Shaping the Pediatricians of the Future: How a Student Initiative Gives Doctors-to-Be Early Practical Experience
Tara Hoffmann and Samipa Pudasaini are now doctors in further medical training. Just over three years ago, while still students, they founded a pediatrics shadowing scheme at Charité – Universitätsmedizin Berlin. The initiative was supported by Stiftung Charité as part of its project funding program. The initiative gives students the opportunity to shadow a child’s medical appointments in the first two years of life on a voluntary basis. They accompany the child and their parents to the standard early diagnostic appointments and also act as an accessible point of contact for the family in their new life with a baby. We invited Dr. Hoffmann and Ms Pudasaini as well as their successors Lea Schwarzlmüller and Athanassia Skaltsas (current project lead) to our office at Stiftung Charité to hear about their experience with this extracurricular project and how it came about.
Great that we get to meet you all today. Could you tell us who does what in the project, where you are in your medical training, and how you all ended up working together?
Hoffmann: I had this idea for a project a while back. I wasn’t sure I could manage it all by myself, so I asked Samipa if she would like to support me in making it a reality. We had known each other for years through our work at the Teddy Bear Hospital. Every summer, we hold two big teddy bear clinics to help children overcome their fear of going to the doctor. I knew that Samipa and I could work well as a team and that she is just as passionate about pediatrics as I am. Since then, I’ve become a doctor in further training in pediatrics at the Virchow Clinic at the Charité.
Pudasaini: I was impressed with Tara’s idea as soon as I heard it. It was a totally new way of working and looked like the answer for so many students, including myself, who want more pediatrics in their medical studies. At the moment, there are just one or two core modules and a couple of optional modules. Our project really got going in summer 2020. I’m currently doing my placement year which consists of three tertials. We are free to choose one of them so right now I’m in pediatrics, also at the Virchow Clinic. Tara and I are still supporting the pediatrics shadowing scheme but only behind the scenes.
Skaltsas: I started shadowing a child’s medical appointments as part of the initiative in the last summer semester and am now the project lead. I’m currently in my fourth semester at the Charité.
Schwarzlmüller: I started shadowing at the same time. From summer 2022 through to summer 2023, I was involved in managing the project too. I’m currently in my third semester at the Charité.
Funding program
Project and event funding
Funding period
2021 – 2023
Specialism
Pediatrics and neonatology
Project
Pediatrics Shadowing Scheme (AG Studierende werden Pat:innen)
Institution
Charité – Universitätsmedizin Berlin
2022 – 2023
Doctor in further training (10 months)
Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité – Universitätsmedizin Berlin
2022
Doctoral dissertation: ‘Pollen Season Definitions in the Context of Seasonal Pollen Induced Allergic Rhinitis in Southern European Countries’
2019 – 2020
Student assistant in the outpatient pediatrics clinic at St. Hedwig Hospital, Berlin
What inspired you to start the initiative, Dr. Hoffmann?
Hoffmann: When I reached my ninth semester, I finally got to study pediatrics in more depth. That was in 2020, when the Covid-19 pandemic led to lots of the practicals not taking place as they should. It was very frustrating for me as a future pediatrian, so I started looking into suitable online training options in my desired specialism across Germany. I happened across a pediatrics shadowing scheme at University Hospital Bonn. It was founded by a neonatologist some years back and she has been leading it successfully ever since. I was so impressed with this idea and thought, that’s just what we need here! I also found something similar in Heidelberg, although the project is organized through the outpatient pediatric clinics. I then contacted two senior physicians in the Department of Neonatology here, Dr. Susanne Römer and Dr. Monika Berns, to make something similar a reality at the Charité. Dr. Berns had already mentored me on the student mentoring program and her advice was very helpful.
How does the shadowing scheme work exactly? How can students and parents take part in the program?
Schwarzlmüller: Students can apply to us to be a shadow. When making our selection, it is important that they have a real interest in pediatrics or neonatology, specifically, and maybe even some prior experience. The chosen students then start the program with tutorials to get them all to a similar level. After all, they’re all in different semesters! The tutorials cover aspects like the children’s standard early diagnostic appointments (labelled U1 to U9 in German), basic lifesaving measures, and topics like lactation counseling and weaning.
And finally the participants work with Tobias Ullrich, the intensive care nurse on the project. His tutorials are very hands-on and are always a highlight! But it’s also important to recognize the limits of the shadowing scheme. As students, we are still undergoing our medical training and are not yet fully qualified experts. But we can indeed act as an initial point of contact for parents on the shadowing program. We can lend the parents an ear and point them in the right direction when they have a specific question or need for information.
Skaltsas: Once the participants have completed the tutorials, they can apply to start shadowing at both the Mitte Campus and the Virchow Clinic. Students get to shadow pediatricians in the ‘children’s room’ on the maternity ward. There they get to sit in on the U2 appointment for newborns between three and ten days old. After this, the students get to tell the parents of the child about the shadowing program and – if there’s time and it feels like a good match – they can ask if they might be able to sit in on the child’s scheduled medical appointments. The parents don’t have to decide right away, they can call us back later.
Schwarzlmüller: The parents that do take part often see it as contributing to the training of the pediatricians of the future.
And the students who take part in the shadowing scheme then attend all the child’s standard scheduled appointments up to their second birthday?
