Pediatric clinical clerkships are associated with an excess risk of acute infection
V. N. Gan, P. Pastor and T. V. Murphy
Department of Pediatrics, University of Texas Southwestern Medical Center at Dallas, USA.
OBJECTIVE: To determine the incidence of acute respiratory and
gastrointestinal tract illness and associated absence by third-year medical
students during pediatric and nonpediatric (control) clinical clerkships.
DESIGN: A self-administered questionnaire was completed by students after
the first 4 weeks of two pediatric clerkships (inpatient and outpatient)
and two non-pediatric clerkships (obstetrics-gynecology and psychiatry).
Information was obtained on the symptoms of acute respiratory and
gastrointestinal tract illness and related absences. ANALYSIS: Results from
each student's pediatric clerkship were compared with the results from the
same student's control clerkship by means of matched-pair analysis.
SUBJECTS: Students who made up the junior class at the University of Texas
Southwestern Medical School at Dallas, July 1, 1990, to June 30, 1991.
RESULTS: Of 177 students (77%) who completed questionnaires after one
pediatric and one control clerkship, 108 students (61%) had had an acute
illness while on pediatric clerkships in contrast to 69 students (39%) on
control clerkships (odds ratio, 3.3; 95% confidence interval, 2.0 to 5.4; P
< .001). More students were absent for illness during pediatric than
control clerkships (23 [13%] vs nine [5%], respectively; odds ratio, 2.7;
95% confidence interval, 1.2 to 6.2; P = .02). The higher risk of illness
during pediatric clerkships was not related to the order of the pediatric
or control clerkship, the order of inpatient and outpatient pediatrics, or
the season of the year. CONCLUSION: Pediatric clinical clerkships in the
third year of medical school were associated with excess morbidity from
acute infectious illness. Studies are needed to determine whether
emphasizing infection control practices decrease this morbidity and any
resulting nosocomial spread to patients.
