Competitiveness... neonatology and cardiology

[docno1]

Hey

I know cards is competitive as per NRMP match statistics but cudnt find the statistics for neonatology.
Also which one has a better job market. i have narrowed my fellowship choices to these two and i enjoyed both rotations hence trying to analyse other factors for which i have limited info to make my final decision.
any info appreciated....

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[drbon]

is it possible to apply for two different fellowships at once? i love Neo and was positive that that's what i wanted to do and now i'm doing a Peds Cardio rotation and it's awesome! i know i'm only a 4th year and have at least a year to figure this out, but i was just wondering if that was a possibility....
p.s. from what i understand Neo is not nearly as competitive as Cardio

 

[14022]

Hey

I know cards is competitive as per NRMP match statistics but cudnt find the statistics for neonatology.
Also which one has a better job market. i have narrowed my fellowship choices to these two and i enjoyed both rotations hence trying to analyse other factors for which i have limited info to make my final decision.
any info appreciated....

I believe this is the first year for the match for nicu, so match data obviously isnt available. OBP may be able to give you more info re: competitiveness, but I don't think it is very competitive. One reason is that it is one of the biggest fellowships in terms of number of spots available nationally.

You can find the most recent match data for all NRMP fellowships here...

http://www.nrmp.org/fellow/match_name/index.html

 

[14022]

is it possible to apply for two different fellowships at once? i love Neo and was positive that that's what i wanted to do and now i'm doing a Peds Cardio rotation and it's awesome! i know i'm only a 4th year and have at least a year to figure this out, but i was just wondering if that was a possibility....
p.s. from what i understand Neo is not nearly as competitive as Cardio

I know for certain there are PICU/NICU and PICU/cards fellowships that are five year fellowships. I dont think there are combined NICU/Cards fellowships, but some programs may allow you to design your own. To be honest though, unlike PICU/cards and PICU/NICU I dont think NICU/cards is a good combination of specialties. Most places have their post-op hearts managed in the PICU or a seperate Cardiac ICU, which makes PICU/cards a reasonable combo. Many NICU's dont even do ECMO, they send those kids to the PICU. There will be PLENTY of things to do in either of those specialties alone, and combining NICU and cards into a five or six year fellowship and having to sit for gen peds, cards, and NICU boards to me would be insane. NICU/PICU makes sense to me since it will make you extremely valuable to smaller hospitals, especially those outside of major metro areas, who can't afford to hire large PICU and NICU staffs.

 

[drbon]

I know for certain there are PICU/NICU and PICU/cards fellowships that are five year fellowships. I dont think there are combined NICU/Cards fellowships, but some programs may allow you to design your own. To be honest though, unlike PICU/cards and PICU/NICU I dont think NICU/cards is a good combination of specialties. Most places have their post-op hearts managed in the PICU or a seperate Cardiac ICU, which makes PICU/cards a reasonable combo. Many NICU's dont even do ECMO, they send those kids to the PICU. There will be PLENTY of things to do in either of those specialties alone, and combining NICU and cards into a five or six year fellowship and having to sit for gen peds, cards, and NICU boards to me would be insane. NICU/PICU makes sense to me since it will make you extremely valuable to smaller hospitals, especially those outside of major metro areas, who can't afford to hire large PICU and NICU staffs.

my question was for someone who can't make up their mind, is it possible to apply to both and see where you end up or will programs find out and deem you not 'committed' enough for either....it's really just a hypothetical, i'm sure i'll have it figured out when the time comes to apply (hopefully!)

 

[14022]

Oh, sorry, I misunderstood. In that case, I can answer the question.

Each pediatric specialty has a different set of dates for their application season. The NRMP is conducting a match for neonatology the first time for the applicants starting fellowship in 2009. See <http://www.nrmp.org/fellow/match_name/neonatal-perinatal/dates.html> for the dates for the NICU match. For appointment in July 2009, rank list submission is Sept 2008. I do not know when programs officially interview, but I imagine it will begin in the late winter/early spring 2008.

For cardiology, assuming the dates for the match for appointment for 2009 will be the same as they are for appointment in 2008, rank list submission is May 2008. They will interview February through April 2008. See <http://www.nrmp.org/fellow/match_name/ped_card/dates.html> for cards dates.

So you apply for each of those in Dec 2007 and need to submit your rank list for cards by May 2008. So applying to both really only buys you an extra 5 months to decide while interviewing. Also, peds cards currently doesn't have a single application that is sent to all programs, so you have to fill out each application ot each program you want to apply, which may be 10 or more programs. This would be a huge pain especially if you decide not to even submit a deadline. Also, you have to go interview at all of these programs, and the costs for travel and the difficulty in arranging time to interview while fulfilling your residency clinical duties is difficult for one specialty, let alone two.

