Year 4 Paediatrics & Child Health — Junior Clerkship

Mount Kenya University Department of Paediatrics, junior clerkship (unit code MBPE 4300, six units). Common lectures for the whole class, then clerking patients on the wards and in clinic and presenting to an attached tutor, across three trimesters.

Assessment: Continuous assessment tests 40% (a written CAT at the end of each trimester) · End-of-year examination 60% (written MCQ, essay and spot, plus a clinical exam: OSCE / mini clinical). The logbook is handed in at the end of 6th year.

Unit codes

• Junior clerkship in paediatrics and child health: MBPE 4300 (6 units).
• MBPE 4337 Lecture I · MBPE 4338 Lecture II.
• MBPE 4313 Clinical rotation I · MBPE 4326 Clinical rotation II · MBPE 4339 Clinical rotation III · MBPE 4340 Clinical rotation IV.

Expected learning outcomes (end of junior clerkship, 4th year)

• Take a history, examine, list differential diagnoses, order relevant investigations and list the proper management for the patient.
• Know the clinical conditions covered in the course content.

Vision, mission and values

• Vision: to produce competent students who can take care of children of all age groups, from preterm babies to adolescents, all over the world.
• Mission: to provide high quality education and research, in line with the university quality policy and medical ethics.
• Core values: integrity, professionalism, respect.
• Course purpose: to enable the student to acquire knowledge and skills in the management of paediatric conditions.

How it is taught

• Students are divided into groups and rotate through the departments.
• Common lectures are delivered in the lecture theatre and all students attend.
• Students rotating in paediatrics and child health then clerk patients in the wards or clinics and present to a tutor attached to them.

Course requirements

• Attend lectures and tutorials.
• Clerkship in the wards and clinics: take histories, examine, and perform procedures under supervision.
• Fill in the logbook given to each student.
• Sit all examinations at the end of each trimester and at the end of the year.

What is expected of students

• Dress decently, with respect for authority and different cultures; closed shoes.
• A clean white coat in the wards and clinics.
• Name tag worn in all clinical areas at all times.
• Clerkship kit: stethoscope, torch, tape measure, patella hammer, otoscope and any other tools needed to examine the different systems.

Textbooks and resources

• Hutchison's Clinical Methods: An Integrated Approach to Clinical Practice (Swash & Glynn).
• Nelson Textbook of Paediatrics (Kliegman).
• Lange Current Diagnosis and Treatment: Pediatrics (Hay, Levin, Deterding, Sondheimer).
• Paediatrics and Child Health (Rudolf & Levene), Wiley-Blackwell.
• Republic of Kenya, Ministry of Health: Basic Paediatric Protocols (2022); Kenya guidelines for malaria, tuberculosis and leprosy, asthma and HIV.
• Online: WHO.int, eMedicine, UpToDate, Google Scholar.

Department

• Head of department: Dr Everlyne Agisa Kegode. Lecturers: Dr Ruth Kihara and Dr Rose Munge. Ask the department office for contact details.

Trimester 1

• Week 1 Paediatric history taking and examination
• Week 2 Growth and development — Developmental milestones, adolescent growth, growth assessment.
• Weeks 3–4 Nutrition — Breastfeeding, protein-energy malnutrition, rickets, micronutrient deficiencies.
• Weeks 3–4 Severe acute malnutrition
• Weeks 3–4 Rickets
• Weeks 5–8 Neonatology — Birth asphyxia, neonatal jaundice, respiratory distress syndrome, neonatal sepsis, prematurity and low birth weight, meconium aspiration, kangaroo mother care, neonatal history and examination.
• Weeks 5–8 Neonatal respiratory distress syndrome
• Weeks 5–8 Prematurity and low birth weight
• Weeks 5–8 Neonatal resuscitation
• Weeks 5–8 Hypoxic-ischaemic encephalopathy
• Weeks 5–8 Neonatal jaundice
• Weeks 5–8 Neonatal sepsis
• Weeks 9–11 Respiratory — Pneumonia, asthma, reporting a chest X-ray, pulmonary TB, aspiration syndromes, croup, bronchiolitis.
• Weeks 9–11 Childhood pneumonia
• Weeks 9–11 Childhood asthma
• Weeks 9–11 Croup
• Weeks 9–11 Bronchiolitis
• Weeks 12–13 Nephrology — Acute kidney injury, acute glomerulonephritis, nephrotic syndrome, urinary tract infections, chronic kidney disease.
• Weeks 12–13 Paediatric acute kidney injury
• Weeks 12–13 Acute glomerulonephritis
• Weeks 12–13 Childhood nephrotic syndrome
• Weeks 12–13 Paediatric urinary tract infection
• Week 14 Assessment test

Trimester 2

• Weeks 1–2 Gastrointestinal system — GORD, gastritis and peptic ulcer disease, hepatitis, acute liver failure, acute gastroenteritis.
• Weeks 1–2 Acute gastroenteritis and dehydration
• Week 3 Neurology — Meningitis and other CNS infections, convulsive disorders, movement disorders, encephalopathies, neurocutaneous syndromes.
• Week 3 Paediatric meningitis
• Week 3 Cerebral palsy
• Week 3 Hydrocephalus
• Weeks 4–6 Cardiovascular — Acute rheumatic fever, rheumatic heart disease, infective endocarditis, congenital heart disease, arrhythmias, ECG.
• Weeks 4–6 Acute rheumatic fever and rheumatic heart disease
• Weeks 4–6 Congenital heart disease
• Weeks 7–8 Blood disorders — Anaemia, haemophilias, sickle cell disease, blood components and transfusion, other bleeding and thrombotic disorders.
• Weeks 7–8 Iron-deficiency anaemia in children
• Weeks 7–8 Haemophilia
• Weeks 7–8 Sickle cell disease in children
• Weeks 9–10 Fluids, electrolytes and acid–base — Hyponatraemia, hypernatraemia, hypokalaemia, hyperkalaemia, blood gas analysis.
• Weeks 11–12 Endocrinology — Hypothyroidism, hyperthyroidism, diabetes and DKA, congenital adrenal hyperplasia, Addison disease, precocious puberty.
• Weeks 11–12 Type 1 diabetes and diabetic ketoacidosis
• Week 13 Assessment

Trimester 3

• Weeks 1–10 Shock
• Weeks 1–10 Immunisation practices
• Weeks 1–10 Fever and fever of unknown origin
• Weeks 1–10 Bacterial infections
• Weeks 1–10 Viral infections
• Weeks 1–10 Measles
• Weeks 1–10 Human immunodeficiency virus
• Weeks 1–10 Paediatric HIV
• Weeks 1–10 Fungal infections
• Weeks 1–10 Protozoal infections
• Weeks 1–10 Malaria
• Weeks 1–10 Parasites and helminths
• Week 11 Poisoning — Paraffin, organophosphate, paracetamol, other household products.
• Week 12 Assessment
• Week 13 Revision
• Week 14 End-of-year examinations

Compiled by Abongo Davis · Ompath Study · shared for MBChB students at Mount Kenya University and other universities.