PASIG CITY GENERAL HOSPITAL Department of Pediatrics Clinical Clerkship SY 2011-2012
Jan 07, 2016
PASIG CITY GENERAL HOSPITALDepartment of Pediatrics
Clinical ClerkshipSY 2011-2012
To acquire the basic knowledge, skills, and attitudes appropriate for the practice of pediatrics that serves as a foundation for providing competent child health care in whatever field of medicine the student pursues.
Objective:PCGH ROTATION OF YL8 ATENEO STUDENTS
(CLERKS )
The Medical City 2wks
Community Pediatrics (Ilugin Health Center, Pasig City) 2 wks
Pasig City General Hospital 2wks
Philippine Children’s Medical Center 2wks
Duration of Rotation: 8 weeks
1 wk NICU1 wk ER/OPD
a tertiary government hospital 150 bed capacity locally funded by City government of Pasig
PCGH
Deficiencies/Limitations of PCGH Limited supplies (budget depends on city hall) Inadequate equipment/Facilities Lack of adequate manpower ( medical and non-medical)
PCGHAccredited Departments Department of Pediatrics Level 1 Accredited training by PPS Department of OB-GYN Department of Surgery Consortium with Mary Chiles Hospital Department of Emergency Medicine
Non-accredited Departments Department of Internal Medicine Department of Radiology Department of Anesthesiology Department of Pathology
PCGHServices: ER OPD Subspecialty Clinics Monday Nephro Clinic
Tuesday Neuro/ Well Baby ( immunization)Wednesday Pulmo/Hema ClinicThursday Neonatology (Sick Babies)Friday Cardio
NICU WARDS PICU Isolation/Newborn Ward
Pulmo Ward Miscellaneous WardPayward Philhealth ward
PCGH Consultant Staff
Medical DirectorPaulo A. Castro, Jr. MD
Asst. Medical DirectorAnthony A. Marquez, MD
Department ChairmanRosario G. Isada, MD
Internal AffairsJorge C. Licsi, MD
Bioethics Finance Socio-Cultural
Research & Dev’tGloria DL Poblete, MD
Out-Patient In-Patient
a. Community Health Education b. Ambulatory
General Pediatrics
Rosario Isada, MD Gloria Poblete, MD Jorge Licsi,MD Amalia Bulaon, MD Rowena Ong, MD
Subspecialties
Loretta Alano, MD Nepthalie Ordonez,MD Jeanna Ples, MD Arleen Galvez, MD Carmina Delos Reyes, MD Neva Batayola, MD Edwin Rodriguez, MD Imelda Tan, MD Jonadav Martinez, MD
General Pediatrics
Rosario Isada, MD Gloria Poblete, MD Jorge Licsi,MD Amalia Bulaon, MD Rowena Ong, MD
Subspecialties
Loretta Alano, MD Nepthalie Ordonez,MD Jeanna Ples, MD Arleen Galvez, MD Carmina Delos Reyes, MD Neva Batayola, MD Edwin Rodriguez, MD Imelda Tan, MD Jonadav Martinez, MD
DEPARTMENT OF PEDIATRICS
Training OfficerJorge C. Licsi, MD
Research Residency Training
ServicesAmalia C. Bulaon, MD
ASMPH FACULTY
Rosario G. Isada, MD, FPPS Chairman
Rowena Ong, MD, DPPS
Carmina Delos Reyes, MD, DPPS
Amalia Bulaon, MD, FPPS
Gloria DL Poblete, MD, FPPS
NON ASMPH FACULTY
Jorge C. Licsi, MD, FPPS Training Officer
Senior Consultants
Loretta Stephanie Alano, MD, DPPS Neonatologist
Arleen Galvez, MD, DPPS Pediatric Nephrologist
Jonadav Martinez, MD, Pediatric Surgeon
Neva Luna Batayola, MD, DPPS Pediatric Intensivist
ACTIVE CONSULTANTS
NON ASMPH FACULTYSenior Consultants
Nepthalie Ordoñez, MD, FPPS Pediatric Pulmonologist
Jeanna Ples, MD, DPPS Pediatric Cardiologist
Edwin Rodriguez, MD, DPPS Pediatric Hematologist
Imelda Tan, MD, FPPS Pediatric Neurologist
ACTIVE CONSULTANTS
NON ASMPH FACULTY
Consuelo Sumayao, MD Mylah Tuazon, MD
Arlyn Baconawa, MD Sophia Mata, MD
VISITING CONSULTANTS
JUNIOR CONSULTANTS
PEDIA RESIDENTS
Irish Cayton, MD Chief Resident
Jinky Borromeo, MD 2nd yr Resident
Kate Callanga, MD 2nd yr Resident
Jennifer Manzano, MD 1st yr Resident
Amor Mia Cruz, MD 1st yr Resident
Marigold Bajar, MD 1st yr Resident
Norhyn Tamano, MD Pre=Resident
Stethoscope (preferable a pediatric stethoscope) Penlight Tape measure Diagnostic set (Otoscope/Ophthalmoscope) BP apparatus (anaeroid type) Neurologic hammer Digital thermometer or thermoscan Calculator Watch with seconds hand Tongue depressor
