children. To this end, each student is made responsible for a small number of assigned cases under the direct supervision of pediatric residents, pediatric critical care fellows, and faculty. The teaching activities emphasize the understanding of pathophysiological processes that lead to respiratory, circulatory, and central nervous system dysfunction and their therapy in the developing subject. Students are expected to participate in all the daily activities of the Pediatric Intensive Care Unit at St. Louis Children’s Hospital and be on occasional call after hours.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 100%; Subspecialty Care 100%

Major Teaching Responsibility
Attending, critical care fellows, and pediatric residents

Patients Seen/Weekly
150

On Call / Weekend Responsibility
Yes

M65/813  Pediatric Cardiac Catherterization

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

Elective will focus on interpretation of hemodynamic and angiographic data acquired in the cardiac catheterization laboratory.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 95%; Conferences/ Lectures 5%; Subspecialty Care 100%

Major Teaching Responsibility
Two attendings, supplemented by one fellow

Patients Seen/Weekly
10

On Call / Weekend Responsibility
None

M65/819  Pediatric Cardiology- Outpatient Service

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

Students will be exposed to the wide spectrum of pediatric cardiology on an outpatient basis. In addition to general cardiology clinics, several subspecialty clinics are also available, including heart failure/transplant, electrophysiology/inherited arrhythmias, pulmonary hypertension, William’s syndrome, Down syndrome, and preventative cardiology clinic. Students will independently evaluate clinic patients referred for a variety of cardiac complaints, such as cardiac murmurs, chest pain, syncope, arrhythmia, as well a wide variety of congenital cardiac lesions, and report their findings to the attending. Cardiac auscultation skills will be enhanced through auscultation of cardiac patients in a clinic environment. Students will learn basics of ECG and echocardiogram interpretation by reviewing studies performed during clinic with the attending. Clinics are held at St. Louis Children’s Hospital, and the Children’s Specialty Care Center in West County. Students also have the option to participate in outreach clinics that occur on a monthly basis (locations include Cape Girardeau, Poplar Bluff, Rolla, Bonne Terre, and Columbia). Depending on interest, students may spend additional time in the echocardiography laboratory for more in depth exposure to echocardiography. Participation in weekly surgical conference and daily cardiology educational conferences is encouraged.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Outpatient 95%; Conferences/Lectures 5%; Subspecialty Care 100%

Major Teaching Responsibility
Multiple attendings

Patients Seen/Weekly
25

On Call / Weekend Responsibility
None required

M65/826  Genetics and Genomic Medicine

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

The goal of this senior elective is to facilitate the acquisition of clinical skills and knowledge in genetics and genomic medicine. The student will actively participate in the diagnosis and management of pediatric and adult patients with genetic disease in both the ambulatory and in-patient settings. Emphasis will be placed on application of the science of genetics to the bedside and will include a broad exposure to patients with biochemical, metabolic, structural and complex genetic diseases. Students will have an opportunity to visit clinical laboratories involved with diagnosis of genetic disorders, including the cytogenetics, molecular genetics and biochemical genetics laboratories. Students will be expected to participate in the weekly clinical case conference.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 30%; Outpatient 60%; Conferences/Lectures 10%; Subspecialty Care 100%.

Major Teaching Responsibility
Attendings

Patients Seen/Weekly
15

On Call / Weekend Responsibility
None

M65/827  Sub-Internship- Pediatric Hematology/Oncology

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

Students will assume the responsibilities of a pediatric resident on the inpatient Hematology/Oncology service at St. Louis Children’s Hospital.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 90%; Conferences/Lectures 10%; Subspecialty Care 100%

Major Teaching Responsibility
Single attending, first-year hematology/oncology fellow.

Patients Seen/Weekly
2-3 patients a day

On Call / Weekend Responsibility
None

M65/836  Pediatric Rheumatology

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

Opportunities are available to care for children with a variety of immunologic and rheumatologic disorders. Students will see patients in outpatient clinics and inpatient consultations. An in-depth approach to evaluating disorders of the immunologic system will be provided. Students will participate in evaluation of new patients with a variety of rheumatologic diseases including JRA, SLE, and scleroderma at both SLCH and Shriners Hospital clinics. Students may elect to participate in conferences and seminars.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 20%; Outpatient 70%; Conferences/ Lectures 10%; Primary Care 30%; Subspecialty Care 70%

Major Teaching Responsibility
Andrew White, MD

Patients Seen/Weekly
35-40

On Call / Weekend Responsibility
None

M65/838  Pediatric Gastroenterology, Hepatology and Nutrition

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

The rotation in Pediatric Gastroenterology, Hepatology, and Nutrition provides broad exposure to specialized and common pediatric problems. Division patients are seen in the outpatient suites and in the hospital. Students evaluate outpatients with common pediatric complaints like abdominal pain, constipation, and poor growth. Additionally, students experience the ongoing outpatient care of patients with liver disease, inflammatory bowel disease, short-gut syndrome, celiac disease, and other rare disorders. The inpatient service provides experience in caring for patients with acute illnesses such as gastrointestinal bleeding, malnutrition, liver failure, complications of inflammatory bowel disease, and pancreatitis. Students participate in diagnostic and therapeutic endoscopic procedures. At weekly divisional conferences, faculty, fellows, and students review pathology slides from current cases and discuss difficult patient problems and topics of interest.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
The time spent in the outpatient clinic and on the inpatient service can be individualized according to the student’s interests. In general, the distribution is: Inpatient 50%; Outpatient 30%; Procedures 10%; Conferences/Lectures 10%; Subspecialty Care 100%

