Pediatric pulmonology

In this rotation at Geisinger Janet Weis Children’s Hospital, you’ll be paired with rounding physicians who are responsible for inpatient consults/rounding, as well as outpatient clinic/same-day appointments. Your day will consist of morning consults/rounding (8 to 10 a.m.), outpatient clinic (10 a.m. to 3 p.m.) and afternoon consults/rounding (3 to 5 p.m.).  

Expectations of the student

• Attend intake rounds from 8 to 9 a.m. each day, as consults may arise during that time.
• Come to rounds each day with new data and proposed plan for inpatients (especially cystic fibrosis patients). 
• Evaluate and follow inpatient consults.
• Evaluate new and return patients in the clinic.  

Competencies to achieve by rotation’s end

• Evaluation of a pediatric patient with respiratory complaint
  • History-taking
  • Physical examination
• Generate differential diagnoses for the following chief complaints
  • Cough
  • Wheeze
  • Chest pain
  • Stridor/laryngomalacia
  • BPD/chronic lung disease
  • Recurrent pneumonia
  • Exertional dyspnea
  • Asthma evaluation
  • Sleep apnea/sleep disorder
• Interpret spirometry/post-bronchodilator studies
• Generate meaningful consult notes for referring physicians
• Demonstrate proficiency for care and effective teaching for the following situations:
  • Asthma – diagnosis of the infant toddler with recurrent wheeze. 
    • Management of persistent asthma
  • BPD – ensuring adequate growth and lung development
  • Cystic fibrosis – how to interpret and manage newborn screen results
    • Management of chronic disease and acute exacerbations
  • Vocal cord dysfunction – identification and management
  • Chronic cough – develop differential diagnosis and evaluation strategy
  • GERD – identify how this may exacerbate/interact with certain lung diseases 
  • When to refer for bronchoscopy – indications for bronchoscopy
    • Limitations of flexible bronchoscopy
  • Sleep apnea – how to identify possible sleep apnea in children
    • when to refer for sleep study