BRONX-LEBANON HOSPITAL CENTER

Cynthia Lewis, M.D.

Adolescent Medicine is a multidisciplinary health care specialty based on the unique physical emotional and social characteristics of adolescents, their health problems and needs. The  focus  of the rotation is to develop familiarity with this subspecialty, develop an approach to interviewing and examining the adolescent and an understanding of ways to address their health care needs.

We expect residents who participate in this elective to gain competency in the following areas:

Primary Goals for this Rotation are

Understand the role of the pediatrician in the prevention of adolescent health problems through screening, counseling and advocacy.

Counsel and provide patient education in a developmentally appropriate manner, remaining respectful of the adolescent’s needs and privacy.

Perform and interpret adolescent screening according to guidelines by experts in the field (e.g., AAP, Bright Futures and GAP), demonstrating familiarity with indications and timing.

Educate adolescents through demonstration and instruction to perform routine breast and testicular self-examination.

Assist adolescents to use health services appropriately during their adolescent years and guide them in their transition to adult care.

Empower adolescents to become increasingly responsible for their own health and well being.

Understand normal adolescent behavior, growth, development and physiology and recognize deviations from the norm.

Recognize the wide range of normal patterns of physical growth and pubertal development during adolescence and appropriately counsel patients and their families about pubertal variations.

Recognize the range of normal psychosocial development in adolescents; the stages of development across early, mid and late adolescent years; and appropriately identify when behaviors lie outside the norm, requiring special intervention or referral.

Order and interpret clinical and laboratory tests to identify adolescent disease versus non-disease, taking into account physiologic values for adolescents at different stages of maturity.

Evaluate and manage common signs, symptoms and situations or risks in adolescents, recognizing when referral is indicated.

Recognize characteristics in the adolescent’s history or health course warranting further diagnostic tests versus watchful and supportive observation.

REFERENCES

Neinstein: Adolescent Health Care A Practical Guide-Third Edition.  Williams & Wilkins, Baltimore, MD 1996.

Emmans & Goldstein: Pediatric & Adolescent Gynecology-Third Edition.  Little, Brown and Company, Inc., 1990.