Focus specialty?

[LIDO]

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I apologize for the newbie question.

Is it possible to focus on pediatric oncology patients as an anesthesiologist? I understand that most Ped Onc/Hemat docs work in large academic hospitals....is it possible to work as an anesthesiologist focusing on these surgical cases? How involved would you be in the oncology treatment team?

I have always loved ped onc/hemat, but have recently found anesthesiology very interesting.

Thanks for any help.

 

[Bertelman]

That would be pretty rare, unless you specialized in peds anesthesia then went to work at a cancer center such as MD Anderson. Furthermore, the only way you might be involved in the actual treatment team is peripherally, such as the acute pain service for post-ops. They probably wouldn't even let you staff the peds ICU, unless you maybe did a peds intern year and several months of peds ICU during your residency.

Apparently I was too slow. That's what I get for opening multiple tabs before responding.

 

[LIDO]

So, is the concensus that this arrangement is not probable? Anesthesiologist cannot staff the Ped ICU...so I couldn't even do that at a cancer institute?

Any recommendations for a person who loves ped onc but also the procedural/critical care aspect of anesthesiology?

 

[countingdays]

So, is the concensus that this arrangement is not probable? Anesthesiologist cannot staff the Ped ICU...so I couldn't even do that at a cancer institute?

Any recommendations for a person who loves ped onc but also the procedural/critical care aspect of anesthesiology?

Do peds and a peds CC fellowship. You wouldn't do many procedures as a peds resident obviously, but at least you'd end up doing the job you really want. Anesthesiology is not a great path to the peds ICU.

Hopkins does offer a combined anesthesiology and pediatric critical care program. If you are a super star medical student, then this is an option I suppose. I don't know if anyone else offers this type of program though. I guess you could always apply for the combined program and peds at the same time.

http://www.hopkinsmedicine.org/anesthesiology/Education/fellowship/PICU.cfm

 

[IlDestriero]

.

 

[DScully]

Penn/CHOP have and Stanford have offered these kind of custom training programs in the past to carefully selected individuals.

As far as I understand, programs now can apply for peds anesthesia residency if you do 3yrs of peds, followed by 2yrs of anesthesia. However, ACGME just approved this last fall and it will take a while (at least a couple of years, I imagine) for this new pathway to be fully accessible for match consideration.

If you truly love PICU, then peds followed by ped ICU fellowship is the way to go. Not a lot of places will allow you (the anesthesia resident) to be in PICU.

 

[Bertelman]

So, is the concensus that this arrangement is not probable? Anesthesiologist cannot staff the Ped ICU...so I couldn't even do that at a cancer institute?

Any recommendations for a person who loves ped onc but also the procedural/critical care aspect of anesthesiology?

Pediatric Surgery.

Or Peds CT

 

[hoyden]

So, is the concensus that this arrangement is not probable? Anesthesiologist cannot staff the Ped ICU...so I couldn't even do that at a cancer institute?

Any recommendations for a person who loves ped onc but also the procedural/critical care aspect of anesthesiology?

Just do peds residency and peds critical care fellowship - then go to work in the peds ICU in the cancer center. You'll have tons of procedures and will be a part of the treatment team.

 

[Gern Blansten]

The combined Peds/Anesth followed by crit care may be a path to consider. The combined program allows you to sit for both the anesth and pedi boards and shaves one year off of the overall training requirements if you did both separately. It is brand new and I don't know who is offering it but I think Brigham might be. I think the goal is to have a "true" pediatric subspecialist who would go on to do a pedi anesth fellowship to be a more complete pedi subspecialist. It will be interesting to see how it plays out and if it is a popular track.
I don't know for sure that you would be eligible for the crit care fellowship through pedi following this experience, but I would suspect you would be.
Pedi oncology is pretty darn specific and you may have a hard time getting a job that specifically deals with this area in an amount that would be meaningful to you. If you became the pedi pain person, that is another route to consider. I know there are a few of those types out there.
Overall, you may be better off pursuing the pedi/crit care route to achieve your goals.

