Preceptor: Philip Kahn, M.D.

Course Code: 13-22

Email: Lakesha.Baker@nyumc.org

Telephone: (212) 263-8111

Prerequisites: Pediatric Clerkship

Description

Students will participate in the clinical activities of the Pediatric Rheumatology Service, including outpatient clinics, private office hours, infusion visits and inpatient/emergency room consultations. A full schedule of educational activities is offered: weekly management conferences, weekly rheumatology journal clubs, weekly rheumatology seminar series, weekly pediatric grand rounds, and monthly adult rheumatology grand rounds as well as other conferences, including pediatrics morning report and morbidity and mortality conferences if appropriate. Students will participate in joint seminars with the Adult Rheumatology Service, as indicated above, working closely with the adult fellows in pediatric rheumatology clinic. Students will be assigned new patients for consultation and chronic patients for follow-up focusing on their medical care as well as the psychosocial aspects of chronic disease in children and its affect on the patient and family.

This clinical rotation will provide a good overview of pediatric rheumatology without requiring a high degree of prior specific knowledge/experience. Within this four week elective students will be exposed to the breadth and depth of pediatric rheumatic disease, as well as other disease masquerading as rheumatic disease.

Objectives of the Elective

1. The elective rotation in Pediatric Rheumatology is designed to accomplish the following goals:
   1. Help train the student to perform a guided, yet thorough history, actively sleuthing for rheumatic disease, which may be subtle in children.
   2. Train students how to perform a thoughtful physical exam, focusing on the musculoskeletal system, as well as looking for signs of systemic disease.
   3. Provide an overview of musculoskeletal disease in children including common orthopedic issues.
   4. Update regarding the management of pediatric rheumatic disease, including Juvenile Idiopathic Arthritis, Lupus, Dermatomyositis, Kawasaki’s disease and more.
   5. Demonstrate a comprehensive approach to systemic disease by including the student in case management discussions.
   6. Integrate molecular biologic/genetic principles with the clinical diagnosis and management in order to better understand the pathophysiologic mechanisms of disease
   7. Gain exposure to physical/occupational therapy and rehabilitation medicine.
2. At the end of the four week rotation the Student will be able to:
   1. Increase understanding of the molecular basis of disease by directed literature review.
   2. Interpretation of laboratory analysis including serology, and knowing when to send certain tests.
   3. Demonstrate skill in the performance of a thorough musculoskeletal exam, as well other disease systems.

Key Responsibilities of the student while on Elective

1. No night call on this service.

2. Students act as primary consultants for inpatient consultations, under the supervision of an Attending. Students are encouraged to pre-round on any in-patients, and communicate with the team in order to begin the process of clinical decision-making prior to speaking with the attending.
3. Students are the primary physicians seeing outpatients with Fellow and attending supervision. Student may more likely shadow attending in the private office.
4. Students attend all educational activities of the Service:
   1. Rheumatology Journal Club Center for Musculoskeletal Care- 333 E. 38th street, 6th floor large conference room, Monday at 8:30AM.
   2. Didactic Teaching sessions, patient management conferences
   3. Research seminars (Thursday/Wednesday mornings to be determined)
   4. Pediatric Grand Rounds, Morbidity and Mortality conferences
   5. Rheumatology Grand Rounds
5. Students are expected to research and present a selected topic of his/her choice related to rheumatic disease focusing on the key elements in a rheumatic history and physical exam to create a broad differential diagnosis.

Didactic Program

Students are fully integrated into the elective, receiving the same didactic program as Pediatric Residents on elective.

Students are encouraged to write up any topic of interest for abstract or manuscript preparation.

Method of Evaluation

Students are evaluated by the faculty with whom they had contact.

Scheduling Information

Months Offered: All Year except Mar, Jun, Oct

Primary Office: 160 E. 32nd Street, L3 Medical, New York, NY 10016

Students Per Period: 1-2

Duration: 4 Weeks

Clinical schedule: (Subject to change, please email Dr. Kahn the week prior)

Monday 8:30AM Rheumatology Journal Club-Center for Musculoskeletal Care- 333 E. 38th street, 6th floor large conference room

Fink Center (160 E. 38th Street, L3 Medical Floor) Monday/Thursday Morning

Bellevue Pediatric Rheumatology Clinic (3rd floor) Tuesday/Wednesday Morning

Woodhull Medical Center- 1st floor pediatric clinics, 2nd and 4th Tuesday afternoon each Month

Hospital for Joint Disease- 301 E. 17th St at 2nd Avenue, 3rd Floor- Thursday Morning

Maimonides Medical Center- 4802 10th avenue (at 48th Street)- All Day Friday