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Adolescent and Pediatric R3 Rotation

Page history last edited by Melanie Baca 1 month ago Saved with comment

This is a new rotation- please give us your feedback so we can help improve the experience!  Also please read the FAQ below that answers some questions that have come up...

 

Rotation Name: Adolescent Medicine

Year:  R3

Location: Please see schedule below

 

Schedule:

WEEKLY SCHEDULE for R3 Adolescent Medicine/Pediatrics

 

Day

Mon 

Tues 

Wed 

Thurs 

Fri 

Morning

Schedule:

Youth Services Center

"YSC"

 

8:00am-12:00pm

 

with

Melanie Baca, MD

5100 2nd St NW,

named "Bernalillo County"

on googlemaps

Presbyterian Pediatrics

(must have Pres paperwork & required urine drug screen done)

Why urine drug screen? -see below-

 

8:00am-12:00pm

 

with Sylvia Crago, MD

 

 

 

Atrisco Heritage High School Clinic

 

7:00am-12:00pm

 

with Melanie Baca, MD

 

Youth Services Center

“YSC”

 

*Please bring a copy of your PREA training certificate

 

8:00am-12:00pm

 

with Valerie Romero-Leggott, MD

Continuity Clinic

Afternoon

Schedule:

Community Health Time & DESEO Clinic

 

Community Health

(free time to work on your projects) two Monday pms of the rotation (2nd and 4th Mondays)

 

Deseo Clinic (Gender Affirming Care)

 with Dr. Molly McClain

1st and 3rd Monday pms of your rotation

 

1st Tuesday of Rotation:

"PREA Training"

MUST BE COMPLETED THIS DAY**

 

 2nd, 3rd, & 4th Tuesdays:

Compensation for One Hope time. Complete the ABFM Care of Children Knowledge Self-Assessment (KSA) Activity  https://www.theabfm.org/   Send completion certificate to Dolores Garcia

 

1:00pm-5:00pm

 

Resident School

 

1:00pm-4:00pm

 

 

 

 

 

Continuity Clinic

Continuity Clinic

 Evening

Schedule:

 

 

 

One Hope Clinic

(aka “East Central Ministries”)

133 Virginia Street NE

4:30pm-8:30pm

(don't forget to log visits)

Must fill out volunteer on-line formhttps://app.betterimpact.com/Application?OrganizationGuid=115a1922-d666-40d8-8993-8dd1f8ad3636&ApplicationFormNumber=1

 

 

 

 

Main Purposes of the Rotation (See below LINK for longer list of Goals and Objectives)

  • Gain experience in the care of adolescent populations, an important population with specific and unique health needs
  • Exposure to school-based health: Family Physicians can have an important role in not only the clinical care of school aged populations but also in education and role modeling for future healthcare fields
  • Exposure to alternate practice locations: Presbyterian is a large health system in the state and the clinic/EMR model is different.  These kinds of distinctions are important to experience as a resident.  Similary One Hope is very different and people consistently feel like the care they provide there taps into why they went into medicine.
  • Completion of an ABFM Knowledge Self Assessment (KSA)- specifically the "Care of Children" KSA.  You must login on to the ABFM to complete this module https://www.theabfm.org/.

 

Contact Info for Sites:

 

UNM ADOLESCENT CLINICAL SITES:

 

1. Bernalillo County Youth Services Center 'YSC':

5100 2nd Street (second building on your right - enter at door next to large multicolored Butterfly Mural)

Primary Contact: Melanie Baca, MD

Phone: 505-670-0560 (cell)

Email: mbaca@salud.unm.edu 

Contact: Valerie Romero-Leggott, MD

Phone: 505-263-8469 (cell)

Email: VRomero@salud.unm.edu

General Information about site: Provide primary care and acute care services for male and female detained youth.

 

2. Atrisco Heritage High School Clinic: 

10800 Dennis Chavez Blvd

Albuquerque NM 87121

Primary Contact: Melanie Baca, MD 505-670-0560 (as above)

General Information about site: Adolescent /Pediatric patients will be seen for Reproductive Health, sports physicals, WCC, psychosocial issues as well as general health

 

3. UNM Deseo Clinic @ the Southeast Heights clinic

8200 Central Ave

Primary Contact: Molly McClain, MD

Phone: 408-597-7322, or  on Tiger Connect

You can park in the gated lot at the front of the building (directly south of Central Ave).  Let the front desk folks you're working with Dr. McClain and they should get you into the back of the clinic. 

General Information about site: Our "clinic within a clinic" is called Deseo, and we work with gender expansive folks of all ages. Trans and non-binary people face discrimination, exclusion and even violence from every institution, even the medical system.  Providing gender affirming care is easy and fun and won't take you too much time to feel comfortable providing.  It is our hope that all primary care providers learn appropriate aspects of gender care to increase access and decrease marginalization of gender expansive people. You don't need to want make this you're entire clinical practice, but it is important that you're comfortable with the words, the terminology and the treatments so that you don't have be one of many medical providers who tells gender diverse people that you "don't treat your kind" some day in your future.

