My pediatrics site evaluator was Professor Gary Maida. I submitted three H&Ps, ten pharm cards and a journal article with summary. This was a unique site visit as it was just me and my colleague in this group and we were both at the same hospital for our rotation. Therefore, it was insightful to hear her experiences and cases on days that I was not at the site, especially while in the emergency department. During the first evaluation, I presented one H&P on a patient with a fever and rash. I thought this was an important case to present because a fever and/or rash is a common reason why a child is brought to the emergency department or to their pediatrician. This case allowed me to personally think of important differentials I must keep in mind if a child presents with these symptoms. During our evaluation, we discussed the drawbacks of this case, such that the clinician I was with made a clinical diagnosis of scarlet fever without ordering a strep swab/culture. While I did not agree with this, I still presented the case as I thought it was important to discuss this pitfall, as we have learned and seen the overuse of antibiotics. On my second evaluation, we discussed an additional H&P and my journal article, both of which were related to hair-tourniquet syndrome. I had an infant present with a hair-tourniquet on one of their toes, which was an issue I have never seen in real-life before. I was able to watch the clinician remove the tourniquet after some time, but I realized the difficulty of this procedure and the skill it requires. While unfortunate for the infant, I was fortunate to see this case, as the clinician stated he has only seen a handful in his entire career. For my journal article, I discussed another possible solution to removing hair tourniquets, as I was interested in learning more about what can be done to remove the hair in a quick and efficient manner. Lastly, I enjoyed being quizzed on the pharm cards of my colleague who was in the site evaluation with me. This allowed me to review the key aspects of the medications and how they work in certain conditions.

The pediatric site evaluations helped me remember the important information that must be included in pediatric notes. These include, but are not limited to, whether the patient was preterm or full term, if vaccinations are up to date, if they are wetting the same number of diapers and tolerating liquids. As I return to an inpatient setting in internal medicine, I plan to continue to work on my different diagnoses, treatment plans and being comfortable with discussing next steps with not only the patient but with the patient’s family.