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Learning Opportunities | Overview

The Region 1 Pediatric Environmental Health Specialty Unit (PEHSU) of New England located at Boston Children’s Hospital provides an opportunity for learners of all stages, levels, and backgrounds to participate in a flexible educational and experiential program with a focus on environmental justice and climate change. Student enrollees — including but not limited to high school students, graduate and undergraduate students, medical and nursing students, residents, etc. — will be learning from and collaborating with health professionals from Boston Children’s Hospital, Boston Medical Center, Cambridge Health Alliance, and Beth Israel Deaconess Medical Center.

In addition to their chosen topic and project work, students will learn how to take an environmental history and field clinical questions regarding childhood/prenatal environmental exposures, such as lead, pesticides, and air pollution.

Students will build their own experience with opportunities to:

  • choose a topic of interest to study
  • shadow physicians in a clinical setting, either in person or via a telehealth visit
  • attend educational seminars and lectures
  • attend meetings with representatives from public health agencies
  • assist in ongoing research and advocacy projects
  • assist in health education and outreach efforts

EJCC Scholar elective curriculum

Curriculum details

Educational objectives**

These objectives are meant to be for information purposes only. Many EJCC Scholars may not be able to achieve many, or even some, of these during a rotation or elective. How many they might accomplish will depend, in part, on the duration and focus of the educational experience.

A. Foundational knowledge in pediatric environmental health

  1. Identify relevant EH resources for screening, diagnosis, risk communication, and treatment.
  2. Explain how fetal and childhood epigenetics, physiology, organ maturation, and behaviors at different stages of development increase the impact of environmental exposures.
  3. Describe prenatal, perinatal, and pediatric conditions linked to environmental factors.
  4. Describe prenatal, perinatal, and pediatric exposures that may lead to disorders in birth outcomes, childhood, adolescence, and/or adulthood.
  5. Describe aspects of the environment that nurture healthy growth and development in the fetus, child, and adolescent.
  6. Describe social determinants of health and health disparities related to physical/social environmental factors

B. Individual patient care

  1. Take an environmental history from a patient/parent.
  2. Apply EH screening questions as developmentally appropriate in preventive care.
  3. Apply appropriate environmental and biological sampling and measurement, both for screening and diagnostic testing and interpreting results appropriately.
  4. Develop a plan to reduce a patient's or a child's exposure to environmental contaminant(s).
  5. Evaluate the effectiveness of therapies and methods of reducing environmental exposures.
  6. Create and implement appropriate EH anticipatory guidance, risk counseling, and hazard reductions.
  7. Identify and coordinate available community resources to improve a patient's well-being.

C. Community health and advocacy

  1. Assess an environmental exposure in a community.
  2. Communicate about environmental risks to community members, school board, or other stakeholders.
  3. Interpret legal, regulatory, and non-regulatory approaches to addressing EH issues.
  4. Identify partners and resources for addressing EH risks, and for counseling and management at the community level.
  5. Develop media literacy in order to use media education as an advocacy tool.
  6. Describe sentinel events and strategies for their public health reporting.

D. Research

Specific research opportunities will be discussed at the beginning of the elective and may include opportunities within the PEHSU or the Boston Children’s Hospital Pediatric Environmental Health Center (PEHC).

E. Course Evaluation

Each student is expected to submit a self-reflection on what they learned during this experience, activities in which they participated, and how it impacted their future educational and career plans.

Topic/areas of interest:

  1. introduction to pediatric environmental health
  2. indoor air quality
  3. childhood lead poisoning
  4. climate change
  5. environmental justice and health disparities
  6. fertility, pregnancy, lactation, and the environment
  7. PFAS/water contamination

**Modified from: Etzel et al. 2003. Pediatric environmental health competencies for specialists. Ambul Pediatr; 3(1):60-63 AND Goldman RH et al. Developing and implementing core competencies in children’s environmental health for students, trainees, and healthcare providers: a narrative review. BMC Medical Education 2021; 21: 503.

Locations

Student trainees will have the opportunity to intern at the following locations:

  • Boston Children’s Hospital Pediatric Environmental Health Center (PEHC), 1295 Boylston Street, Suite 100, Boston
  • The PEHC patient clinic, which is located at 333 Longwood Avenue, 5th Floor, Boston
  • Boston Medical Center, located at One Boston Medical Center Place, Boston
  • Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston
  • Cambridge Health Alliance, 1493 Cambridge Street, Cambridge

What is environmental justice?

According to the EPA, environmental justice is defined as the fair treatment and meaningful involvement of all people regardless of race, color, national origin, or income, with respect to the development, implementation, and enforcement of environmental laws, regulations, and policies. This goal will be achieved when everyone has:

  • the same degree of protection from environmental and health hazards
  • equal access to the decision-making process to have a healthy environment in which to live, learn, and work

Length of course

The length of training in EJCC is necessarily variable, since trainees at every level may have constraints imposed by their own high school, college or university, medical or nursing or public health school, medical residency or fellowship, or other educational institutions.

“Mini-electives” may be as short as two to four weeks, for which the learning objectives will be abbreviated. Longer electives, externships, non-course-credit volunteer experiences, rotators, and observers may span one or more months in duration, with the opportunity for more in-depth study and more structured activities.

Course credits and financial compensation

Participating students may earn course credit or receive a small stipend, as allowed by their academic institution. Stipends may only be available for a limited time.

Applications

EJCC Scholars positions are limited, and the application process is competitive. Only one or two interns are selected each academic year. Women and under-represented minority students are encouraged to apply. Prospective applicants can inquire by emailing Ms. Kim Manning at Kimberly.Manning2@childrens.harvard.edu. Please be sure to include your updated resume.

Alternatively, you can leave your contact information at 617-355-8177, and someone will contact you.

Applicants must complete and submit the following:

  1. Region 1 PEHSU EJCC Scholars application form
  2. EJCC supplemental questionnaire
  3. letter from the school’s registrar’s office denoting that they are a student in good standing
  4. letter of support of this activity from their current supervisor, high school or college advisor, or another school official who knows them well
  5. current and updated resume

Staff

Clinical elective directors

  • Boston Children’s Hospital: Alan Woolf, MD, MPH; Marissa Hauptman, MD, MPH; Shalini Shah, DO
  • Cambridge Health Alliance: Rose Goldman, MD, MPH
  • Beth Israel Deaconess Medical Center: Blair Wylie, MD, MPH
  • Boston Medical Center: Noah Buncher, MD

Faculty

  • Aaron (Ari) Bernstein, MD
  • Noah Buncher, MD
  • Rose Goldman, MD, MPH
  • Marissa Hauptman, MD, MPH
  • Shalini Shah, DO
  • Alan Woolf, MD, MPH
  • Blair Wylie, MD

Elective coordinator

  • Kim Manning

Administrative credentialing

  • Alba Savinon
  • Le Pham

Contact information

Email Region1pehsu@childrens.harvard.edu or call 617-355-8177.

Disclosures: The Pediatric Environmental Health Specialty Units (PEHSUs) are supported by the American Academy of Pediatrics (AAP) and funded (in part) by the cooperative agreement FAIN: NU61TS000296 with the Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry (CDC/ATSDR). The U.S. Environmental Protection Agency (EPA) supports the PEHSUs by providing partial funding to CDC/ATSDR through Inter-Agency Agreement number DW-75-95877701. The content on this website has not been formally disseminated by CDC/ATSDR or the EPA and should not be construed to represent any agency determination or policy. Use of trade names that may be mentioned is for identification only and does not imply endorsement by the CDC/ATSDR or EPA.