Prerequisites:PCGH ROTATION OF YL8 ATENEO STUDENTS
(CLERKS )
MUST SEE CASES:Nursery Rotation
OPD Rotation
Newborn Care and Discharge
TTNB / RDS Sepsis Neonatorum Hyperbilirubinemia
• Immunization • Anticipatory Guidance growth and dev’t• Pulm Tuberculosis • Acute Resp Infection Otitis/Pharyngitis• IMCI Fever, Diarrhea, Immunization, Pneumonia, Breastfeeding• Common infectious conditions:
Roseola, Viral Exanthem, Measles, Varicella
• Common dermatologic conditions: Atopic / Seborrheic Dermatitis,
Scabies, Carbuncle/Furuncle, Cellulitis/Abscess/Impetigo, Fungal skin infections, Eczema
• Common cardiologic conditions: RHD, CHD
• Common nephrologic conditions: UTI, AGN, NS
• Common developmental and behavioral conditions: MR, ASD, ADHD
• Common hematologic conditions: IDA / Leukemia
ER Rotation
• Dehydration/Shock• Seizures/Febrile seizures• Respiratory distress
BP measurement 10Otoscopy 10IV insertion 5IV injection/push 5NGT insertion 1Gastric lavage 1Venipuncture/blood extraction 1Blood culture sampling 1Heel prick for newborn screening 1Cord care and dressing 1Skin testing and reading 1Urine output monitoring 5Immunization procedure 2 each (intramuscular, intradermal, subcutaneous) Assist in umbilical cannulation 1Assist in lumbar tap 1Assist in endotracheal intubation 1
MUST DO Procedures(Skills Log):
Case Patient Age/Sex Date Noted
Noted by
Hospital Seen
1.2.3.4.5.
Logbook of Cases:
Clinical Preceptorials Small Group Discussions (Endorsement/Bedside rounds/Admitting Conference) Case presentation (NICU) Nelson Club with residents MMEI (Grandrounds & CPC) PPS scientific meetings Perinatal Conference Lectures
Instructional Activities:
Schedule of ASMPH Consultants:
NICU Consultants OPD/ER Consultants
Dr. PobleteDr. BulaonDr. Ong
Dr. IsadaDr. Delos Reyes
Monday Tuesday Wednesday
Thursday Friday Saturday
Dr. Isada Dr. Bulaon Dr. Delos Reyes
Dr. Poblete Dr. Ong Dr. Isada
Schedule of ASMPH Consultants:
NICU ROTATION
PCGH - 1 Week NICU Schedule
DAILY SCHEDULE: 7:30 - 8:30 Endorsement with residents 8:00 - 9:00 Direct Patient Encounter 9:00 - 10:00 Writing Progress Notes and others 10:00 - 12:00 AdCon /SGD 1:00 - 3:00 Direct Patient Encounter 3:00 - 4:00 Writing Progress Notes and others 4:00 – 5:00 Endorsement with residents
Attendance logbooks should be signed by the clerk rotator and countersigned by the resident
NICU rotator will go on 24hrs duty every 3 daysEndorsement rounds (Bedside rounds) with the residents will be at 7:30am
and 4:00 in the afternoon
Attend all conferences, lectures and other instructional activities of the department
Clerks should be in the NICU at all times except during conferences, meetings or lunchbreak. Residents should be informed of the whereabouts of the clerkNICU Rotators should be in scrubsuits while in the NICU
Duties and Responsibilitiesof NICU Rotator
Time-in at 7am; time-out at 5pm
Catch /Do admission history on babies delivered from 7am to 5pm (to be checked by the pedia resident)
Do, assist or observe procedures on assigned patients
Follow up endorsements from post duty clerk’s patients
Endorse own patients to Clerk on duty by 5 pm
NICU Rotator:Pre -Duty
Time-in at 7am
Receive endorsements from outgoing clerks by 7:30am
Respond to DR call and admit patients with residents-on-duty during his/her tour of duty
Catch /Do admission history on babies delivered from 5pm to 7am ( to be checked by the pedia resident)
Do, assist or observe procedures on assigned patients
Follow up endorsements from co-clerks
NICU Rotator:Duty
NICU Rotator:From Duty
Finish work-ups (laboratory procedures) for patients by 7 am
Endorse patients to Pre-duty clerk by 7:30 am
Attend conferences up to 5 PM
Do NBS and discharge PE with the pedia resident-in charge at OB ward
Do progress notes (SOAP format) on all babies at the pathologic room.
