MD Courses — Pediatrics

First year

Selectives

M04 526 NEW DISEASES, NEW PATHOGENS
For full description, see Department of Molecular Microbiology.

Second year

M65 640A PHYSICIANS, PATIENTS & SOCIETY: PEDIATRICS
Instructors: Amanda Emke, MD and Erika Hayes, MD

This year-long curriculum introduces students to the unique nature of pediatrics as a subspecialty focused on the role of pediatricians in assessing and managing growth and development, the impact of environment on growth and development, and the way a pediatrician’s role changes in concert with the patient’s growth and development. Through a series of lectures and Team-Based Learning sessions, students are given the knowledge, skills and attitudes to understand and recognize pediatric pathology through an intricate understanding of preventative health and health supervision, normal growth and development, focused pathologies in each organ-specific area, and the unique physician-patient relationship in such a dynamic specialty. The unique aspects of the physical examination of patients across various ages and developmental levels are presented in an optional Physical Examination Night.

Third year

M65 760 PEDIATRICS CLERKSHIP
Instructors: Michelle Estabrook, MD and Colleen Wallace, MD (both: 454-6299)

This six-week curriculum emphasizes pediatric pathophysiology and normal growth and development from birth through adolescence. The clerkship consists of three two-week rotations that encompass inpatient medicine, newborn nursery and an ambulatory experience. Sites include St. Louis Children’s Hospital, Progress West, and Missouri Baptist Medical Center as well as community pediatricians’ offices.  Students will learn to perform and document age appropriate pediatric histories and physical examinations, develop evidenced based differential diagnoses, and construct logical plans for diagnosis and treatment. Daily rounds with house staff and attending physicians, as well as weekly case management conferences and grand rounds, further this emphasis.

Fourth year

Electives

M65 801 / GENERAL PEDIATRIC SUB-INTERNSHIP – ST. LOUIS CHILDREN’S HOSPITAL
Instructor(s): Michele Estabrook, MD
Location: St. Louis Children’s Hospital
Elective Contact: Liz Scott, 4S30, St. Louis Children’s Hospital, 314-454-6299

Other Information: The student can choose either 8 East or 8 West. If both students prefer the same floor, a lottery will be used for assignments.
Enrollment limit per period: 2
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This is the general pediatric sub-internship. The student will be assigned patients on one of two inpatient pediatric floor teams. They will follow patients from initial evaluation and for continuing care until discharge. Students work directly under the supervision of the senior resident and manage their own patients without co-coverage by an intern. Teaching rounds are conducted by the faculty. The elective will provide experience in the management of many pediatric medical conditions (variable depending on floor) and will include the care of patients with various diseases including pulmonary, infectious diseases, gastrointestinal, renal, neurological, endocrine, and rheumatologic issues.  Additionally, patients with failure to thrive, asthmatic exacerbations, poisonings, PICU transfers and undiagnosed conditions may be seen.

Student time distribution: Inpatient 100%; Subspecialty Care/General Pediatrics 100%
Major teaching responsibility: Attendings and residents
Patients seen/weekly: Approximately 12
On call/weekend responsibility: 2-3 weekend days, 5 consecutive night shifts

M65 808 / PEDIATRIC ASTHMA AND ALLERGY
Instructor(s): Leonard B. Bacharier, MD; Caroline Horner, MD; Robert C. Strunk, MD; Avraham Beigelman, MD; Alysa Ellis, MD; and Maleewan Kitcharoensakkul, MD; 314-454-2694
Location: St. Louis Children’s Hospital and St. Louis Children’s Specialty Care Center
Elective Contact: Kim Tinsley, 314-454-2158

Other Information: Students should call 314-454-2158 prior to the start of this elective for location and time.
Enrollment limit per period: 1
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

In predominantly an outpatient setting, students will evaluate patients with a wide variety of allergic and immunologic disorders including asthma, allergic rhinitis, anaphylaxis, food allergy, atopic dermatitis, urticaria, angioedema and primary immunodeficiency. Rotation goals include: (1) the extension of history-taking skills to include environmental exposures, (2) the recognition of physical findings suggestive of allergic disease, (3) understanding the indications and interpretation of diagnostic testing including skin testing and assessment of pulmonary function, and (4) application of appropriate therapeutic strategies to these disorders. Weekly didactic conferences and inpatient consultations provide additional educational opportunities to the student.