We start clinic at 1 pm in order to discuss patients, patient plans and divvy up the folks we'll be seeing amongst you, myself and a Family Medicine resident or other learner. 

 

NON-UNM ADOLESCENT CLINICAL SITES:

 

3. Presbyterian Outpatient Pediatric Clinic:

YOU SHOULD RECEIVE AN EMAIL FROM Dr. Crago PRIOR TO START OF ROTATION WITH SPECIFIC INSTRUCTIONS. 

Primary Contact: Sylvia Crago, MD (Bernalillo Clinic)

Email: SCrago@phs.org

Phone for clinic: 505-404-2590, Cell: 505-321-0630 

Address: 3777 Highway 529 Rio Rancho, NM 89144

Directions: Take I-25 N to the 2nd Bernalillo exit and go west on 550 through Bernalillo to the intersection of 550 and 528. Turn left (south) onto 528 and then take right at stoplight onto Enchanted Hills.  Take immediate right through the parking lot of Albertsons and the clinic will be right in front of you. Park in the front of the clinic and come in and ask for Dr. Crago.  

Description of clinical experiences in this clinic: will see pediatric patients of all ages with an emphasis on adolescent medicine

 

 

 

Rotation Logistical Requirements:

 

-**PREA Training: has to be done prior to working at YSC, so you MUST do it the first Tuesday am. Click here for training info and username

-Childhood Illness Knowledge Self-Assessment (KSA) Activity (aka SAM): On this rotation, you are required to complete the 'Childhood Illness' Knowledge Self-Assessment (KSA) Activity (aka SAM.)  This will also be great boards prep.  To help with this, we've blocked off the 2nd-4th Tuesdays for you to do this.\

 

-Presbyterian Hospital Required Training -   You do not need to repeat this step if you did this for Urgent Care.

  • Urine Drug Screening - Dolores Garcia will have screening paperwork for you to take the Testing Facility (see below) 
    •  Quest Diagnostics

                         8900 San Mateo NE

                         Albuquerque, NM 87113-2459

                         Hours of Operation: 7am-6pm Mon-Fri

                         Phone:  505-449-3246

 

***IMPORTANT PAGES, PLEASE READ PRIOR TO YOUR ROTATION START***

-RESIDENT PAGER/CALL SCHEDULE during rotation

-Guidelines for Residents Handling Weekday and Weeknight Pages During this Rotation 


Rotation F.A.Q

 

Q: Why does the rotation have so many different experiences?

A: We're trying to meet a new requirement in the highest-yield way possible.  No one clinic site was going to meet our needs so we've selected a few that we think are high value experiences but don't have huge amounts of time available.  We also generally prioritized experiences with FM docs who have in interest in teaching and working with residents. We also wanted to work in something with two good Pres pediatricians who want to work with our residents.

 

Q: Why are residents handling phone calls from YSC?

A: This was decided after a long, thought out process and lots of discussion.  Please understand we wouldn't just put more work on the residents if we didn't think it was striking an educational balance.  The first issue is that we really wanted out residents to experience YSC.  In order to do that, our UNM affiliation with YSC needed to continue, which required support for call.  The small number of providers willing to work at YSC were not able to do the call.  We also felt that a certain amount of "home call" is an important experience and common to several other residencies.  We've spent a lot of time over the years removing uneducational calls that used to go through residents (residents used to be available overnight for clinic patients to call with questions, inevitably about controlled substance prescriptions).  We felt that there was some educational value overall to this new experience, especially since residents could field calls and then potentially see patients soon in clinic.  Resident leaders asked that the inpatient residents covered the weekends so the month wasn't as hard call-wise.  

 

Q: Why do we have to do a urine drug screen to work at Presbyterian for only 4 half days?

A: While the reality is that around 50% of FM residencies nationally require an initial drug screen (prior to starting as an intern), this is not the case at our residency or at other facilities in New Mexico.  Still, the idea of drug screening can feel as if an employer doesn't trust the employee, something we are very sensitive to.  This message was relayed to Presbyterian, and Pres medical leadership did make attempts to have this requirement waived.  The discussion reached the highest levels at Presbyterian, but ultimately it was seen as an institutional requirement unable to be waived; "from the CEO on down to the janitorial staff, everyone takes a urine drug screen" was the message.

 

Q: Do I really have to do the KSA (formerly "SAM") on Childhood Illness?

A: Yes!  We've carved out time and you have to do 2 SAMs to sit for the boards, this will get one done.  This is a topic that our residents have consistently said they don't feel comfortable with: consider it protected board study/prep time, which is hard to get.

 

Q: Why do we have to do evenings at One Hope?

A: One Hope is an experience that many residents have felt was a valuable breath of fresh air during their residency, so we wanted to build that in more formally.  Wednesday night is the best time for the clinic and our faculty.  In exchange, we tried to make sure there was compensatory time in the rotation to pay you back.  We feel that with the community health activity time, time for the SAM (which likely won't take 3 full half days), that it was a good balance.