Major Teaching Responsibility
Faculty and fellows

Patients Seen/Weekly
150 (entire division) /week (outpatients), 70/week (inpatients), 20/week (procedures). Students participate in a subset (most interesting/instructive cases)

On Call / Weekend Responsibility
None

M65/839  Antimicrobial Use, Resistance, and Stewardship

Valid start weeks for four-week blocks are: Weeks 1, 9, 13, 17, 33, 37, and 41.

Valid start weeks for two-week blocks are: Weeks 1, 3, 5, 9, 11, 13. 15, 17, 19, 21, 27, 33, 35, 37, 39, and 41.

In 2013 the CDC estimated that 23,000 Americans die annually from antibiotic-resistant infections, and an additional 2 million are infected with one of these difficult-to-treat pathogens. The primary driver of this resistance is the use – and, more importantly, the misuse – of antibiotics. In 2015, the White House published the National Action Plan for Combating Antibiotic Resistance Bacteria. This plan calls for improvement in antimicrobial use in human and agriculture medicine, better diagnostics, increased collaboration domestically and internationally, and accelerated development of new antibiotic agents. This 4th year elective rotation will be focused on educating the student on the current state of domestic and global antibiotic resistance and the mechanisms by which healthcare systems are addressing this problem. The student will participate in the daily antimicrobial stewardship activities conducted at St. Louis Children’s Hospital, attend weekly stewardship and clinical infectious diseases meetings both at the hospital and BJC system level, review antimicrobial use data, and participate in hands-on activities in the microbiology laboratory.

At the end of this rotation, the student will be able to:
1. List the antimicrobials and the pathogens they effectively treat
2. Analyze bacteria for genotypic and phenotypic resistance through standard and rapid microbiologic techniques
3. Describe the antimicrobial stewardship interventions that can be implemented in the different healthcare settings
4. List the social determinants that impact antimicrobial stewardship programs
5. Explain how the microbiome and resistome are important in our efforts to improve antimicrobial use

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 60%, Outpatient 10%, Conferences/Lectures 30%; Primary Care 10%, Subspecialty Care 90%

Major Teaching Responsibility
Course Master

Patients Seen/Weekly
50

On Call / Weekend Responsibility
N/A

M65/840  Pediatric Infectious Diseases

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This elective is designed to introduce students to the clinical aspects of infectious diseases in children. Students will consult on both inpatients and outpatients. Regular daily activities will include evaluation of new patients, work rounds on inpatient consults, microbiology teaching rounds in the bacteriology and virology labs, and teaching rounds with the infectious diseases attending. Students will attend the general pediatric clinic and the pediatric HIV clinic once per week. Formal teaching sessions include a weekly pediatric infectious disease case conference, a weekly joint clinical conference with the adult infectious diseases group, and a weekly pediatric infectious diseases research conference.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 70%; Outpatient 20%; Conferences/ Lectures 10%; Subspecialty Care 100%

Major Teaching Responsibility
One or two attendings, one or two fellows

Patients Seen/Weekly
5-10 new patients primarily, over 15-20 new patients with team

On Call / Weekend Responsibility
None

M65/845  Pediatric Emergency Medicine

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

The goal of this elective is to provide the senior medical student with a broad introductory clinical experience in pediatric emergency medicine. Functioning as a subintern in the Emergency Unit of St. Louis Children’s Hospital, the student will have the opportunity to evaluate and manage patients with a wide variety of emergent and urgent medical and surgical problems. Examples include: respiratory distress, abdominal pain, lacerations, bone injuries, rashes, fever, etc.

Students will work either a day shift (7:30 a.m.-3:00 p.m.) or an evening shift (3:00 p.m.-11:00 p.m.) in rotation. Daily teaching conferences are provided by the attending staff. A weekly meeting of the students and senior faculty will occur to review interesting cases. Also, attending staff and senior pediatric residents provide 24-hour on-site supervision. Each medical student will be asked to prepare a 20-minute presentation on a topic of his/her choosing.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Outpatient 90%’ Conferences/Lectures 10%; Subspecialty Care (Emergency Medicine) 100%

Major Teaching Responsibility
All EM attendings

Patients Seen/Weekly
~30

On Call / Weekend Responsibility
None (unless making up time)