Skaltsas: Exactly. Depending on their rapport and availability, some students also accompany the child to their vaccinations. Some even meet up with the parents and child completely outside of the medical appointments. It’s really up to them. You can commit as much or as little as you like!
What are the aims of the pediatrics shadowing scheme?
Schwarzlmüller: To me there are two main goals. We obviously want to play a role in training the pediatricians of the future by enabling them to build up practical experience. And we also want to improve teaching. We would love to expand the project to other universities so that as many medical students as possible get to experience the shadowing scheme. Things like the general meetings of the German Medical Students’ Association are an opportunity for us to communicate that we are very open to supporting others who are interested in establishing the project within their own city, university, or clinic.
Skaltsas: We also want students to develop certain soft skills through our project, from which they’ll benefit long-term in their later working lives.
Hoffmann: Exactly. In pediatrics in particular, you are basically treating the whole family. You’re not just looking at one patient in isolation. And because of the time pressure you’re under, it’s even more important to be able to get a quick sense of the kind of family you’re dealing with. Sometimes a family looks fine but underneath they actually need a lot of support. We hope to help students to get a bit of a feel for that through our project.
Pudasaini: We also want to increase awareness of preventive medicine in pediatrics. Seriously ill children are the exception, not the norm. It’s much more about identifying what can be done to prevent children getting ill. Lots of families find it hard to understand the system behind it. Not everyone is aware of the scheduled appointments in a child’s early years. I like to think that our project helps to address social inequalities and fill certain gaps – at least on a local level here in Berlin.
How do students find out about your initiative and the opportunities it provides?
Pudasaini: At the start, Tara and I put up lots of posters and stood with signs at places like the vaccination centers at the Charité where we could reach lots of medical students. We also built our website early on.
Skaltsas: After I took over the project I thought, who still looks at websites first? It’s all on Instagram these days! So we set up an Instagram account which has been going for about nine months now. We also have a stand at the volunteer fair, aimed mainly at first-years, and we offer info sessions for people to ask questions. And relatively recently we’ve started hosting expert talks on key aspects of children’s health for interested students and parents.
Hoffmann: We place a special emphasis on giving parents and families that extra space to ask whatever questions they want, no matter how silly they might seem. During their child’s appointments there’s often not enough time or they don’t feel confident enough in an unfamiliar medical setting with so much new stuff to process already. We want to provide space for more in-depth conversations and further expand such opportunities with these talks.
What prompted you to apply for Stiftung Charité project funding?
Hoffmann: We quickly realized that we would incur costs, especially during the set-up phase. Samipa and I could cover some of them ourselves, but this wasn’t feasible for us as students in the long run. So I googled our options and started by taking a look at the internal funding options at the Charité. I came across the call for the Max Rubner Award at Stiftung Charité, which we actually ended up applying for originally. What can I say, it was a little ambitious! But one thing led to the next, and when I phoned Stiftung Charité sometime after making the application, I was encouraged to apply to the project funding program with the idea.
What comes to mind when you think back to the start of the initiative? What have you taken from the last three years of your work on the project and as a team?
Pudasaini: It wasn’t easy to make the project a reality in the clinic because the pandemic limited shadowing opportunities for students. Thankfully that’s all in the past now, though we obviously still have to adapt to the latest developments like the winter waves of illness. Keeping the project running despite the restrictions and other requirements that we also had to fulfil was one of the many secondary learning effects. At the same time, Tara and I were completing our state examinations and writing our dissertations! Working as a team has had a long-term impact on us. We’ve learned to identify who has what strengths and how we can make the most of them. And then there’s the privilege of getting to teach during our studies while also continuing to learn ourselves, discussing the different experiences that the participants have had in pediatrics. I’m sure we have gained a lot that will continue to benefit us in future.
Ms Skaltsas, Ms Schwarzlmüller, you both took part in the shadowing scheme yourselves. Do you have any strong memories from this time?
Skaltsas: I have several favorite moments. I remember the huge smile on the child’s face as I came through the door for the U6 appointment. At that moment I thought, wow, they remember me! Or the photo their mum sent me on their first birthday to show me how happy they were with my present. And there was another heartwarming moment at the Charité children’s party this summer. The child had just started walking the day before and came running up to me as soon as they saw me. It was so sweet!
Schwarzlmüller: In general, I was impressed by how open the mother of the child was with me. It’s great to get an insight into the psychosocial changes that you undergo after the birth of a child and to hear this perspective firsthand. I’m really interested in the intersection between pediatrics and gynecology. It’s a privilege to gain such intimate insights. And then there’s your relationship to the child. You get the chance to watch a child grow up and may well become a trusted person for the family. It’s such a wonderful experience, I think. And from a medical point of view, it was great to be included by the doctor treating the child. He let me listen to the child’s chest with a stethoscope and included me wherever possible.
And finally, what hopes do you have for the pediatrics shadowing scheme in future?
Pudasaini: We’d like the initiative to be better integrated into the curriculum in the long term! Professor Bührer, the director of the Department of Neonatology, told us that there used to be a similar program in neonatology where, as part of their course, the students each accompanied a child on the ward for several months and indeed visited them every afternoon.
Hoffmann: Athanassia is currently working on making the shadowing scheme an optional part of the course. If it works out, then students will be able to get course credits for taking part.
Marike de Vries & Dr. Nina Schmidt
July 2023