developmental peds

[doctorE2010]

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I'm looking to get some more info of developmental peds. I'm an MSII and think this might be something I would be interested in. Is there are large genetic/ counseling component? What sort of patients do you see? Are these private practice or hospital based positions? I'm worried about seeing 90% autistic children--is there much diversity? Any info on this field would be great. Thanks!

 

[eviorr]

I'm a peds intern, and I just finished my Development month. All peds residencies are required to have one month of development, so you will get the chance to check it out, usually in your first year. I had a great time on development, but that may have been a combination of working with a great attending, and the fact that in my program, devo is our one call-free month.

I'd say about one-third of the patients we saw were autistic, one-third were ADHD, and one-third had miscellaneous developmental delays - obviously this is a very rough breakdown given the amount of overlap and comorbidity. In terms of genetic counseling, we usually referred patients to Genetics if we identified a genetic syndrome or cause for their delay, or if we were particularly concerned about a syndromic cause of some sort (e.g. the kid with obvious facial dysmorphism and midline defects whose delay was far out of proportion to her history of being and ex-35-weeker).

Hope the info helped.
- Erick

 

[Bernardo_11]

I'm looking to get some more info of developmental peds. I'm an MSII and think this might be something I would be interested in. Is there are large genetic/ counseling component? What sort of patients do you see? Are these private practice or hospital based positions? I'm worried about seeing 90% autistic children--is there much diversity? Any info on this field would be great. Thanks!

Hello DrE, thanks for your interest. I'm a 3rd yr DB Peds fellow. To answer your questions you should know there exists two "developmental" specialties in pediatrics. One is a NeuroDevelopmental specialty. Usually it entails 2 years of pediatric residency, then during your PGY-3 year you start a 4 year track consisting of Child/Adult Neurology and Developmental Disability work. It's pretty clinical and gets down to the nitty gritty of potential problems with the developing brain. You will be able to sit for the General Pediatrics, Child Neurology, and the Neurodevelopmental Disabilities boards. More info on this specialty is linked here:

http://www.sfmatch.org/residency/child_neurology/ndd.htm

The specialty I'm in, Developmental/Behavioral Pediatrics is a little more holistic. It's a 3 year fellowship done after completing your pediatric residency. Many people feel this fellowship started to create academic physicians who can train peds residents regarding the developmental and behavioral problems they will face during practice. The specialty has grown on its own though, and many practitioners just do DB peds without teaching or doing any general pediatrics. Like the NDD specialty, it includes a lot of neurodevelopmental disabilities, but also has a component of of child psychiatry. You do a lot of interdisciplinary work and try to be familiar with the community resources that exist for your patient. Sometimes I do feel like a GSW (glorified social worker). But you do have an ability to diagnose and treat a lot of developmental/behavioral problems like autism or ADHD. My main reason for entering this specialty was to make me a better general pediatrician as it had a more integrative nature. As I also wanted to continue general pediatric practice, I didn't want to be too "overspecialized" after completing any post-residency training. More info on DB Peds can be found here:

http://www.aap.org/family/WhatisDevBehPeds.pdf

Although more learned in genetics than your regular general pediatrician, you don't see many dysmorphology patients and would usually work with a geneticist to help with a diagnosis (if it exists). I can't speak for the NDD specialty though.

Hope this helps, feel free to PM me if you have any further questions.

Nardo

 

[TexasRose]

Okay Nardo, after a week on my Developmental rotation I definitely see the appeal of this field. 🙂 It's also nice that my education and speech therapy experience are so applicable here. Great kids, interesting field and really nice lifestyle. But I suppose the reason so few residents seem to like it is the lack of emergencies and the long periods of time spent talking and playing. I'm surprised it hasn't become a more popular field solely for the lifestyle. 😉

 

[Bernardo_11]

Hey there Rose, Glad you're enjoying yourself. Had I known you had an educational and SLP background, I would have chatted more about the specialty when you were out here on Hawaii. If you do plan on maintaining your interest in the educational field, DB Peds may be a natural fit for you. I'll send you a reply to your private message when I get the chance.

Nardo

 

[waldenwoods]

Okay Nardo, after a week on my Developmental rotation I definitely see the appeal of this field. 🙂 It's also nice that my education and speech therapy experience are so applicable here. Great kids, interesting field and really nice lifestyle. But I suppose the reason so few residents seem to like it is the lack of emergencies and the long periods of time spent talking and playing. I'm surprised it hasn't become a more popular field solely for the lifestyle. 😉

Maybe because demand for developmental pediatricians outstrips the supply? Two-year wait for a new patient appointment? However, I realize that this may be dependent upon location.

(Not to get too far off-topic, but I was reminded of the following thread on pediatric rheumatology and its discussion about the shortage that exists within the specialty: http://forums.studentdoctor.net/showthread.php?t=517834 and thought that maybe some of those forces in rheum could be at play in developmental pediatrics.)