Outpatient US Clinical Experience in Pediatrics in New York

Information about this clinical experience:

You will be under the supervision of a board-certified pediatrician who has had many years of experience educating medical students and pediatric residents. The preceptor is a Clinical Professor of Pediatrics at SUNY Downstate Medical School. The physician holds hospital privileges at One Brooklyn Health. The physician is also actively involved in research, having contributed to articles in different journals including Pediatrics.

The patient population that this preceptor cares for in Brooklyn is underserved. Approximately 50% of patients have Medicaid as their primary insurance. There is a high prevalence of chronic conditions such as obesity and asthma among children in this community. In some segments of the borough, infant mortality is quite high. One-third of families residing in the area struggle with food insecurity. Nearly 20% report unstable housing situations which required them to move within the past year. In this backdrop, missed appointments are a major problem due to work constraints, loss of insurance, and lack of available transportation.

Having established a practice in the community many years ago, this pediatrician has been working feverishly to provide children with the highest quality of care by addressing both medical and social issues. For rotators, this will be an excellent opportunity to understand how these factors are intertwined and how providers can address the social determinants of health to improve health outcomes.

An important aspect of this clinical experience is exposure one day per week to adolescent gynecology. In the U.S., over 50% of females report being sexually active by the age of 18 years. Therefore, it is imperative that aspiring pediatricians receive training in gynecologic care of children and adolescents. Unfortunately, research shows significant gaps in training in this area among graduating pediatric residents. Many programs have no dedicated pediatric and adolescent gynecology clinics or outpatient rotations. Residents also report relatively few hours of didactics dedicated to the subject matter. Early exposure to this aspect of pediatrics will help you direct your future learning efforts as a pediatrics resident to meet the gynecologic needs of your patients.

Please note that the preceptor will assign you topics to research on a regular basis. Rotators will be expected to make presentations on these topics to the team. As you will be expected to do the same during your residency, this will give you a chance to refine your skills in this important area and receive feedback from a seasoned educator.

After a few days of observation, you will take on an increasing role in patient encounters and learn the following under the preceptor’s supervision:

• Taking patient histories under supervision.

• Performing exams under the physician's supervision.

• Presented cases to the preceptor.

• Navigating EMR (eClinicalWorks).

• Researching the literature to answer clinical questions at the point of care.

• Spending time with other healthcare professionals to understand their roles and responsibilities.