OPD / ER ROTATION
Duties and Responsibilitiesof ER Rotator
Time in is 7:00am for incoming and pre-duty Attendance logbooks should be signed by the clerk rotator and countersigned by the resident ER rotator will go on 24hrs duty every 3 days Postduty clerks will be off at 12nn unless there is a scheduled conference or lecture in the afternoon Pre-duty clerks will be required in the hospital from 7:00am -5:00pm Endorsement rounds (Bedside rounds) will be at 7:00am Attend all conferences, lectures and other instructional activities of the department
Duties and Responsibilitiesof OPD Rotator
Time in is 7:00am to 5:00 pm OPD Clinic hours is from 9:00am -12:00nn and 1:00pm – 4:00pm ( Mon to Fri) except holidays Attendance logbooks should be signed by the clerk rotator and countersigned by the resident The clerk rotator may attend ward endorsements at 7:30am Attend all conferences, lectures and other instructional activities of the department
ER / OPD Rotator:Pre -Duty
Report for work at 7 am- 4 pm at the OPD
Do history taking and PE on assigned patients
Do, assist or observe procedures like immunization,anthropometric / BP measurements, etc.
ER / OPD Rotator:Duty
Report for work at 7 am to 7 am the following day at the Emergency Room
Receive endorsements from co-clerks by 7am
Do history taking and PE of assigned patients
Do, assist or observe procedures on assigned patients
ER / OPD Rotator:From Duty
Report for work at 7 am- 12 pm at the OPD (unless there is a scheduled lecture/conference in the afternoon
Do history taking and PE on assigned patients
Do, assist or observe procedures like immunization,anthropometric / BP measurements, etc.
Summary of Requirementsof ASMPH Clerks
2 Preceptorial / SGD / AdCon evaluation by ASMPH Faculty1 NICU Rotation ( Dr. Poblete/ Dr. Bulaon/ Dr. Ong)1 OPD/ER Rotation ( Dr. Isada / Dr. Delos Reyes)
1 Case Presentation - NICU (Dr. Poblete/Dr. Bulaon/Dr. Ong)4 Patient Encounter Form during ER/OPD rotation4 Patient Encounter Form during NICU rotation5 Professionalism evaluation (Residents or Junior Consultants)
5 Skills Evaluation (Residents or Junior Consultants)
2 Quizzes
*** Deadline for submission of Patient Encounter Form 5 pm the following day
Scope of Quizzes
NICU Newborn Care / P.E. of the
Newborn Non-Infectious Ds of the Newborn
HyperbilirubinemiaTTNHMD
Infectious Ds of the NewbornSepsisPneumonia
OPD/ER BFC (guidelines) Dengue Fever / DHF PTB (guidelines) PCAP (guidelines) AGE (WHO)
Breakdown of Evaluation:
Percentage
40% 10% Case Presentation30% Preceptorial/Adcon
5% Written Reports / Logbooks
5% Quizzes
10% Skills
10% Professionalism
30% End Rotation Exam
ASMPH Clerkship Requirements for Pediatrics
Completion of MUST SEE CASES in any rotation of pediatrics. (TMC/COMPEDS/PCGH/PCMC)
Completion of Skills log and charts in the respective areas.(WARD/ER/OPD/NICU)
All requirements and projects are due on the Sunday of your last day of rotation.
End of Rotation exam will be given on the last Saturday of the pediatrics rotation.
Attendance to department conferences/small group discussions is a priority. Out of hospital conference is at the discretion of Consultant Clerks Monitor.
Direct Observation of history taking, physical examination and skills
Rating scale for SGD, case presentation, professionalism, skills
Completion of Technical skills Logbook/Individual Booklet
Quizzes End-rotation Exam OSCE Final exam (at the end of clerkship) Attendance
Summary of Evaluation:
Grading and Evaluation: The passing score of the final exam is 75%. If you fail during
the 1st try, you can take it again and if passed, the score given is 75% irrespective of the raw score. If you fail a second time, it is equivalent to repeating the rotation.