Student time distribution: Inpatient 10%; Outpatient 80%; Conferences/ Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: Leonard B. Bacharier, MD, and Caroline Horner, MD
Patients seen/weekly: 40
On call/weekend responsibility: None

M65 809 / PEDIATRIC PULMONARY SUB-INTERNSHIP
Instructor(s): Thomas Ferkol, Jr., MD; Leonard Bacharier, MD; Avraham Beigelman, MD; Joshua Blatter, MD; Ferdinand Coste, DO; Andrea Coverstone, MD; Alysa Ellis, MD; Albert Faro, MD; Amjad Horani, MD; Kay Horner, MD; James Kemp, MD; Maleewan Kitcharoensakkul, MD; Peter Michelson, MD; Jessica Pittman, MD; Katherine Rivera-Spoljaric, MD; and Stuart C. Sweet, MD, PhD
Location: St. Louis Children’s Hospital
Elective Contact: Thomas Ferkol, Jr., MD, 314-454-2158, or Ferdinand Coste, DO, 314-747-5752

Other Information: Students report to 7 East Respiratory Unit, St. Louis Children’s Hospital, 7:00 a.m. first day of elective.
Enrollment limit per period: 1
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

On the 7 East Respiratory Unit, the sub-intern is an active member of a multidisciplinary care team, consisting of attending pulmonologist or allergist, advanced practice nurses, second-year pediatric residents, unit nurses, and other care providers and takes responsibility for children with acute and chronic lung diseases admitted to the unit.  The student will be co-managed with a senior pediatric resident and the sub-intern will be directly supervised by the pediatric residents and attending physician in the daily care of patients.  The rotation is structured to provide students with a primarily clinical experience to allow them to gain exposure to the breadth of lung diseases seen at St. Louis Children’s Hospital.

The volume of patients on the 7 East Respiratory Unit varies with the number of patients covered by the sub-intern at any time, and he or she will typically be responsible for the care of two to six patients at any given time.  The student will be exposed to children with wide-ranging lung diseases and breathing disorders, such as asthma, cystic fibrosis, bronchopulmonary dysplasia, bronchiolitis, pneumonia, chronic respiratory insufficiency, and congenital lung anomalies during their clinical rotation.  The student will also have the opportunity to participate in tests and procedures essential to the practice of pulmonary and allergy medicine, including pulmonary function studies, flexible fiberoptic bronchoscopy, and overnight polysomnography. Sub-interns do not have evening coverage responsibilities, and weekend responsibilities are limited to two days during the four-week block.  They are strongly encouraged to attend departmental and divisional conferences.

Student time distribution: Inpatient 80%; Outpatient 10%; Conferences/ Lectures 10%; Primary Care 30%; Subspecialty Care 70%
Major teaching responsibility: Attending Physician
Patients seen/weekly: 10-15
On call/weekend responsibility: Two weekend days per month

M65 811 / PEDIATRIC CRITICAL CARE MEDICINE
Instructor(s): Stuart Friess, MD
Location: St. Louis Children’s Hospital
Elective Contact: Stuart Friess, MD, Friess_S@kids.wustl.edu, 286-2799

Other Information: Students report to the PICU, 7th Floor St. Louis Children’s Hospital, 6:30 a.m. first day of elective.
Enrollment limit per period: 1
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This elective is designed to familiarize the student with the diagnosis and treatment of critical illness in infants and children. To this end, each student is made responsible for a small number of assigned cases under the direct supervision of pediatric residents, pediatric critical care fellows, and faculty. The teaching activities emphasize the understanding of pathophysiological processes that lead to respiratory, circulatory, and central nervous system dysfunction and their therapy in the developing subject. Students are expected to participate in all the daily activities of the Pediatric Intensive Care Unit at St. Louis Children’s Hospital and be on occasional call after hours.

