Description

The pediatric subinternship provides additional experience for fourth-year medical students interested in the care of infants, children, and adolescents. Visiting students will function as part of the inpatient pediatric care team at Eugenio Litta Children’s Hospital in Rochester, MN, serving in a subintern role for four weeks.

During the subinternship the students will function as an intern under the supervision of the Senior Medical Resident. Subinterns will assume primary responsibility for the patients admitted to the service. The number of patients assigned to the subintern will be determined by the SMR and consultant on the service and will depend on the complexity of the cases, the number of patients on the students' service, and the clinical skills of the student. Graduated responsibility will be granted by supervisors, based on individual performance.

Prerequisites

• Completion of third-year core internal medicine clerkship
• Promotion to fourth-year status, of no failures in third year core clerkship (visiting students)

Specific goals

1. Gain increased clinical experience and responsibility in the medical care of infants, children, and adolescents
2. Experience an in-depth, supervised exercise in pediatric medicine with an emphasis on clinical problem-solving and therapeutics
3. Increase skills in performing diagnostic and therapeutic bedside procedures such as venipuncture, fluid administration, and spinal taps
4. Learn how to arrange for laboratory examinations efficiently
5. Increase professional confidence and strengthen professionalism including a willingness to assume responsibility for patient welfare, and a sensitivity to cultural and economic issues
6. Stimulate independent thinking and self-directed learning
7. Benefit from opportunities to attend conferences, seminars, and teaching rounds

Activity outline

Students participating in the pediatric inpatient rotation at Eugenio Litta Children’s Hospital will serve as integral members of the care team, gaining hands-on clinical experience in a supportive, educational environment. Students will perform comprehensive histories and physical examinations on pediatric patients admitted to the hospital service. They will be actively involved in developing differential diagnoses, formulating diagnostic and therapeutic plans, and writing orders for assigned patients, which will be reviewed and co-signed by the supervising resident.

Students will engage with pediatric residents to discuss patient management, clinical reasoning, and decision-making. They will present new admissions during morning sit-down rounds and join the team for bedside walk rounds. Each day, students will document progress notes and assist in discharge planning, including writing summaries and helping to coordinate follow-up care.

Call responsibilities are shared with the resident team, with students participating in in-hospital call approximately every fourth night. During these shifts, they will admit new patients to the Pediatric & Adolescent Medicine Service, including new admissions and transfers. When opportunities arise, students may also take part in supervised procedures such as venipuncture and lumbar puncture.

Throughout the rotation, students are expected to attend scheduled educational activities, which include:

• Daily work rounds (7–8:30 a.m.)
• Team discussions (8:30–10 a.m.)
• Walk rounds (10–11:30 a.m.)
• Core curriculum sessions on Tuesdays, Wednesdays, and Fridays at noon
• Morning report on Thursdays at 7:45 a.m.
• Pediatric Grand Rounds on Fridays at 12:15 p.m.

To enhance team learning, students will also deliver brief, patient-centered presentations (“mini-lectures”) as directed by the senior resident.

Method of evaluation

Consulting staff and fellow residents will provide performance assessments at the end of the rotation. During the rotation, the student will complete a guided individualized learning plan with the faculty advisor, a brief supervised observation, and a standardized patient handoff.  This successful completion of these activities will also be used for final evaluation.   

Per Mayo Clinic institutional policy, faculty, and residents/fellows will not complete any outside evaluations. You will be provided with an electronic performance evaluation via Mayo Clinic’s MedHub portal. A final summative evaluation will be sent to you and your school official upon completion of your clerkship.