The Physical Diagnosis course is offered to Brown medical students on Thursday afternoons throughout their second year of medical school. There is an orientation week at the end of August at which I deliver a 2 hour lecture as an introduction to pedia! tric physical diagnosis. In that lecture, I emphasize differences between children and adults, a need to know what is normal before embarking on an exploration of the abnormal, and the importance of the assessment of growth and development in pediatri! c medicine. I demonstrate some of these principles with my own children. For the rest of the year, the students are disbursed to diverse sites to pursue a hands-on, organ system approach to physical diagnosis, mostly with adult patients. Three sessio! ns, as described below, are devoted to Pediatrics.

Structure of pediatric component of physical diagnosis course:

1. Students (in a group of 2-4) spend one afternoon in one of the six Brown affiliated newborn nurseries (WIH, MHRI, Brockton, Kent county Hosp, St. Lukes, Charlton) with a staff physician at that site learning and practicing the physical examination! of a newborn.
2. Students spend 2 afternoons in pairs with a single dedicated pediatrician, preferably in an ambulatory setting, where the students can be exposed to a wide variety of ages and be given supervised, hands-on opportunities to practice pediatric physi! cal examinations. It is hoped that fewer, more concentrated experiences rather than tag-along exposures will be of better quality and more easily integrated into a working site.

Goals and Objectives for pediatric component of physical diagnosis course:

Upon completion of this component of the course, the student should be able to:

1. Describe the differences between the approaches to the pediatric versus the adult patient
2. Take a history from the mother of a pediatric patient
3. Be aware of and have experienced the differences in the approach to and handling of a newborn, a toddler, a school-aged child and an adolescent
4. Perform a complete physical examination of at least one of the following:
   • a newborn
   • a toddler
   • a school-aged child
   • an adolescent
5. Organize the information obtained from one of the above listed physical examinations into a coherent written description of your findings
6. Present your findings from one of the above listed physical examinations in an organized and concise oral presentation