SOM Elective Brochure

Electives Type:  Clinical

Elective Title
Acting Internship in Pediatrics-Inpatient-Dell Children's Medical Center of Central Texas in Austin
Course Number
Prerequisites: Successful completion of Year 2 
      Additional Requirements:
Inpatient pediatric experience is preferred but not required. C form and letter of intent to Judy Terlik at
Responsible Faculty Director:
Valli Annamalai, M.D.
Other Faculty:
Location to Report on First Day
Judy Terlik at or 512-324-7860
Periods Offered
including Period 12 (June), NOT including the holiday vacation Period 13 (Dec)
Maximum Enrollment

 The student will develop skills in the care of hospitalized children and will learn an approach to the management of complex illnesses. The key concept to this elective is that the student will be facing many of the same challenges as an intern.

 At the completion of this course the student should: 1. Feel comfortable obtaining a complete history and a physical examination on a pediatric patient. 2. Formulate a problem list and a pertinent differential diagnosis and develop a therapeutic plan for common pediatric problems. 3. Establish priorities in formulating plans. 4. Identify rationale for diagnoses and plans. 5. Utilize appropriately a consultantís opinion. 6. Be able to admit and enter orders on new patients. 7. Be comfortable with patient presentations during family-centered rounds.

Description of course activities
 The student will have the opportunity to function as a pediatric intern on the inpatient service at Dell Childrenís Medical Center of Central Texas. He/she will be assigned to a team consisting of an attending, a senior resident, two junior residents, and third year medical students. The student will be assigned patients for whose care he/she will be responsible. The student will round with their inpatient team daily and attend morning reports and noon conferences. The student will have the opportunity to interact with the attendings, subspecialists, and other members of the healthcare team.

Type of students who would benefit from the course
 Students interested in a residency in Pediatrics or Family Medicine, or other fields that involve caring for children. To enroll, UTMB students should submit a C-form and a letter of intent to Judy Terlik at for approval. Visiting students should submit an application through VSAS: Select UTMB at Galveston as the host institution and indicate you wish to take PEDU 4034 on the application as well as a letter of intent outlining you interest in pediatrics, why the Austin program and inpatient experience.

Weekly Schedule
  Clinical Activities (please insert estimated schedule here)
  Day of Week AM PM
  Monday Morning conference/Ward rounds Patient care
  Tuesday Ward rounds Patient care
  Wednesday 7-9 am Morning didactic/Ward rounds Patient care
  Thursday Morning conference/Ward rounds Patient care
  Friday Morning conference or Grand Rounds/Ward rounds Patient care
  Average number of patients seen per week: 10-15  
  Call Schedule:   3 wks Mon ĖFri 6A-6P; 1 wk Sun-Fri nights 6P-6A  

  Research Activities (please insert estimated schedule here)
  Activity Hours per Week
  Faculty contact time


  Self-directed study

  Data collection/analysis


Method of student evaluation
Check all that apply - complete appropriate section(s) only:
1.  Clinical Observation
  A. Where are students observed on this elective?
    Inpatient service   Ambulatory   Surgery   Standardized patients
Patients simulators   Other
  B. Frequency - How often are students observed clinically?
    Daily rounds
  C. Format - What method(s) are used to document the student's clinical performance?
    Daily oral feedback   End of period oral feedback   Written feedback

2.  Oral Presentation
  A. Audience - To whom does the student present?
    Faculty physician
  B. Frequency / duration of presentation(s)?
  C. Format - What guidelines are set for the student's presentation?
    Clinical presentation format, similar to SOAP format in written form.
  D. Assessment - Who assesses the student's presentation performance?
    Self-assessment   Peer assessment   Faculty assessment
  E. Method of content selection
    Current cases  Student-selected topic   Assigned topic

3.  Written Assignment (H&P's, notes, papers, abstracts, etc.)
  A. Frequency of written assignment(s)?
  B. Format - What guidelines are set for the student's written work?
    Clinical SOAP format
  C. Length of written assignment(s)?
    Abstract   Annotated bibliography   1 - 2 page paper   3+ page paper
  D. Are recent references required?   No    If yes, how are they selected?
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
    Case presentations, senior-resident selected cases
  F. Audience - Who assesses the studentís written performance?
    Peer Assessment     Faculty Assessment     Other

4.  Examination
    Oral   Written multiple choice   Written essay / short answer   OSCE

5.  Extra Course Activities
  What expectations do you have for the student to demonstrate participation in the elective (e.g. small group activities, seminars, thoughtful questions, providing resources, journal club, resident lecture attendance)?
    The student is expected to take ownership of his/her patients, including presenting to the families, communicating with nurses and other staff, and following up on patient care tasks. The student will also be asked to write or type a discharge summary on their patients so that the senior resident may use this for their dictations.

6.  Other Modes of Evaluation
  Please explain below.
    Students will be evaluated by the Pediatric Attending Physician using the student's offical school evaluation form.
7.  If this course is an Acting Internship, please complete the following:
  A. Specify how the student will be given formative feedback on their clinical skills.
    At a minimum, biweekly face to face formative feedback will be provided to the student by their attending and/or senior resident.
B. List advanced clinical skills that a student will be assured an opportunity to practice.
    The student will lead the discussion of their patients on rounds, including educating the family by providing anticipatory guidance, and educating the team on their readings. The student will take on primary responsibility for their patients; focus histories, physicals, and oral and written communication appropriately; share information effectively with patients and families; prioritize and organize work effectively; anticipate what a patient will need during the course of the hospitalization and communicate this information in handoffs; continuously re-evaluate patients to notice a change in status and communicate this to their supervisors; cope with uncertainty in patient care issues; recognize when to ask for help; function as a team player with residents, attendings, nurses, and ancillary staff; coordinate the care of patients during hospitalization and in discharge planning.
C. List other advanced clinical skills that a student may be exposed to depending on clinical case availability.
    The student may be able to participate in a care conference on a patient with medical complexity, transfer a patient to a higher level of care such as the ICU, or consult a subspecialist for recommendations.
  D. How will the acting intern student have responsibilities similar to a PGY1 resident? How will their responsibilities differ?
    Similar: having primary responsibility for patient care and education of family; taking focused history and physical examinations; handoff their own patients in the evenings, and receive handoffs in the mornings. Differences: Currently, unable to enter notes in the EHR (but this will be changing soon); dictating discharge summaries (will be written or typed instead); entering prescriptions
  E. How will this course help prepare a student enter an internship in this field or a related field?
    Inpatient pediatrics is a major component of pediatrics residency training. Having practice in the role of the intern, from start to finish of a patient's hospitalization, with a similar work schedule, similar responsbilities, and earning more autonomy, will help prepare the student for the rigorous workday an intern experiences.
  F. How will midpoint feedback be provided to the student? How will you remediate deficiencies identified at midpoint?
    Midpoint feedback will be provided with a face to face discussion with the faculty. Deficiencies identified at midpoint will be addressed along with an action plan after discussion. Faculty and senior resident will provide guidance on how improvements can be made.
  G. Acting Internship students often seek letters of recommendation following their experience. How many different faculty are they likely to encounter during this course? What is the usual number of working days they can expect to encounter the same individual faculty member? Describe the degree of supervision and interaction with faculty vs. residents or other providers.
    Typically, there are 2 primary faculty who will be the supervisors for the team during the day. On nights, the student will work with various other faculty, but this will not be consistent as the daytime attendings. The student will work with 1 faculty member for 10 days, and the other for 5 days. Direct supervision is provided by the senior resident and by faculty on rounds and with faculty and senior residents on call on the week of nights.