Student time distribution: Inpatient 100%; Subspecialty Care 100%
Major teaching responsibility: Attending, critical care fellows, and pediatric residents
Patients seen/weekly: 150
On call/weekend responsibility: Yes

M65 813 / PEDIATRIC CARDIAC CATHETERIZATION
Instructor(s): David Balzer, MD, and Shabana Shahanavaz, MBBS
Location: St. Louis Children’s Hospital
Elective Contact: David Balzer, MD, 314-454-6095

Other Information: Students report to  St. Louis Children’s Hospital Cath Lab (7th Floor), 8:00 a.m. first day of elective.
Enrollment limit per period: 1
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

Elective will focus on interpretation of hemodynamic and angiographic data acquired in the cardiac catheterization laboratory.

Student time distribution: Inpatient 95%; Conferences/ Lectures 5%; Subspecialty Care 100%
Major teaching responsibility: Two attendings, supplemented by one fellow
Patients seen/weekly: 10
On call/weekend responsibility: None

M65 819 / PEDIATRIC CARDIOLOGY-OUTPATIENT
Instructor(s): Georgeann Groh, MD; George Van Hare, MD; Shafkat Anwar, MD; Dave Balzer, MD; Charles Canter, MD; Chesney Castleberry, MD; Mark Grady, MD; Patrick Jay, MD; Mark Johnson, MD; Caroline Lee, MD; Jennifer Silva, MD; Shabana Shahanavaz, MBBS; Kathleen Simpson, MD; Gautam Singh, MD; and Bridget Zoeller, MD
Location: St. Louis Children’s Hospital and Children’s Specialty Care Center
Elective Contact: Georgeann Groh, MD, groh_g@wustl.edu, 314-454-6095

Other Information: Schedules are kept on the residents’ hard drive.  For additional information and questions, students should report to 8th Floor, Northwest Tower, Division of Cardiology, Kim Graham, Room 8206, 8:00 a.m. first day of elective to pick up a clinic schedule.  Students are encouraged to contact/meet with the elective coordinator, Dr. Groh, prior to the elective, to plan their rotation according to their interests and career goals
Enrollment limit per period: 1
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

Students will be exposed to the wide spectrum of pediatric cardiology on an outpatient basis.  In addition to general cardiology clinics, several subspecialty clinics are also available, including heart failure/transplant, electrophysiology/inherited arrhythmias, pulmonary hypertension, William’s syndrome, Down syndrome, and preventative cardiology clinic.  Students will independently evaluate clinic patients referred for a variety of cardiac complaints, such as cardiac murmurs, chest pain, syncope, arrhythmia, as well a wide variety of congenital cardiac lesions, and report their findings to the attending.  Cardiac auscultation skills will be enhanced through auscultation of cardiac patients in a clinic environment.  Students will learn basics of ECG and echocardiogram interpretation by reviewing studies performed during clinic with the attending.  Clinics are held at St. Louis Children’s Hospital, and the Children’s Specialty Care Center in West County.  Students also have the option to participate in outreach clinics that occur on a monthly basis (locations include Cape Girardeau, Poplar Bluff, Rolla, Bonne Terre, and Columbia).  Depending on interest, students may spend additional time in the echocardiography laboratory for more in depth exposure to echocardiography.  Participation in weekly surgical conference and daily cardiology educational conferences is encouraged.

Student time distribution: Outpatient 95%; Conferences/Lectures 5%; Subspecialty Care 100%
Major teaching responsibility: Multiple attendings
Patients seen/weekly: 25
On call/weekend responsibility: None required

M65 826 / GENETICS AND GENOMIC MEDICINE
Instructor(s): D. Kathy Grange, MD
Location: St. Louis Children’s Hospital
Elective Contact: D. Kathy Grange, MD, 314-454-6093

Other Information: Students should report to the Genetics office on the 9th floor of the Northwest Tower at 9:00 a.m. first day of elective.
Enrollment limit per period: 1
Valid start weeks for four-week blocks are:  Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

The goal of this senior elective is to facilitate the acquisition of clinical skills and knowledge in genetics and genomic medicine.  The student will actively participate in the diagnosis and management of pediatric and adult patients with genetic disease in both the ambulatory and in-patient settings.  Emphasis will be placed on application of the science of genetics to the bedside and will include a broad exposure to patients with biochemical, metabolic, structural and complex genetic diseases.  Students will have an opportunity to visit clinical laboratories involved with diagnosis of genetic disorders, including the cytogenetics, molecular genetics and biochemical genetics laboratories. Students will be expected to participate in the weekly clinical case conference.

