Anyone interested in pediatric cardiology?

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Just wanted to see if anyone was considering this field or had completed a rotation in it? If so, was it primarily a clinic based specialty (outside of ep/cath) and what are some of the more common pathologies you encountered? Lastly, how long have you been interested in the field?

Trying to get an idea if this may be a good fit for me. Thanks!

Originally Posted by Dawkter

Just wanted to see if anyone was considering this field or had completed a rotation in it? If so, was it primarily a clinic based specialty (outside of ep/cath) and what are some of the more common pathologies you encountered? Lastly, how long have you been interested in the field?

Trying to get an idea if this may be a good fit for me. Thanks!

I did some peds cards; it's an awesome field. My understanding is limited given that I only saw the inpatient side, though. There can be quite a bit of inpatient work for both the Peds Heart Failure/Transplant and the pulmonary hypertension teams (those are the first two that come to mind outside of EP and interventional).

The sky was the limit on the different kinds of pathology: transposition of the great vessels, congenitally corrected transposition of the great vessels, HLHS, coarctation of the aorta, major aortopulmonary collateral arteries, dilated cardiomyopathy, hypertrophic cardiomyopathy, primary pulmonary hypertension tetralogy of fallot, VSDs, ASDs, complete atrioventricular canal, etc.

You should try to shadow someone in the office or spend a day on service.

That sounds kind of awesome.

I'm applying for peds cards this year. It has a huge amount of variety, you can do 100% outpatient, 100% inpatient, or a combination of both.

Originally Posted by Dawkter

Just wanted to see if anyone was considering this field or had completed a rotation in it? If so, was it primarily a clinic based specialty (outside of ep/cath) and what are some of the more common pathologies you encountered? Lastly, how long have you been interested in the field?

Trying to get an idea if this may be a good fit for me. Thanks!

There really is a huge, huge variety. I'm entering a peds critical care fellowship this summer, of which cardiac critical care is a huge portion. Even at the ICU level of care, there's a lot of potential directions to go. Some places, the Cardiac ICU's are very cardiologist driven, others they're the realm of the intensivists. After completing a cardiology fellowship, if the Cardiac ICU, with the post op hearts, myocarditis, ECMO, etc, is what lights your fires, you can complete a 4th year of fellowship in Cardiac Critical Care. More and more places are splitting their PICU's into separate Cardiac and general PICU's (see the construction projects at Seattle Children's or Children's Memorial in Chicago). Or if you're really crazy and want to do it all - PICU, CVICU, outpatient clinic - you can do a 5 year combined CCM/Cardiology fellowship and become board certified in both Critical Care and Cardiology.

In addition to the recognized 4th year fellowships in Interventional and Critical Care, there are also some options for further training in diagnostic and EP fields. Additionally, as mentioned, transplant is a major setting, and if you were interested in a med/peds sort of set up, you could also go into Adult Congenital Heart Disease management (which can also be entered from adult cardiology).

Though I have no personal interest in the field, I have to say that the operations they do to correct congenital heart defects are some of the most bad*ss things I've heard of in medicine. Correcting a transposition of the great vessels or a tetralogy of Fallot? Incredible.

Originally Posted by BigRedBeta

There really is a huge, huge variety. I'm entering a peds critical care fellowship this summer, of which cardiac critical care is a huge portion. Even at the ICU level of care, there's a lot of potential directions to go. Some places, the Cardiac ICU's are very cardiologist driven, others they're the realm of the intensivists. After completing a cardiology fellowship, if the Cardiac ICU, with the post op hearts, myocarditis, ECMO, etc, is what lights your fires, you can complete a 4th year of fellowship in Cardiac Critical Care. More and more places are splitting their PICU's into separate Cardiac and general PICU's (see the construction projects at Seattle Children's or Children's Memorial in Chicago). Or if you're really crazy and want to do it all - PICU, CVICU, outpatient clinic - you can do a 5 year combined CCM/Cardiology fellowship and become board certified in both Critical Care and Cardiology.

In addition to the recognized 4th year fellowships in Interventional and Critical Care, there are also some options for further training in diagnostic and EP fields. Additionally, as mentioned, transplant is a major setting, and if you were interested in a med/peds sort of set up, you could also go into Adult Congenital Heart Disease management (which can also be entered from adult cardiology).

This sounds awesome

Can anyone discuss some of the downsides of this career? I assume that it must be very difficult to deal with the fact that many of your patients are dying. Is it frustrating like neurology in the fact that many of the diseases have no tangible cure?

Originally Posted by Dawkter

Can anyone discuss some of the downsides of this career? I assume that it must be very difficult to deal with the fact that many of your patients are dying. Is it frustrating like neurology in the fact that many of the diseases have no tangible cure?

I wouldn't really say most of the patients are dying. You do have patients pass more often than some other specialties in Peds - and the death of a child is always tragic - but compared to many fields in adult medicine? Kids just really don't die that often, even ones with chronic conditions. Most PICU's have mortality rates of only about 4% while adult ICU's are generally over 15%.

The downsides are the length of training, the lower salaries in peds compared to adult fields, the intensity of fellowship. Generally, pediatric subspecialists are geographically limited in their careers to larger cities, which may be a drawback for some. So too might be the limited private practice opportunities, and having to be affiliated with a children's hospital.

Originally Posted by Dawkter

Can anyone discuss some of the downsides of this career? I assume that it must be very difficult to deal with the fact that many of your patients are dying. Is it frustrating like neurology in the fact that many of the diseases have no tangible cure?

If you are talking about drawbacks of peds cards relative to other subspecialties within peds, then the answer is there arent any.

If you are talking about drawbacks relative to other non-peds fields, then the poster above me is accurate.