The rest will be graded through the rating scale that you would give to your resident/consultant. You are responsible to give the grading sheets to them.
Sanctions:
For Tardiness: First Offense: Warning Second Offense: 4 hours extra duty Third Offense: 24 hours extra duty Fourth Offense: 1 Sunday duty Fifth Offense: 2 Sunday duties
For Out of Post: First Offense: 1 week extension Second Offense: 2 weeks extension Third Offense: 1 month extension Fourth Offense: Repeat Rotation
Sanctions: For Absences
◦ Excused Absences are made up on a 1:1 basis (one day absence = one day make up) as long as a letter addressed to the Consultant Clerks Monitor with the reason for the absence and a medical certificate is submitted the next day the absence was incurred.
For Absences (Unexcused)◦ First Offense: 1 week extension (?)◦ Second Offense: 4 weeks extension (?)◦ Third Offense: Dismissal
*** Unexcused absences are made up on a 1:2 basis (one day absence = 2 days make up) (?)
Sanctions: For deficiencies in Requirements
– For every deficiency in requirements - 4 hours make-up. For every day that a requirement is still not submitted, an additional 4 hours of makeup will be added.• If the total make up of hours exceeds the number of
hours spent in a rotation, it is equivalent to a repeat rotation.
– For every deficiency in professionalism grading – 4 hours makeup.(?)
For noncompletion of LOGBOOKS, SKILLS LOG and MUST SEE CASES– Each case missed must be seen and completed within
the pediatric rotation, otherwise a written report regarding the missed case must be submitted.
– Each skill missed must be done and completed within the pediatric rotation. Routine procedures (?) must all be completed. For special procedures(?), a written report regarding the procedure must be submitted.
Sanctions:
End of Rotation Exam. The passing score of the final exam is 75%. A repeat exam will be given on the next scheduled end of rotation exam for those who fail the first time. Failure on the repeat exam is equivalent to a repeat rotation.
No clearance will be given if you still have incomplete logbooks, deficiency in requirements or pending make up. Your final grade will be submitted as INCOMPLETE until all deficiencies and make up have been completed.
Make Ups: To schedule make ups, inform Resident Clerks’ Monitor at least one day in advance. ◦ Have the senior resident on duty sign an index card with
the following information; name, LEC #, date of makeup, hours spent. (?)
Sanctions:
Monday Tues Wed Thur Fri Sat SunWEEK 1 8-Aug 9-Aug 10-Aug 11-Aug 12-Aug 13-Aug 14-AugPCGH chua chua chua chua chua chua chua
de la cruz de la cruz de la cruz de la cruz de la cruz de la cruz de la cruz
joaquin joaquin joaquin joaquin joaquin joaquin joaquin
rayel rayel rayel rayel rayel rayel rayel
redota redota redota redota redota redota redota
teo teo teo teo teo teo teo
uy uy uy uy uy uy uy
WEEK 2 15-Aug 16-Aug 17-Aug 18-Aug 19-Aug 20-Aug 21-AugPCGH chua chua chua chua chua chua chua
de la cruz de la cruz de la cruz de la cruz de la cruz de la cruz de la cruz
joaquin joaquin joaquin joaquin joaquin joaquin joaquin
rayel rayel rayel rayel rayel rayel rayel
redota redota redota redota redota redota redota
teo teo teo teo teo teo teo
uy uy uy uy uy uy uy
LEC 8
Monday Tues Wed Thur Fri Sat SunWEEK 1 8-Aug 9-Aug 10-Aug 11-Aug 12-Aug 13-Aug 14-Aug
PCGH NICU PCGH OPD/ER
chua chua chua chua chua chua chua
de la cruz de la cruz de la cruz de la cruz de la cruz de la cruz de la cruz
rayel rayel rayel rayel rayel rayel rayel
teo teo teo teo teo teo teo
redota redota redota redota redota redota redota
uy uy uy uy uy uy uy
joaquin joaquin joaquin joaquin joaquin joaquin joaquinWEEK 2 15-Aug 16-Aug 17-Aug 18-Aug 19-Aug 20-Aug 21-Aug
PCGH NICU PCGH OPD/ER
redota redota redota redota redota redota redota
uy uy uy uy uy uy uy
joaquin joaquin joaquin joaquin joaquin joaquin joaquin
chua chua chua chua chua chua chua
de la cruz de la cruz de la cruz de la cruz de la cruz de la cruz de la cruz
rayel rayel rayel rayel rayel rayel rayel
teo teo teo teo teo teo teo
LEC 8