Student time distribution: Inpatient 30%; Outpatient 60%; Conferences/Lectures 10%; Subspecialty Care 100%.
Major teaching responsibility: Attendings
Patients seen/weekly: 15
On call/weekend responsibility: None

M65 827 / SUB-INTERNSHIP – PEDIATRIC HEMATOLOGY/ONCOLOGY
Instructor(s): Robert Hayashi, MD
Location: St. Louis Children’s Hospital, 9 West
Elective Contact: Robert Hayashi, MD, 314-454-4118

Other Information: Students report to 9 South Nursing Station, 8:00 a.m. first day of elective.
Enrollment limit per period: 1
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

Students will assume the responsibilities of a pediatric resident on the inpatient Hematology/Oncology service at St. Louis Children’s Hospital.

Student time distribution: Inpatient 90%; Conferences/Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: Single attending, first-year hematology/oncology fellow.
Patients seen/weekly: 2-3 patients a day
On call/weekend responsibility: None

M65 836 / PEDIATRIC RHEUMATOLOGY
Instructor(s): Andrew White, MD; Kevin Baszis, MD; Megan Cooper, MD, PhD; and Anthony French, MD, PhD
Location: St. Louis Children’s Hospital
Elective Contact: Andrew White, MD, 314-454-6124

Other Information: Students report to Rheumatology Clinic, Suite C, St. Louis Children’s Hospital, 8:30 a.m. first day of elective.
Enrollment limit per period: 1
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

Opportunities are available to care for children with a variety of immunologic and rheumatologic disorders. Students will see patients in outpatient clinics and inpatient consultations. An in-depth approach to evaluating disorders of the immunologic system will be provided. Students will participate in evaluation of new patients with a variety of rheumatologic diseases including JRA, SLE, and scleroderma at both SLCH and Shriners Hospital clinics. Students may elect to participate in conferences and seminars.

Student time distribution: Inpatient 20%; Outpatient 70%; Conferences/ Lectures 10%; Primary Care 30%; Subspecialty Care 70%
Major teaching responsibility: Andrew White, MD
Patients seen/weekly: 35-40
On call/weekend responsibility: None

M65 838 / PEDIATRIC GASTROENTEROLOGY, HEPATOLOGY & NUTRITION
Instructor(s): Alex Weymann, MD (medical student supervisor); Brian DeBosch, MD, PhD; Christina Hickey, MD; Lori Holtz, MD; Shannon Joerger, MD; Robert Rothbaum, MD; David Rudnick, MD; Chip Samson, MD; Phillip Tarr, MD; Yumi Turmelle, MD; and Liz Utterson, MD
Location: Gastroenterology Clinical Offices, 9th Floor, Northwest Tower
Elective Contact: Maida Redzic, 286-2848, redzic_m@kids.wustl.edu

Other Information: Students should contact Maida Redzic at least one week in advance of first day of elective for further information.
Enrollment limit per period: 1
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

The rotation in Pediatric Gastroenterology, Hepatology, and Nutrition provides broad exposure to specialized and common pediatric problems.  Division patients are seen in the outpatient suites and in the hospital.  Students evaluate outpatients with common pediatric complaints like abdominal pain, constipation, and poor growth.  Additionally, students experience the ongoing outpatient care of patients with liver disease, inflammatory bowel disease, short-gut syndrome, celiac disease, and other rare disorders.  The inpatient service provides experience in caring for patients with acute illnesses such as gastrointestinal bleeding, malnutrition, liver failure, complications of inflammatory bowel disease, and pancreatitis.  Students participate in diagnostic and therapeutic endoscopic procedures.  At weekly divisional conferences, faculty, fellows, and students review pathology slides from current cases and discuss difficult patient problems and topics of interest.