 

[Jeff05]

do peds fellowship after anesthesia and then work at a large cancer hospital.

 

[Pilot Doc]

As far as I understand, programs now can apply for peds anesthesia residency if you do 3yrs of peds, followed by 2yrs of anesthesia. However, ACGME just approved this last fall and it will take a while (at least a couple of years, I imagine) for this new pathway to be fully accessible for match consideration.

If you truly love PICU, then peds followed by ped ICU fellowship is the way to go. Not a lot of places will allow you (the anesthesia resident) to be in PICU.

I think it's 2 yrs peds + 3 anesthesia. But 5 years either way.

There really aren't many peds onc cases - you would have to be at a very, very specialized facility to focus on that.

As for PICU, if you want to do that and gas, the path is

peds residency
anesthesia residency
peds anes fellowship
PICU fellowship

The order and exact length is variable, but figure 8-9 years total. Not bad for a super-sub specialty, actually.

 

[MCYan]

Penn/CHOP have and Stanford have offered these kind of custom training programs in the past to carefully selected individuals. If you want to do peds icu, you will have to do a peds residency.
If you just want to subspecialize in "oncologic" pediatric anesthesia, any of the peds cancer centers or major peds hospitals could allow you to focus primarily on those types of cases.

I am pretty sure USC is offering a peds/anes combined program for 5 years as well.

 

[Bertelman]

What kind of job will this combined peds/anes candidate take? Half time gas and half-time wards? Or is it just a super-trained peds anesthesiologist?

 

[LIDO]

So, most people agree that the following options are my best bet:

1. Pediatric residency followed by Pedi ICU fellowship

2. Combined Pedi/Anesth followed by Pedi ICU fellowship

I must admit that option 2 sounds like the best bet, but how many of the programs do/will exist? Is Hopkins currently the only option with more programs opening in the near future? Are they extremely competitive?

Would I be able to work the OR and Pedi ICU? That would be a terrific combo in a cancer institute......is this all wishful thinking?

Thanks!

 

[IlDestriero]

.

 

[proman]

We have a ton of PICU anesthesia trained attendings. After a while, they mostly practice anesthesiology (maybe it's lifestyle or burnout, I don't know).

You can do the training any number of ways. Everyone has to do peds (3 years). Most then do anesthesiology (3 years), followed by PICU. That way ends up being 8 years because your CA3 year is spent in the PICU and as peds anesthesia fellow (for example, they don't take CA3 call). So you ultimately get: peds, peds anesthesia and PICU for only 2 more years than PICU would be otherwise. Plus your earning potential and lifestyle is much better. Hopkins and Penn/CHOP are some of the big names in the combined track. I've heard Boston Children's will do it, but you definitely want to go somewhere that's used to the combination so they dont' mess up the ABA paperwork. One last thing, it's a hard road. We've had several very smart, very hard working fellows drop the PICU part. 8 years of training is a long time.

 

[Gswami]

So, most people agree that the following options are my best bet:

1. Pediatric residency followed by Pedi ICU fellowship

2. Combined Pedi/Anesth followed by Pedi ICU fellowship

I must admit that option 2 sounds like the best bet, but how many of the programs do/will exist? Is Hopkins currently the only option with more programs opening in the near future? Are they extremely competitive?

Would I be able to work the OR and Pedi ICU? That would be a terrific combo in a cancer institute......is this all wishful thinking?

Thanks!

I think your best option is attempt to do a Peds/anesth combined residency and then apply for a PICU fellowship. There is a very good chance that you would be able to complete your Peds anesthesia fellowship during your PICU fellowship. Currently there are no peds anesthesia boards, but that is likely to change in the next few years. With those credentials, I doubt you would have too much difficulty finding a job doing peds anesthesia and PICU regardless of whether you were fully peds anesthesia fellowship trained.

Therefore your time would be 5years of combined peds/anes and 3 years of PICU/peds anesthesia combined fellowship. Now your question should be whether it's all worth it or not.