Student Spotlight: Ariel Breeze

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.