Student time distribution: The time spent in the outpatient clinic and on the inpatient service can be individualized according to the student’s interests.  In general, the distribution is: Inpatient 50%; Outpatient 30%; Procedures 10%; Conferences/Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: Faculty and fellows
Patients seen/weekly: 150 (entire division) /week (outpatients), 70/week (inpatients), 20/week (procedures).  Students participate in a subset (most interesting/instructive cases)
On call/weekend responsibility: None

M65 840 / PEDIATRIC INFECTIOUS DISEASES
Instructor(s): David Hunstad, MD; Alexis Elward, MD; Michele Estabrook, MD; Stephanie Fritz, MD; Ericka Hayes, MD; S. Celeste Morley, MD, PhD; Audrey Odom, MD, PhD; Gregory Storch, MD; Indi Trehan, MD; and Rachel Orscheln, MD; 314-454-6050
Location: St. Louis Children’s Hospital
Elective Contact: Pam Wilson, 314-286-2778

Other Information: Students should contact Fellow on call at 314-424-6877 one week prior to start of elective.
Enrollment limit per period: 1
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This elective is designed to introduce students to the clinical aspects of infectious diseases in children. Students will consult on both inpatients and outpatients. Regular daily activities will include evaluation of new patients, work rounds on inpatient consults, microbiology teaching rounds in the bacteriology and virology labs, and teaching rounds with the infectious diseases attending. Students will attend the general pediatric clinic and the pediatric HIV clinic once per week. Formal teaching sessions include a weekly pediatric infectious disease case conference, a weekly joint clinical conference with the adult infectious diseases group, and a weekly pediatric infectious diseases research conference.

Student time distribution: Inpatient 70%; Outpatient 20%; Conferences/ Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: One or two attendings, one or two fellows
Patients seen/weekly: 5-10 new patients primarily, over 15-20 new patients with team
On call/weekend responsibility: None

M65 845 / PEDIATRIC EMERGENCY MEDICINE
Instructor(s): Kimberly S. Quayle, MD and Robert (Bo) M. Kennedy, MD
Location: St. Louis Children’s Hospital
Elective Contact: Carol Heller, 454-2341

Other Information: Students report to Room 9105 Northwest Tower, 8:30 a.m. first day of elective.
Enrollment limit per period: 2
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

The goal of this elective is to provide the senior medical student with a broad introductory clinical experience in pediatric emergency medicine. Functioning as a subintern in the Emergency Unit of St. Louis Children’s Hospital, the student will have the opportunity to evaluate and manage patients with a wide variety of emergent and urgent medical and surgical problems. Examples include: respiratory distress, abdominal pain, lacerations, bone injuries, rashes, fever, etc.

Students will work either a day shift (7:30 a.m.-3:00 p.m.) or an evening shift (3:00 p.m.-11:00 p.m.) in rotation. Daily teaching conferences are provided by the attending staff. A weekly meeting of the students and senior faculty will occur to review interesting cases. Also, attending staff and senior pediatric residents provide 24-hour on-site supervision. Each medical student will be asked to prepare a 20-minute presentation on a topic of his/her choosing.

Student time distribution: Outpatient 90%’ Conferences/Lectures 10%; Subspecialty Care (Emergency Medicine) 100%
Major teaching responsibility: All EM attendings
Patients seen/weekly: ~30
On call/weekend responsibility: None (unless making up time)

M65 849 / PEDIATRIC ENDOCRINOLOGY AND DIABETES
Instructor(s): Abby Hollander, MD; Bess Marshall, MD; Paul Hruz, MD, PhD; Ana Maria Arbelaez, MD; Neil White, MD; Andrea Granados, MD.; and Jennifer Sprague, MD, PhD, 314-454-6051
Location: St. Louis Children’s Hospital
Elective Contact: Kathy Corey, 314-286-2725

Other Information: Student has the option to extend elective. Students report to Endocrinology and Diabetes Office, 9th Floor Northwest Tower, 8:30 a.m. first day of elective.
Enrollment limit per period: 2
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This elective is designed to include broad clinical experience in pediatric endocrinology and diabetes. The student will have an opportunity to evaluate both patients admitted to St. Louis Children’s Hospital and patients referred for consultation in our three outpatient clinics each week. In addition to a divisional conference to review referred patients, several joint conferences with the adult Endocrinology and Diabetes Division (clinical rounds, journal club/research seminar, case conference) are held weekly.

