EM/Peds Residency

[heliotrope]

I am a 3rd year student who will be applying for EM residencies next year. I am considering also applying to the EM/Peds programs. Are there thoughts/experiences anyone can relay on these three programs and even the match this year regarding them. Is going through one of these programs the only way to eventually work in a dedicated pediatric emergency department? Thanks for your replies.

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[Sweet Tea]

If you want to work in a dedicated PediED, then my advice would be to go through a plain ol' EM residency and then do a peds fellowship...this will get you boarded in EM and boarded in PediEM. If you do the combined EM/Peds residency, you walk away boarded in Peds and boarded in EM, but NOT PediEM. You could probably find some places where you could work in a dedicated PediED, but it'd be easier if you had the fellowship. If your goal is not to be a pediatrician but rather to work in a PediED, then go for the fellowship after an EM residency. It's certainly a much shorter training period.

I had a similar thought last year and talked to my mentor about it, who is a graduate of a EM/Peds double residency (but not the PediEM fellowship). She told me that I should do the double residency if I could see myself doing both careers...as in, I could work happily as an EP or I could work happily as a pediatrician. As much as I loved kids in the ED, I just don't see myself as a pediatrician, but I could happily be an EP without the extra training in peds. So I chose to apply to straight EM programs.

 

[heliotrope]

Thanks for clarifying this for me, Sweet Tea.

The straight EM programs sound good to me too. I guess as time goes on I can see if I want to do a Pedi/EM fellowship.

 

[drdrtoledo]

I interviewed at 2/3 EM-Peds spots last year. I have a strong interest in Peds-EM. I chose to do EM first then Peds fellowship. Being dual-boarded will allow you to work at most Peds hospitals...I'm told. But fellowship appears to be the gold standard. But no matter what anyone tells you, there are plenty of non-fellowship peds doctors running peds ed's. There just aren't enough fellowship trained people. Being dually accredited will put you at an advantage in that case. In all honesty when I interviewed, I either didn't like the vibe of EM at one place or the vibe of Peds in the other. Also realize that combined Peds/EM is a full peds residency, including clinic, floor months, genetics, and others which I was not too keen on doing.

EM + Peds fellowship = 5 years (3 EM +2 Fellow), 6 years if you accept a fellowship that does not offer a specific EM track, or do a 4 year EM program

EM/Peds combined = 5 years.

Peds + Peds EM fellowship = 6 years

EM/Peds Benefit: You can work in a Peds office, You can work in a Peds ED, You will definitely have some extra peds know-how compared to general EM alone, you can do any peds or EM fellowship you may choose. You can still work in adult EM for extra cash, ability to do adults also makes you more marketable, more opportunity to do cool procedures on adults. Negative = you can never sit for the subspecialty board... the value of this is arguable.

EM + Peds fellowship Benefit: You are technically a subspecialist, you can sit for the subspecialty exam, you can still work in adult EM for extra cash, ability to do adults also makes you more marketable, more opportunity to do cool procedures on adults.

Peds + EM fellowship: No adults ever, for the most part (+ or -).


My advice, consider interviewing at the combined programs and get the vibe. There is a difference between being a pediatrician, and being peds ER doctor. It all depends on what you feel you want to be. I hope this helps. Feel free to ask any further questions.

 

[doctawife]

If you want to work in a dedicated PediED, then my advice would be to go through a plain ol' EM residency and then do a peds fellowship...this will get you boarded in EM and boarded in PediEM. If you do the combined EM/Peds residency, you walk away boarded in Peds and boarded in EM, but NOT PediEM. You could probably find some places where you could work in a dedicated PediED, but it'd be easier if you had the fellowship. If your goal is not to be a pediatrician but rather to work in a PediED, then go for the fellowship after an EM residency. It's certainly a much shorter training period.

I had a similar thought last year and talked to my mentor about it, who is a graduate of a EM/Peds double residency (but not the PediEM fellowship). She told me that I should do the double residency if I could see myself doing both careers...as in, I could work happily as an EP or I could work happily as a pediatrician. As much as I loved kids in the ED, I just don't see myself as a pediatrician, but I could happily be an EP without the extra training in peds. So I chose to apply to straight EM programs.

Yes, what she said. If you want to avoid smelly adults, the other option is to do a pedi residency followed by a PediEM fellowship. The overall length of training is the same, but there are no icky adults. However, make sure you get into a GOOD residency program and have some research in the works. PediEM is getting more and more competitive.

 

[MDrugger]

I also considered doing the EM/Peds 5 year track. Especially because one of the places that has it was my home school (UMD). Most of the people I know either currently and who finished planned on working in both adult and pediatric ERs or places where the ED population is mixed. While its true you are not technically double boarded in Peds-EM, I have yet to hear of one of the graduates having trouble finding a job doing just that. And they are still fighting to be allowed to sit for the Pedi-EM subspecialty boards, as always that aspect seems mostly a political thing.
That said I decided not to do it after my 2 months of rural medicine/AHEC where i was in a peds clinic. I realized I really dislike primary care peds, well checks and ADHD assesment forms, and idiot parents who complain about the cost of their children's asthma meds and continue to smoke....
I may end up doing one of the Peds-EM fellowships after residency but this way I have 3 years to decide. However, if you are at all interested i think its wise to give the programs and look-see and def. consider applying. The people I know in the program are amazing doctors and its def. a pretty unique training oppurtunity