So I think it will be a major pain in the rear to do this. If I were you, if you really cant decide, take a year off and work as a hospitalist or apply to be chief resident to have an extra year to decide.

 

[oldbearprofessor]

my question was for someone who can't make up their mind, is it possible to apply to both and see where you end up or will programs find out and deem you not 'committed' enough for either....it's really just a hypothetical, i'm sure i'll have it figured out when the time comes to apply (hopefully!)

Although pedi cards and neo share in common both patients and being critical care specialties of pediatrics (along with PICU), in my experience, there is relatively little overlap in interest between the two among residents. I've only ever known one person to change mid-fellowship between these two. Both groups self-select early, in my experience this is especially true for pedi cards. I suspect by the time the middle of your PL-2 year comes around you'll have an idea which of these two you prefer.

If not, the suggestion of doing an extra year as chief or hospitalist is a very good one. I know it wasn't your question, but I wouldn't recommend doing a combination of any 2 of PICU/NICU/pedi cards. From a career perspective, right now it doesn't make much sense given the extra 2-3 years you'd need to spend as a low-paid fellow and the near certainty you'd spend nearly all your time in one of them. In the past NICU/PICU was more common when it was "easier" to go back and forth.

 

[sydney1]

i love both NICU and cards. Do NICU if you want to treat disease in many organ systems and have close relationships with a family daily for 1-3 months. Do cards if you want to focus on 1 organ system, treat kids of all ages, and do more outpatient work. NICU is often at night and more in the hospital. As far as lifestyle, they both can be hard----you probably can tailor cards to easier hrs if you do mostly outpatient. However, in academic NICU, you could be at an institution where you were "on service" say 3 months out of the yr ---or find a private type job with shift work. good luck!

 

[drbon]

Thanks everyone for the responses...they are all very helpful. The year off in between is an excellent idea that i didn't even think of. Hopefully I'll figure it out by the time i need to! I hate not being able to make up my mind...I thought for sure it was going to be Neo after I finished my elective over the summer, but now I'm doing my Cards elective and once again I'm all confused...I hope I'm not the only one that this happens to

 

[m1234d]

Thanks everyone for the responses...they are all very helpful. The year off in between is an excellent idea that i didn't even think of. Hopefully I'll figure it out by the time i need to! I hate not being able to make up my mind...I thought for sure it was going to be Neo after I finished my elective over the summer, but now I'm doing my Cards elective and once again I'm all confused...I hope I'm not the only one that this happens to

you are definitely not alone, every few days PICU and NICU switch as my future fellowship. the stressful thing for me is that most programs don't have a PICU rotation during 1st year. sometimes, it can be an elective, so i'm going to ask about that, and i am doing picu my last month of med school working (the last 6wks i'm off though) i figure, it's kind of crazy, but at the same time good preparation for intern year...

 

[swozbie]

...once again I'm all confused...I hope I'm not the only one that this happens to

My $0.02:

You are certainly not alone. When I was in med school, I was "hellbent" on Peds Cards - in my opinion, it is the best combination of physiology, anatomy, embryology out there. I got into residency, though, and found that I liked NICU a lot. I didn't want to go straight into fellowship (for a variety of reasons), so I have been in the "real world" for the past several years. I have worked as a peds hospitalist in 4 different hospitals and spent 2 years in private practice. It has been great experience and wouldn't change much if I could do it over again...

Now I am going back to do a fellowship in...NICU. For me, I have found that I like the whole body and not one organ system. The research (I plan to do basic science/academics) that I am interested in can be done through Neonatology or Peds Cards - one of the Neos I have corresponded with said, "Don't be afraid to do Neonatology and love the heart." Although there are not many neonatalogy researchers doing cardiac stuff, there are some.

NICU will limit some of the exposure to the clinical cardiac stuff, unless you go to a place where the neos are involved in post-op hearts (not a lot, as mentioned above). A recent article in Pediatrics (Su and Munoz) discussed the need for regimented cardiac critical care training for the newly developing field of pediatric cardiac critical care medicine (a sub-sub-specialization). Although they do not exclude neos (they mention broadly "critical care"), the reality is that unless one does a dual cardiology/NICU fellowship, the critical cardiac kids may be in the CICU/PICU and Neos will be only peripherally involved, if at all. As the field evolves, CICUs will become more commonplace and cards kids will be managed by ICU/Cards specialists (see also http://www.pcics.com/ - Pediatric Cardiac Intensive Care Society)

Bottom line: if it's all about the heart, do Cards. If you like the heart, and are willing to be innovative and seek out opportunities, NICU can be just fine. Either choice is excellent.

S

Also, the top programs in Neonatology are probably as competitive as any other specialty, but there are a lot of spots nationally making it a little easier. We'll know more next year....