Student time distribution: Inpatient 40%; Outpatient 50%; Conferences/Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: Attending physicians and fellows
Patients seen/weekly: 10-20 by student
On call/weekend responsibility: None

M65 852 / CLINICAL PEDIATRIC PULMONARY MEDICINE
Instructor(s): Thomas Ferkol, Jr., MD; Leonard Bacharier, MD; Avraham Beigelman, MD; Joshua Blatter, MD; Ferdinand Coste, DO; Andrea Coverstone, MD; Alysa Ellis, MD; Albert Faro, MD; Amjad Horani, MD; Kay Horner, MD; James Kemp, MD; Peter Michelson, MD; Jessica Pittman, MD; Katherine Rivera-Spoljaric, MD; Robert C. Struck, ND; and Stuart C. Sweet, MD, PhD; 314-454-2694
Location: St. Louis Children’s Hospital
Elective Contact: Kim Tinsley, 314-454-2158

Other Information: Students should call 314-454-2158 prior to the start of  elective for location and time.
Enrollment limit per period: 2
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This elective provides an excellent opportunity for students to be exposed to the full scope of respiratory diseases and sleep disorders in infants and children.  Pediatric referrals will be seen in both an inpatient and outpatient setting.  Rotation goals for students include:  (1) gain greater insights into the genetics, epidemiology, pathophysiology, and clinical presentations of lung diseases in children; (2) learn the importance of the physical examination using inspection, percussion, and auscultation; (3) understand indications and interpretation of diagnostic tests, such as chest imaging, blood gas measurements, polysomnography, pulmonary function testing, and bronchoscopy with biopsy and lavage; and (4) learn to apply therapeutic interventions to common lung diseases.  Unique aspects of this rotation include, a broad exposure to children with asthma, cystic fibrosis, ciliopathies, interstitial lung diseases, chronic lung disease of infancy, congenital lung malformations, and end-stage cardiopulmonary diseases referred for lung transplantation.  Weekly didactic sessions, as well as divisional clinical conferences, provide opportunities for the trainee to develop his or her presentation skills.

Student time distribution:  Inpatient varies; Outpatient varies; Conferences/Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: Attendings
Patients seen/weekly: 25
On call/weekend responsibility: None

M65 861 / NEWBORN MEDICINE
Instructor(s): Akshaya Vachharajani, MD
Location: 8th Floor Northwest Tower
Elective Contact: Emily Alexander, 314-454-6148

Other Information: Students should schedule an appointment with Emily to meet with Dr. Vachharajani. Appointments should be scheduled one week prior to class start date.
Enrollment limit per period: 2
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

The goal of this course is to provide students with responsibility for caring for newborn infants who range from normal, to acutely ill, to chronically ill, and for their families.  The physiology of the transition from fetal to extrauterine existence, the pathophysiology of specific diseases, and primary accountability of the student for patient management decisions and procedures, will be emphasized.  In addition, collaboration with nursing staff, other health care providers in decision-making (especially concerning the viability of individual infants), and family management will be regularly required.

Students, during each rotation, will have the option to rotate through the Neonatal Intensive Care Unit at St. Louis Children’s Hospital and/or the labor and delivery services at Barnes-Jewish Hospital.  Students assigned to the Labor and Delivery Service will routinely be involved in normal newborn care and delivery room management.  The student will be expected to rotate patient responsibilities every fourth night.

Student time distribution: Inpatient 90%; Outpatient 5%; Conferences/ Lectures 5%; Subspecialty Care 100%
Major teaching responsibility: Attending, fellow and residents
Patients seen/weekly: 30
On call/weekend responsibility: Every fourth night

M65 875 / PEDIATRIC RENAL DISEASE
Instructor(s): Vikas Dharnidharka, MD, MPH; Keith A. Hruska, MD; S. Paul Hmiel, MD, PhD; Carmen Halabi, MD, PhD; Thomas Keefe Davis, MD; and Tara Neumayr, MD
Location: St. Louis Children’s Hospital
Elective Contact: Vikas Dharnidharka, MD, MPH, 314-454-6043