M65/849  Pediatric Endocrinology and Diabetes

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This elective is designed to include broad clinical experience in pediatric endocrinology and diabetes. The student will have an opportunity to evaluate both patients admitted to St. Louis Children’s Hospital and patients referred for consultation in our three outpatient clinics each week. In addition to a divisional conference to review referred patients, several joint conferences with the adult Endocrinology and Diabetes Division (clinical rounds, journal club/research seminar, case conference) are held weekly.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 40%; Outpatient 50%; Conferences/Lectures 10%; Subspecialty Care 100%

Major Teaching Responsibility
Attending physicians and fellows

Patients Seen/Weekly
10-20 by student

On Call / Weekend Responsibility
None

M65/852  Clinical Pediatric Pulmonary Medicine

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This elective provides an excellent opportunity for students to be exposed to the full scope of respiratory diseases and sleep disorders in infants and children. Pediatric referrals will be seen in both an inpatient and outpatient setting. Rotation goals for students include: (1) gain greater insights into the genetics, epidemiology, pathophysiology, and clinical presentations of lung diseases in children; (2) learn the importance of the physical examination using inspection, percussion, and auscultation; (3) understand indications and interpretation of diagnostic tests, such as chest imaging, blood gas measurements, polysomnography, pulmonary function testing, and bronchoscopy with biopsy and lavage; and (4) learn to apply therapeutic interventions to common lung diseases. Unique aspects of this rotation include, a broad exposure to children with asthma, cystic fibrosis, ciliopathies, interstitial lung diseases, chronic lung disease of infancy, congenital lung malformations, and end-stage cardiopulmonary diseases referred for lung transplantation. Weekly didactic sessions, as well as divisional clinical conferences, provide opportunities for the trainee to develop his or her presentation skills.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient varies; Outpatient varies; Conferences/Lectures 10%; Subspecialty Care 100%

Major Teaching Responsibility
Attendings

Patients Seen/Weekly
25

On Call / Weekend Responsibility
None

M65/861  Newborn Medicine

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

The goal of this course is to provide students with responsibility for caring for newborn infants who range from normal, to acutely ill, to chronically ill, and for their families. The physiology of the transition from fetal to extrauterine existence, the pathophysiology of specific diseases, and primary accountability of the student for patient management decisions and procedures, will be emphasized. In addition, collaboration with nursing staff, other health care providers in decision-making (especially concerning the viability of individual infants), and family management will be regularly required.

Students, during each rotation, will have the option to rotate through the Neonatal Intensive Care Unit at St. Louis Children’s Hospital and/or the labor and delivery services at Barnes-Jewish Hospital. Students assigned to the Labor and Delivery Service will routinely be involved in normal newborn care and delivery room management. The student will be expected to rotate patient responsibilities every fourth night.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 90%; Outpatient 5%; Conferences/ Lectures 5%; Subspecialty Care 100%

Major Teaching Responsibility
Attending, fellow and residents

Patients Seen/Weekly
30

On Call / Weekend Responsibility
Every fourth night

M65/875  Pediatric Renal Disease

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This course is designed to provide the student with a wide exposure to all aspects of pediatric renal disease and an opportunity to explore a desired aspect of the field in-depth. The student will be an integral part of the Renal Team and as such will see both inpatients and outpatients. Students will have an opportunity to follow the courses of patients with acute renal disease as well as those with more chronic problems and will help to plan the evaluation and therapeutic management of these patients. Discussions and rounds with the attending staff and fellows emphasize the relationship between clinical problems and the pathophysiology of the underlying disease. These informal teaching sessions are supplemented by more formal sessions. These include renal attending rounds, renal research rounds and grand rounds, which are conducted weekly in conjunction with the Renal Division of Barnes-Jewish Hospital. Renal biopsy material is reviewed with the renal pathologists. Attendance at the weekly pediatric grand rounds and pediatric case conferences is encouraged. Opportunities in clinical and translational research projects will be discussed with interested students.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 50%; Outpatient 40%; Conferences/ Lectures 10%; Subspecialty Care 100%

Major Teaching Responsibility
Attendings

Patients Seen/Weekly
12-15

On Call / Weekend Responsibility
None

M65/876  Pediatric Lung Transplantation

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

St. Louis Children’s Hospital has the largest pediatric lung transplantation program in North America. This unique clinical rotation will enable students to be exposed to the process of transplantation from referral and listing to the actual surgery and post-operative care. Both inpatient and twice weekly outpatient clinics will be available for participation and learning. The use of diagnostic tests, including flexible fiberoptic bronchoscopy with biopsies and bronchoalveolar lavage, histopathology of infection and graft rejection, and the complexities of immunosuppression will all be explored. Weekly multidisciplinary meetings with our team, as well as didactic, psychosocial, and ethical meetings will be available. Our patient referral base is worldwide, and includes infants and children with cystic fibrosis, pulmonary hypertension, complex congenital heart defects, surfactant protein defects and alveolar proteinosis.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 50%; Outpatient 40%; Conferences/ Lectures 10%; Subspecialty Care 100%

Major Teaching Responsibility
Attendings

Patients Seen/Weekly
20-30

On Call / Weekend Responsibility
None