EM/PEDS..any thoughts

[marcusaurelius]

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I am an MS3 that likes both EM and Peds. I am wondering if I am competitive, and if its better doing the combined residency, doing EM then peds fellowship, or Peds then EM fellowship. Anyone have any insight on this subject? It is not easy to find info on it. Firstly, my competitiveness...I believe there are about 6 spots in the country for the combined, in AZ, IN, and MD... daunting prospect to say the least...Step I 244, honored about 2/3 of preclinicals, honored majority of 3rd year rotations. Most glaring negative, I only passed medicine, my first rotation. I have set up a PEDS/ENT research project, but otherwise have no research (or many other extracurics) during med school. I did do a year of research at Yale before med school. No pubs from it though. My 4th year schedule is due in a week, and I just want to know if combined is a good option (realistic), or a res and fellowship better. Plus, what to do 4th year to make myself competitive? Any advice much appreciated.

 

[BKN]

I am an MS3 that likes both EM and Peds. I am wondering if I am competitive, and if its better doing the combined residency, doing EM then peds fellowship, or Peds then EM fellowship. Anyone have any insight on this subject? It is not easy to find info on it. Firstly, my competitiveness...I believe there are about 6 spots in the country for the combined, in AZ, IN, and MD... daunting prospect to say the least...Step I 244, honored about 2/3 of preclinicals, honored majority of 3rd year rotations. Most glaring negative, I only passed medicine, my first rotation. I have set up a PEDS/ENT research project, but otherwise have no research (or many other extracurics) during med school. I did do a year of research at Yale before med school. No pubs from it though. My 4th year schedule is due in a week, and I just want to know if combined is a good option (realistic), or a res and fellowship better. Plus, what to do 4th year to make myself competitive? Any advice much appreciated.

Do either the combined residency or EM first, then consider the fellowship is you're still interested. Do not do peds and then the fellowship because:

1. It takes the same amount of time as to get double boarded, but you only can see kids.
2. It doesn't pay as well.
3. Adult EM is more interesting and the patients are sicker.

Just my .02 cent.

p.s. You're competitiveness is just fine. There may be only 6 slots for the combined program in the country, but only 4 filled in 2005. There are a lot of pediatricians looking to get into the fellowships, but that needn't concern you. If you're EM trained, you can see kids as well as adults. If you want the additional residency or fellowship, you'll be able to get it.

 

[DeLaughterDO]

Just keep in mind that if you do the EM/PEDS combined residency you CANNOT get board certified in Pedi EM, just double boarded in Peds and EM. You can only be certified in Pedi EM if you do either a PEDS or EM residency followed by an Pedi EM fellowship (3 years after PEDS residency, 2 years after EM residency)

good luck,

jd

 

[DeLaughterDO]

I found this on the ABEM website at http://www.abem.org/public/portal/alias__Rainbow/lang__en-US/tabID__3375/DesktopDefault.aspx

Professional Education

For admission to the certification examination in Pediatric Emergency Medicine, the diplomate must have completed a Pediatric Emergency Medicine Fellowship. The Pediatric Emergency Medicine Eligibility Criteria for Certification and Maintenance of Certification describes the fellowship training requirements.

Physicians who entered training in Pediatric Emergency Medicine on or after July 1, 2000, are required to have completed their training in a Pediatric Emergency Medicine fellowship accredited by the Accreditation Council for Graduate Medical Education.

Dual Certification

A candidate who is certified by ABP and ABEM may apply via the dual certification pathway. Only candidates who completed training to meet the primary certification requirements of ABP and ABEM before January 1, 1999, may apply via this pathway.

 

[missdr]

i debated this a lot as well marcusaurelius and came to the conclusion that it only makes sense to do the peds/EM combined programs if you think you might actually WANT to practice general pediatrics in the future. pediatrics is VERY different in many ways from EM and i would recommend that you try to figure out which one suits your personality and lifestyle desires before applying. if you really LOVE both--apply peds/em combined and i am sure you will be a very competitive applicant (don't worry about 1 pass!). if you decide that you really LOVE taking care of kids in the ED then go the EM and fellowship route....it is a VERY different career path and if you really want to do peds EM and NOT general pediatrics then really think about it before you apply to a 5 year combined program! the move in my part of the country (and large urban institutions across the country) is to only hire peds em folks who are board certified and the only way to get board certified is through the fellowship. feel free to PM me as i went through this last year at this time!!! 🙂

 

[EctopicFetus]

I interviewed at Arizona for Peds/Em and IMO it is a decent choice if you are more research oriented. IIRC over 50% (small sample pool) of double boarded people went on to academic spots. That being said if you want only pediatric emergencies then you need the peds fellowship. If you have Qs PM me.

 

[cowgirlcarrie]

I agree with what BKN said. I am currently a pedi intern and am now switching over to EM (hopefully! we'll find out in about 11 days). I went through the same thought process last year after I figured out how much I loved EM. I thought that I would do Pedi and then do an EM residency afterwards and at one point considered just doing pedi and then an EM fellowship. For me a year of general pedi has been I think helpful in the long run as far as my knowledge of pedi, but I wouldn't consider doing it again if I could change it. Pedi EM is great but the reality is that kids don't get sick that often. If you are like me, part of the draw to EM is the variety and you will miss that being strictly pedi EM, plus your volume won't be as high. I haven't enjoyed my pedi year very much and I think a lot of that has to do with my personality. If you get bored easily and spending an excruciating amount of time talking about child development, poop and carseats doesn't excite you then it may not be a good choice for you either. So in my opinion do EM first, then if you want to be better at peds do a fellowship. I hope that is helpful. PM me if you have more questions.

 

[EctopicFetus]

Carrie,

Thats a very good point, the emphasis in Peds seems to be more about development, vaccinations, child safety etc this is different from the emphasis on kids in the ED. Lastly, as Carrie stated there arent that many sick kids (which is a good thing of course) at the same time though for training you have to see enough of them to at least be comfortable.

In the end while I looked at both of these issues you have to ask yourself what you want out of your own career. If you have further Qs about this PM me with your email and I have some interesting stuff I accumulated on this topic from people.

 

[drdrtoledo]

Everyone has made great points. I interviewed for the 6 spots this year and ended up not even ranking any of the combined programs. Part of it was because I either loved EM at one place and wasn't comfortable with the Peds program there or vice versa. I did a bunch of peds electives (NICU, PICU, Peds EM) just to see if I really wanted to do general peds. To be honest I was kind of sad that I didn't fit into any of the combo programs. But when I sat and thought of my future plans, I really didn't see myself wanting to do office based practice. All the reasons cited by everyone else are something to strongly consider, but interviewing and getting a feel for the program won't hurt.

As for the subspecialty board certification, you definitely cannot take it with the combined program. How important that is, is debatable. If you want to practice at a large children's hospital, they tend to prefer the fellowship from what I heard on my interviews. Other than that you will be highly recruited to do most other things you can do with the fellowship. I plan on doing a peds fellowship after EM (will find out in 9 days 🙂 ). PM if I can be of assistance.