Other Information: Students report to the Division of Nephrology, 314-286-1574, 10th Floor Northwest Tower, 8:15 a.m. first day of elective.
Enrollment limit per period: 1
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This course is designed to provide the student with a wide exposure to all aspects of pediatric renal disease and an opportunity to explore a desired aspect of the field in-depth. The student will be an integral part of the Renal Team and as such will see both inpatients and outpatients. Students will have an opportunity to follow the courses of patients with acute renal disease as well as those with more chronic problems and will help to plan the evaluation and therapeutic management of these patients. Discussions and rounds with the attending staff and fellows emphasize the relationship between clinical problems and the pathophysiology of the underlying disease. These informal teaching sessions are supplemented by more formal sessions. These include renal attending rounds, renal research rounds and grand rounds, which are conducted weekly in conjunction with the Renal Division of Barnes-Jewish Hospital. Renal biopsy material is reviewed with the renal pathologists. Attendance at the weekly pediatric grand rounds and pediatric case conferences is encouraged. Opportunities in clinical and translational research projects will be discussed with interested students.

Student time distribution: Inpatient 50%; Outpatient 40%; Conferences/ Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: Attendings
Patients seen/weekly: 12-15
On call/weekend responsibility: None

M65 876 / PEDIATRIC LUNG TRANSPLANTATION
Instructor(s): Stuart C. Sweet, MD; Peter Michelson, MD; Albert Faro, MD; and Joshua Blatter, MD, 314-454-2214
Location: St. Louis Children’s Hospital
Elective Contact: Kim Tinsley, 314-454-2158

Other Information: Students should call 314-454-2158 prior to the start of elective for location and time.
Enrollment limit per period: 2
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

St. Louis Children’s Hospital has the largest pediatric lung transplantation program in North America. This unique clinical rotation will enable students to be exposed to the process of transplantation from referral and listing to the actual surgery and post-operative care. Both inpatient and twice weekly outpatient clinics will be available for participation and learning. The use of diagnostic tests, including flexible fiberoptic bronchoscopy with biopsies and bronchoalveolar lavage, histopathology of infection and graft rejection, and the complexities of immunosuppression will all be explored. Weekly multidisciplinary meetings with our team, as well as didactic, psychosocial, and ethical meetings will be available. Our patient referral base is worldwide, and includes infants and children with cystic fibrosis, pulmonary hypertension, complex congenital heart defects, surfactant protein defects and alveolar proteinosis.

Student time distribution: Inpatient 50%; Outpatient 40%; Conferences/ Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: Attendings
Patients seen/weekly: 20-30
On call/weekend responsibility: None

M65 878 / CLERKSHIP IN RURAL PRIMARY CARE PEDIATRICS
Instructor(s): Michele Estabrook, MD, 314-454-6299; Claudia Preuschoff, MD, in Cape Girardeau, MO
Location: Cape Girardeau, MO
Elective Contact: Liz Scott, St. Louis Children’s Hospital, 314-454-6299

Other Information: Students should call Liz Scott, 314-454-6299, at beginning of school year to confirm dates.  Students should then report to the site on their first day, at time determined by Dr. Preuschoff.  Enrollment limit per period: 1
Valid start weeks for two or four-week blocks are: Weeks 1, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 23, 25, 27, 29, 31, 33, 35, 37, 39, and 41.

The clerkship in rural primary care pediatrics is designed to provide the student with first-hand experience in general pediatric practice in a rural community setting.  Students will have the opportunity to see patients in a private office, participate in delivery room resuscitation, evaluate patients in the emergency department, and provide pediatric consultation to family practitioners, obstetricians, and surgeons.  The objective of this elective is to provide the student with the experience of serving as a general pediatrician providing comprehensive health services in a rural community.  Students assume responsibility for ongoing care of patients and have opportunities to perform procedures. Two-week or four-week blocks are available.

Student time distribution: Inpatient 10%; Outpatient 90%; Primary Care 100%
Major teaching responsibility: Single attending
Patients seen/weekly: 25-50
On call/weekend responsibility: Call with instructor, not in-house call