Transitioning into clinical rotations has
been a component of the program I have been looking forward to since as early
as the application cycle. I started my rotation block with pediatrics at the
Children’s Hospital of Pittsburgh, which has proven to be an incredibly
rewarding experience in such a brief period. Prior to rotations beginning, I
was paired with a genetic counselor working at the hospital who has provided me
with significant guidance throughout the rotation, helping me to find certain
types of conditions and appointments to shadow or participate in and helping to
build my confidence and comfortability.
Pediatrics at the Children’s Hospital of
Pittsburgh provides a truly unique experience with a host of opportunities outside
of the typical clinical indications you anticipate seeing. Specifically,
everyone who rotates at Children’s is given the opportunity to see three
specialties beyond typically pediatric cases: inborn errors of metabolism
(IEM), lysosomal storage disorders (LSD), and inpatient. The IEM component of
the rotation involves seeing patients with a physician, a nurse specialized in
metabolic genetics, a dietician, and a genetic counselor depending on the
indication. You may also observe an abnormal newborn screen if the opportunity
arises while in this portion of your clinic experience. As each student is
provided with the opportunity to choose an optional rotation experience, I have
elected to pursue mine in the newborn screening and IEM space especially given
my interest in public health screening initiatives as a dual-degree student.
The LSD component of the clinic allows students to see these patients both in
an outpatient setting and while they are receiving enzyme infusions, one of the
treatment types that works most effectively in these patients. We also spend
two weeks seeing inpatient cases, which involve patients having been admitted
to the hospital that have had genetic consults requested. These cases arise
spontaneously and are both fascinating and rewarding. I have had the
opportunity to observe one inpatient case during my rotation block thus far,
and the entirety of the session feels vastly different than a typical
outpatient case from the pedigree creation process to the discussion of genetic
testing. Parents are exhausted and, understandably, scared, and this provides
an opportunity to really put those counseling skills to work and help these
patients as much as possible despite the tense environment.
Additionally, any students interested in
other opportunities can spend their time at Children’s seeing patients in the
pediatric cardiogenetic clinic, the pediatric cancer predisposition clinic, or
at satellite clinics serving Plain communities in Hermitage or other hospitals
in Wexford and Monroeville. Personally, I have made time in my rotation block
to see pediatric cardiogenetics patients considering my wide interest in
cardiovascular conditions. I learned so much during these cases, and despite
being a pediatric case at Children’s as well, the workflow for these cases
looks vastly different than what you will see with typical outpatient
experiences. Generally, these patients enter will enter their appointments
already aware of the sort of condition they likely have, allowing for more
tailored sessions of the genetic condition being considered and the inheritance
pattern of these conditions (for example, Long QT syndrome).
Transitioning from a full class load into
full-time rotations has certainly been an adjustment. While I find myself as
busy as ever, looking through my patients’ medical histories in preparation for
sessions feels important and rewarding. Though I have just started my
rotations, I have already learned so much and my supervisors have provided me
with several tips to help me hone my genetic counseling skills. The types of
indications you will see in pediatrics is so broad that you end up learning so
much simply by talking to your patients that you would not necessarily read
about otherwise. Rarely does the amount of time spent feel like a chore when
there is so much to look forward to during these rotation blocks. Pitt offers a
rich variety of clinical rotation experiences even housed within the typical
core rotation blocks, and so there is truly something for everyone throughout
your time spent in the clinical setting.
