Madigan Army Medical Center Robert J. Newman, MD

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Madigan Army Medical Center Robert J. Newman, MD

  1. 1. Madigan Army Medical Center Robert J. Newman, MD COL MC Pediatric Endocrinology
  2. 3. Madigan - Pediatrics <ul><li>Military and Civilian Staff </li></ul><ul><ul><li>General Pediatrics – 9 (4 military & 5 civilian) </li></ul></ul><ul><ul><li>Adolescent Medicine – 1 </li></ul></ul><ul><ul><li>Cardiology – 2 </li></ul></ul><ul><ul><li>Developmental Pediatrics – 4 (2 military & 2 civilian) </li></ul></ul><ul><ul><li>Developmental Fellows – 5 </li></ul></ul><ul><ul><li>Endocrinology – 2 </li></ul></ul><ul><ul><li>Gastroenterology – 1 </li></ul></ul><ul><ul><li>Genetics & Dysmorphology – 1 (civilian) </li></ul></ul><ul><ul><li>Hematology-Oncology – 2 </li></ul></ul><ul><ul><li>Infectious Disease – 1 </li></ul></ul><ul><ul><li>Neonatology – 5 (4 military and 1 civilian) </li></ul></ul><ul><ul><li>Neurology – 2 (1 military and 1 civilian) </li></ul></ul><ul><ul><li>Pulmonology – 1 </li></ul></ul><ul><ul><li>Rheumatology – 1 </li></ul></ul>
  3. 4. Madigan - Other <ul><li>Pediatric Surgery </li></ul><ul><li>Pediatric Orthopedics </li></ul><ul><li>Pediatric Ophthalmology </li></ul><ul><li>Pediatric Otolaryngology </li></ul><ul><li>Pediatric Urology </li></ul><ul><li>Pediatric Radiology </li></ul>
  4. 5. Pediatric Residency <ul><li>6 Residents per year group </li></ul><ul><li>Clerkship site for USUHS since 1999 </li></ul><ul><li>Clerkship site for WAMI (U of W) since 1982 </li></ul><ul><li>Currently 39% USUHS graduates (although USUHS accounts for only 15-25% of the annual applicants) </li></ul><ul><ul><li>3 PL-3’s </li></ul></ul><ul><ul><li>2 PL-2’s </li></ul></ul><ul><ul><li>2 PL-1’s </li></ul></ul><ul><li>2 of the 3 Army USUHS grads of 2003 </li></ul>
  5. 6. The Rotation <ul><li>2 weeks Pediatric Ward / ICU </li></ul><ul><li>2 weeks General Pediatric Clinic </li></ul><ul><li>1 week Well Child Clinic </li></ul><ul><li>1 week Mother-Baby Unit </li></ul>
  6. 7. General Pediatric Ward / ICU <ul><li>Average census: 10-20 patients </li></ul><ul><li>Average length of stay: 2-4 days </li></ul><ul><li>Staff attending </li></ul><ul><li>Senior resident </li></ul><ul><li>Supervising resident </li></ul><ul><li>One or two interns (pediatric, family practice, transitional (elective)) </li></ul><ul><li>One to three students – MS-III & MS-IV </li></ul>
  7. 8. General Pediatric Ward / ICU <ul><li>Each student responsible for one to three patients daily </li></ul><ul><li>Admission H&P; daily notes </li></ul><ul><li>Presents at rounds </li></ul><ul><li>Presentations at morning report </li></ul><ul><li>Case discussions with attending </li></ul><ul><li>On-call twice per week </li></ul><ul><li>Evaluated by attending and senior resident </li></ul>
  8. 9. Pediatric Clinic <ul><li>Three to five patients per half-day </li></ul><ul><li>General pediatric or subspecialty clinic </li></ul><ul><li>Precepts with attending </li></ul><ul><li>Observed history and physical </li></ul><ul><li>Treatment room half-day </li></ul><ul><li>Evaluated by attending </li></ul>
  9. 10. Well Child Clinic <ul><li>Birth to 24 months </li></ul><ul><li>Age-cohort half-days </li></ul><ul><li>Infant growth and development, newborn metabolic screening, infant nutrition and normal physical findings </li></ul><ul><li>Immunization room half-day </li></ul><ul><li>Required reading of selected articles </li></ul><ul><li>Works with single preceptor who evaluates every third year student </li></ul>
  10. 11. Mother-Baby Unit <ul><li>Pregnancy and delivery history </li></ul><ul><li>Newborn physical examination </li></ul><ul><li>Attends normal deliveries </li></ul><ul><li>Assessment of risks for sepsis, hypoglycemia, hyperbilirubinemia, etc </li></ul><ul><li>On-call in NICU once or twice </li></ul><ul><li>Circumcisions </li></ul><ul><li>Works with single attending who evaluates every student – One student per week </li></ul>
  11. 12. Educational Opportunities <ul><li>Morning report – case discussion </li></ul><ul><li>Morning Pearl </li></ul><ul><li>Morning lecture – 4 days per week </li></ul><ul><li>Multi-disciplinary conferences (Pediatric ER, Peds-OB, Peds Path) monthly </li></ul><ul><li>Noon lectures – general pediatrics </li></ul><ul><li>Continuity clubs – twice monthly </li></ul><ul><li>SIM center </li></ul><ul><li>Wilderness medicine / cardiology conf. </li></ul><ul><li>Combat pediatrics / Treatment guidelines </li></ul><ul><li>Physical diagnosis rounds </li></ul>
  12. 13. Educational Opportunities <ul><li>Medical Library access </li></ul><ul><li>Ward and NICU libraries </li></ul><ul><li>Computer / Network access </li></ul><ul><li>Up to date </li></ul><ul><li>MD Consult </li></ul><ul><li>OVID / Pub Med </li></ul><ul><li>Courses available to students – (sporadic) MMHAC, PALS, NRP, Winter Conference </li></ul>

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