 

 

Rotation Goals and Objectives

 

Competencies

At the completion of this rotation, a family medicine resident should:

  •  Be able to develop patient-centered treatment plans for adolescents based on comprehensive risk-based assessments that take into account the cultural, linguistic, and socioeconomic backgrounds of adolescent patients (Patient Care, Medical Knowledge)
  • Optimize treatment plans based on knowledge of adolescent care resources that include local, state, and federal agencies (Systems-based Practice, Practice-based Learning and Improvement)
  • Be able to coordinate ambulatory, inpatient, and institutional care and advocate for adolescents across health care providers, institutions, and governmental agencies (Systems-based Practice)
  • Demonstrate the ability to communicate effectively with the adolescent patient and his or her family in order to establish and maintain therapeutic relationships in the context of confidentiality (Interpersonal and Communications Skills)
  • Demonstrate sensitivity and responsiveness to the adolescent patient’s race, ethnicity, culture, language, gender, sexual orientation, gender identity, and disabilities (Professionalism)

 

Attitudes

The resident should demonstrate attitudes that:

  • Recognize that each adolescent has strengths that serve as protective factors and support his or her development during adolescence
  • Acknowledge that connection to parents, school, and community is essential to an adolescent’s successful development
  • Understand that adolescence is a time of experimenting, learning, and developing and offer guidance that encourages healthy behaviors and responsible decision making
  • Support confidentiality while also encouraging the adolescent to communicate with his or her parents (and other supportive adults)
  • Treat each encounter with an adolescent as an opportunity to act as a caring adult and to engage the adolescent in conversations about healthy living

 

Knowledge

In the appropriate setting, the resident should demonstrate the ability to apply knowledge of:

 1. Normal growth and development in the adolescent years that includes physical, mental, emotional, and sexual milestones

2. The major health risks and behaviors of adolescents and methods to address them

3. Strategies for providing preventive services, immunizations, health promotion, and guidance to adolescent patients during annual wellness visits, routine care visits, and acute care visits

4. The challenges facing an adolescent to establish his or her identity and to learn responsible behaviors, including self-care and attention to mental health, sexual health, and reproductive health

5. The core conditions that may affect the health of an adolescent, such as family problems, poverty, depression, school failure, obesity, eating disorders, violence, drug use, unintended pregnancy, and STIs


 

Supplemental Reading: Below are resources we think you will find helpful during this rotation

 

Helpful Web Links

Society for Adolescent Health and Medicine: https://www.adolescenthealth.org/Home.aspx

Contraceptive pearls: http://www.reproductiveaccess.org

 

Modules:

 

1) Adolescent Consent and Confidentiality

Minors and the Right to Consent to Health Care.pdf

Confidentiality Overview ppt.ppt

Details on Duty to Report.pdf

 

QUIZ Take our online test" target="">http://www.classmarker.com/online-test/start/?quiz=ccg54d106ad8952e" title="Take our online test">Take our online test

**PLEASE NOTE: you must complete Module quizzes in listed order to access subsuquent quiz.**

 

 

2) Puberty, Adolescent Development and Screening

Normal Growth and Development: https://hslic-unm-on-worldcat-org.libproxy.unm.edu/oclc/324993274?databaseList=1834,1920,1931,2236,2375,2507,2897,2977,2979,638 
Biro, Frank M., MD
Adolescent Medicine, Chapter 1, Pages 1-1
Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc.

(**search through UNM Library**)

 

Adolescent Health Screening and Counseling.pdf

Adolescents and LARCs.pptx

 

USC-Adolescent Health Curriculum: Normal Growth and Development in the Adolescent.

 

Go to link to access reading, which includes questions, diagrams and two cases

http://www.usc.edu/student-affairs/Health_Center/adolhealth/content/a1.html 

 

QUIZ:  Take our online test" target="">http://www.classmarker.com/online-test/start/?quiz=c7x54d1070644368" title="Take our online test">Take our online test

**PLEASE NOTE: you must complete  Module quizzes in listed order to access subsuquent quiz.**

 

 

3) Common Adolescent Medical Problems

Osteochondrosis: Common Causes of Pain in Growing Bones - American Family Physician.pdf

Adolescent Idiopathic Scoliosis: Diagnosis and Management - American Family Physician.pdf

USC Adolescent Health Curriculum, Common Ortho problems: https://www.usc.edu/student-affairs/Health_Center/adolhealth/content/b4orth.html#references

USC Adolescent Health Curriculum, Common Medical problems: https://www.usc.edu/student-affairs/Health_Center/adolhealth/content/b4misc.html

QUIZ: http://www.classmarker.com/online-test/start/?quiz=cca54d94f9fb36cc

**PLEASE NOTE: you must complete Module quizzes in listed order to access subsuquent quiz.**

 

 

4) Adolescent Mental Health

Initial Evaluation, Diagnosis, and Treatment of Anorexia Nervosa and Bulimia Nervosa - American .pdf

Guidelines for Adolescent Depression in Primary Care (GLAD-PC): II. Treatment and Ongoing Manage.pdf

 

Other Useful Articles:

Adolescent Headds Screening Article

 

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