This service has been performing the follow-up of healthy and ill patients since 1982, with an assistential-teaching aim through resident physicians under the supervision of an instructor. Primary care training is also developed at the sanitary unit located in Arturo Segui, as part of the pediatric residency program of the Province of Buenos Aires.
Since May 2009, the service forms part of IDIP since both entities have a similar teaching and training objective; almost 90% of research protocols are concerned with maternal and infant health, environment and nutrition, all of them applied to the community and public health. Children receiving care at the consulting rooms form part of cohorts and are subject to long-term epidemiological follow-up, giving rise to pediatric research lines.  These strategies permit the evaluation of the main health problems affecting the population being followed up and of the primary healthcare hospital system.

Contribution of the consulting teaching service to the professional being trained in our hospital

The pediatric residency trains physicians for the diagnosis and care of children with prevalent pathologies in the province of Buenos Aires, providing excellence quality of care from the human, ethical and scientific points of view within the frame of evidence-based medicine.
Bur primary care is fundamental for the implementation of actions related to health prevention and promotion. Such actions, if implemented adequately, will improve child health at all levels, either decreasing frequent pathologies, or the associated economic, physical and human costs. This is clearly seen in countries with low health resources but low child mortality due to investments in primary health care.
The training of residents in ambulatory care is concerned with a vision and knowledge centered in improving public health through general and specific actions in primary healthchare, at individual and community level.
The early diagnosis of diseases is also involved, so that professionals are trained to develop skills for diagnosis, through the recognition and interpretation of signs and symptoms within the short period of an ambulatory care visit.
In parallel, residents develop research activities (short-term simple, observational works, surveys) and permanently update their scientific information.
The teaching area supports the development of “complementary blocks”, namely, health and epidemiology courses, English learning, Research methodology, giving priority to epidemiology and the impact on public health through the analysis of scientific papers or the performance of a scientific protocol.
Concerning the English language, most papers are written in English, therefore translation and the correct interpretation of the language are supported.

General aims of resident rotation in the consulting teaching service
Give priority to the knowledge of the healthy child

Through pediatric semiology, the wide variations of normality during infant growth are shown (knowing the variations of normality is more difficult than knowing the pathology).

Evaluate growth and normal development
Incorporate knowledge about normal and pathological development, with adequate tools (growth tables) for the correct interpretation of results.

Evaluate the relationship health / illness and the social environment of the child
Knowledge about the environment of the patient during his development and growth is fundamental due to the impact on the onset of different pathologies. Therefore, the interpretation of its effect on health or disease is important to improve diagnosis or prevent future disorders.
In this regard, our tool is to perform an adequate  semiology of the family: origin, integration, composition, to collect data for a better understanding of situations.

Implement actions for health promotion and prevention
Ambulatory visits are particularly adequate to apply these concepts. From the promotion of maternal lactation to the prevention of iron-deficiency anemia – which conditions the intelligence quotient during childhood – by means of advice on food intake, using the same resources as those employed by family members. The impact on infant  morbidity and mortality is well-known (eg., populations supplemented with vitamin A have lower number of infant disease and deaths).

Early diagnosis of pathologies
Early diagnosis improves the results of treatments and the evolution of diseases, through a better knowledge of signs and symptoms and the identification of populations at risk (eg., know that the clinical signs of pneumonia occur 48-72 h before radiological signs; i.e., the disease is not discarded when the thorax Xray is not available yet).

Adequate relationship physician / patient (family care)
Although the period of rotation is relatively short, the resident should incorporate basic tools to correctly decodify the mother´s narration about the child´s problem. The resident should be aware of the importance the mother will grant to the attention given to his child, and that he should count on the mother´s confidence since she will be the one to comply with his prescriptions.
It is important to have a specific objective in mind, i.e., giving care to all family children, he will become a family physician.

Specific aims of the residency
First year:  basic knowledge about most frequent pathologies in ambulatory care; development of skills to perform specific diagnosis: otoscopic diagnosis of the different ear pathologies, habitual and less frequent semiological  handling; eg., search of ectopic testicle, eye exam, examination of the lower limbs, feet exam, non-traditional examinations: hips, hair, nails, mouth, atypical swallowing, etc).
Implementation of diagnostic tests to assess psychomotor development, to detect retardation, provide advice on psychomotor stimulation (overstimulation is the most frequent cause of psychomotor retardation). In older children, know and implement tools to evaluate child language according to age.
Select vulnerable patients for further specific screening.

Second year: (2-month rotation) Supervision of first year´s activities with respect to the accomplishment of the principles established for patient care in the consulting room; reflexive approach for the interpretation of signs-symptoms; supervision of the adequacy of prescriptions to mothers and of their feasible accomplishment. Clarification and understanding of doubts that may arise during consultation (through reading of pertinent literature or with the help of an instructor/older resident).

Third year: Update and organization of patient data for future programmed theoretical activities. Performance of scientific work and development of educational material for the community.  
All the above mentioned activities must be supervised by the instructor or a more experienced resident.
Learning from the patients´experience is essential, but always under the supervision of an instructor, who will improve and give meaning to those experiences.