Katherine Pogrebniak ’14, The Children’s Hospital of Philadelphia

Day 1

On the first day of our Princeternship, the other Princerterns and Itook three trains, walked about fifteen minutes, and arrived at nine o’clock at the Children’s Hospital of Philadelphia.  Sharon Brown, one of the administrators who works with Dr. Snyder, greeted us and gave us a tour of the Urology Department.  She showed us around the clinic, including the exam rooms, scheduling desks, and physician offices, introduced us to the residents, who would, later in the day, take me to the OR.  After the tour, the other two Princeterns spent the day shadowing Dr. Snyder in the clinic, while I spent the day in the operating room.  Due to the small size of the exam rooms, all three of us could not shadow Dr. Snyder at once, so we took turns alternating between the clinic and the OR.  I spent the first day observing three surgeries by Dr. Pat Casale.  Before today, I had never observed a surgery or been in an OR, so this was something I was looking forward to experiencing.  I felt quite professional in my blue scrubs and mask!  Dr. Casale is the Director of Minimally Invasive Surgery for the Urology Department: he specializes in laparoscopic and robot-assisted surgeries.  Today I was fortunate to see him, as well as the residents and fellow, Dr. Tasian, perform two laparoscopic surgeries as well as one surgery that required a larger incision due to the particularly complicated nature of the case.  Everyone in the OR was very welcoming, and Dr. Tasian was kind enough to explain to me the basics of each surgery before it began.  It was interesting to see how an OR is run with the urologists and anesthesiologists working together.  Care is put into every surgery.  For example, before an incision is ever made, the attending physician has to do a “time out” recognizing the OR team members present, reviewing the procedure that is to be done, and any relevant patient history.  After the surgeries for the day had ended, we returned to Dr. Snyder’s office and discussed various aspects of medicine, including his personal life story, public policy, and the Mutter Museum of Medical Sciences in Philadelphia.  He explained to us how there is a need for more young urologists.  Right now, the number of urologists is in decline and the average age of urologists is getting older.  This first day was an incredible way to start my Princeternship!  My biggest accomplishment:  not fainting or feeling sick during the OR procedures- Yeah!!

Day 2

Dr. Snyder, and his Princeterns

I spent today shadowing Dr. Snyder in clinic.  Dr. Snyder works closely with Nurse Practitioner Kristen Rudnick, so I was able to observe them working together as a team.   Dr. Snyder was often able to console anxious patients, telling them that surgery was unnecessary after reviewing the patients’ charts and medical tests.  Dr. Snyder explained that radiologists tend to report pathology instead of explaining what is actually seen on the ultrasound, causing patients to end up in Urology for a normal variant, rather than a pathological kidney.  I watched Dr. Snyder read multiple renal ultrasounds that day.  Dr. Snyder interacted amiably with both the patients and the parents, taking the time to make sure that the patient’s parents understood the diagnosis.  He then dictated a letter on each patient, while the patient was offered a sugarless lollipop!  In the evening we attended a radiology rounds meeting with the residents and attending physicians.  During this meeting, various residents presented the radiology images from particularly complicated cases so that all of the physicians could discuss the case and help the treating physicians ensure that they are following the most appropriate course of treatment.  I noticed during the meeting the amount of respect that the other physicians had for Dr. Snyder, the most senior attending physician.  They often said, “What do you think, Howard?”  What I learned today:  being a physician is not like what is seen on the TV show House.  Respect and teamwork are essential!

Day 3

On the final day, I spent the morning in the OR and the afternoon in the clinic.  In the morning, I observed Dr. Kolon, another of Dr. Snyder’s partners, in the OR.  I observed two of his procedures.  We spent some time talking about the best way to prepare academically for medical school.  In the afternoon, I shadowed Dr. Snyder again, learning more about methods for effective patient care.  Dr. Snyder gave me articles to read concerning common urological conditions that we had been seeing in patients that day.  Final thought:  this Princeternship crystallized my desire to become a physician.  I recommend this Princeternship to anyone interested in an up close and personal medical experience with multiple doctors and perspectives in a premier medical setting!