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Medical clerks get access to wide range of paediatric cases at St. Joe’s

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Third-year medical student Miralem Mrkonjic is still deciding what field he’d like to specialize in as a doctor, but the clerkship rotations he is doing at four hospitals may help him choose his specialty.

Mrkonjic is currently doing a six-week clerkship in the Paediatrics department at St. Joseph’s Health Centre, Toronto. Of his core clerkship rotations, he still has Obstetrics and Gynecology, Family Medicine and Psychiatry to complete at other Greater Toronto Area hospitals.

He chose St. Joseph’s for his paediatric training because he knew he’d get a well-rounded experience focused on a variety of issues facing children under 17. He was also excited about working directly with various paediatric staff at this hospital located in a South West community in Toronto.

“St. Joe’s has a community feel. I get the bread and butter of paediatric (issues),” says Mrkonjic in March at the beginning of his clerkship at St. Joseph’s. “At St. Joe’s, I get a lot of exposure to patients. When we are on call, we do (patient) consultations and review them with the on-call Paediatrician.”

“The number one goal is to experience what paediatrics is like and the most common issues that patients are dealing with,” he adds.

Dr. Sharon Naymark did her paediatric clerkship at St. Joseph’s and chose to work as a paediatric doctor at this hospital. Things have come full circle as part of her job includes mentoring the current clerks including Mrkonjic.

Medical clerks who work with Dr. Naymark not only get one-on-one time with her and other paediatric doctors, but also receive extensive, hands-on experience treating patients alongside a physician in a variety of settings.

Clerks work with Dr. Naymark over six weeks covering the paediatric inpatient ward at St. Joseph’s, working in the Paediatric consultation clinic and working in the hospital’s Just For Kids Clinic. The Clinic treats patients 17 years of age and under and provides access to X-ray, ultrasound, MRI and blood work facilities, plus clinical, diagnostic and therapeutic services by fully trained paediatric doctors.

Dr. Naymark works on call for the hospital and has her own private clinic. Clerks at St. Joseph’s will also do 24-hour on call, work in a broad variety of general and sub-specialty paediatric clinics as well as have the opportunity to work in a primary care paediatric doctor’s office.

“A lot of students choose St. Joe’s,” says Dr. Naymark. “We want them (clerks) to see common problems and recognize when patients need to be referred to a specialist and to be able to communicate with families.”

Dr. Naymark’s colleague Dr. Nirit Bernhard has the same rigorous schedule as a St. Joseph’s paediatric physician. When she is on call, Dr. Bernhard covers any concerns for children at the hospital from emergencies to inpatients and labour and delivery. She also works at two other Toronto hospitals.

Dr. Bernhard did her community paediatric rotation at St. Joseph’s during her residency at the University of Toronto. Now she enjoys being a staff physician at this community hospital. Dr. Bernhard and Dr. Naymark both help co-ordinate undergraduate paediatric education at St. Joe’s and enjoy working with medical clerks.

“We want to give them as well-rounded an education as possible. We also hope to role model,” explains Dr. Bernhard. “We are also fortunate because St. Joe’s has become a centre that is recognized for it’s excellence in paediatric teaching.  Many of our staff have received teaching awards from the University of Toronto and that is something we are very proud of,” concludes Dr. Bernhard.

St. Joseph’s vision is to become Canada’s Best Community Teaching Hospital, so education of the next generation is a priority.

Dr. Eddy Lau is the hospital’s Chief of Paediatrics and also mentors the residents along with his medical duties.

At any given time, the Paediatric Unit will have three clerks for six-week stints and two or three residents over four weeks. This education cycle repeats throughout the year, except for breaks in the summer.

Dr. Lau says, “The clerks often choose St. Joe’s precisely because of the wide range of issues they will deal with including caring for newborns at birth who may require admission to the Neonatal Intensive Care Unit and doing routine newborn exams for babies who don’t yet have their own family doctor.”

“Clerks see high risk newborns to teenagers from acute to non-acute patients. They get clinical experience and it is all supervised with staff one-on-one,” explains Dr. Lau.

Clerks and residents also get access to an interprofessional team. They work along side a paediatric doctor of course, but also have informal teaching in morning sessions with dieticians, speech therapists and other professionals that patients have access to.

“Clerks get direct access to staff teaching for the majority of their learning,” adds Dr. Lau.  “For clerks and medical students, it is important to be exposed to a range of paediatric problems in clinical rotation and working in a paediatric office or hospital that mirrors what you have in the community.”


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