Stepping Into the World of Pediatrics

The medical field is a dynamic and competitive world in which, when one embarks, there is an ocean of opportunities. The utilization of such opportunities at a correct time by correct person is the hallmark of success. Electives serve such purpose very well. The main aim of doing an elective is to get a good insight of any particular health care specialty as well as improve the previously existing skills. Today, overseas electives are becoming increasing popular and competitive entities. It has always been my wish to work and learn at world renowned hospitals as one of my clinical experience. This dream came true when I was accepted for the elective program at The Hospital for Sick Children – popularly “SickKids” – one of the state of the art teaching hospitals of the University of Toronto. It was a joy to get an opportunity at such prestigious medical facility located right in my home city. The General Pediatrics Department at SickKids was about to be my home for the next four weeks.

FIRST DAY AT THE HOSPITAL FOR SICK CHILDREN

 After a series of paperwork, I was ready to join in on the 1^st day of rotation. SickKids is located at the heart of downtown Toronto, approximately an hour away from my residence. The first day started with my reporting at the office of undergraduate medical education and thereafter getting the student identification badge made. Next, I was schedule for the Clinical Systems Training called KidCare. It is an online system which virtually holds every patient’s complete records including the patient’s visit details, diagnosis, diagnostic images and laboratory results. A person with authorization can put in the orders for nursing, pharmacy and other services through the KidCare system. Lastly, I was scheduled to report at my department which was General Pediatrics 7C where I met my team. The team is headed by a staff physician, supervised by a senior resident and includes 2 to 3 junior residents, clinical clerk (which was my designation), pharmacists and nurses. Once I was oriented with the ward, the routine work began.

A TYPICAL DAY AT SICK KIDS

A typical day at SickKids General Pediatrics Department starts at 7:30 a.m. with the handovers from the night team. Morning team is informed about last night’s patients’ condition as well as an update on new admissions overnight. The team’s family centered rounds begin around 8 a.m. headed by the staff physicians. During the rounds, detailed history of new admissions is discussed with patients and their families and a plan for the day is drawn. Previously admitted patients’ conditions and further management is discussed. Usually a family centered round takes about 2 hours. After completion of rounds, residents and clinical clerks divide the patients among themselves. A clinical clerk usually gets 4 to 5 patients per day to manage. For each assigned patient, I was suppose to follow up with the plan agreed in during the rounds, do the complete assessment and follow up with the laboratory and imaging results. I was also responsible to address any queries of parents of the patients and respond to any emergencies. Once the patient is ready to go home, I was responsible for preparing the complete discharge summary of the patient prior to departure from the hospital. Each day, one hour was designated for teaching rounds. These were either sit-down rounds in form of lecture or table rounds where real cases were discussed. These lectures and discussions greatly aid students and residents to enhance their clinical knowledge. The day usually ends around 5:30 p.m. with handover to the night on-call team. Thus, a tiring but extremely rewarding day would come to an end. I was fortunate to work with the team which was not only dedicated to their work but also keen in teaching and learning. Our staff physician Dr. Eyal Cohen would take every opportunity to instill every learning point we come across during the day. I had the opportunity to observe and manage some very interesting pediatric cases including cystic fibrosis, sickle cell disease, MCAD deficiency, glycine encephalopathy and cyclic vomiting syndrome.

 THE CITY OF TORONTO

Though I was raised in Toronto, Canada, it is always refreshing to visit back the city. Toronto every time has something new and exciting to offer. I was lucky to get my own home comfort though getting a temporary place to live in Toronto is much hassle free. Toronto has one of the world’s best public transit systems. It would take me 45 minutes to travel by underground subway trains to reach my destination – not underrating the comfort and the perfect on time schedule! Toronto is the largest city of Canada and its economic capital. Downtown Toronto is not only the hub of economy but of entertainment and fashion as well. During my busy schedule, I did manage some exploring at the Art Gallery Ontario, Harbourfront, and the historical campus of University of Toronto and of course, the famous Niagara Falls. Toronto is, nonetheless, a city bursting with energy and colors. Most visiting students prefer to find accommodation around the hospital vicinity which saves the cost and time of traveling (about $100 per month). However, the rents of main city accommodations are relatively higher then suburbs. On the other hand, food and utilities are much cheap and every taste is easily available throughout the city. For non-citizens or residents of Canada, obtaining Canadian visit visa for educational purpose should not be a difficult task comparatively. Students should apply for electives at least six months before to allow adequate time for visa processing. More information regarding visa application can be found through Canadian High Commission in Islamabad: http://www.cic.gc.ca. To sum it up, this elective at SickKids hospital not only enhanced my clinical skills but also gave me a better insight to the field of Pediatrics. I believe this will greatly aid me in making my decision for post-graduation as well. It was an excellent opportunity to understand the North American health care system and learn some of its very positive aspects. I strongly suggest those medical students who wish to pursue their post graduate studies in North America to avail this excellent opportunity simply by logging on to University of Toronto website: http://admin.med.utoronto.ca/utme/international/index.cfm for more info. I am sure this elective experience will go a long way with me.