General academic pediatrician

[DPPM]

Is it necessary to do a fellowship to become a general academic pediatrician? Also, just out of curiosity, is there a big difference in the average salary between a general academic pediatrician and a pediatric specialist?

---

Members don't see this ad.

 

[notstudying]

Is it necessary to do a fellowship to become a general academic pediatrician? Also, just out of curiosity, is there a big difference in the average salary between a general academic pediatrician and a pediatric specialist?

I'm planning on doing general academic peds (I'm currently an R2). I already have an MPH and significant research experience, and I have been counseled that even so, it would be difficult for me to get a tenure track faculty position without a fellowship. You can do a 2 or 3 year fellowship; most places will have you get an MPH as part of the curriculum. While for most specialties fellowship is for learning more clinical skills, as well as research, in general academic peds you are really learning the research skills (and getting protected time), and function basically as an attending clinically.

The salary comparison depends on the specialty-from what I have seen they would be comparable to most non-procedural specialties, and quite a bit less that something like cards or NICU.

 

[DPPM]

Thanks for the reply. Forgive the question if it sounds ignorant, but if you have to do a fellowship anyway to get into academics, why not specialize? Even if it's roughly the same salary, it just makes more sense to me, rather than essentially spending all 5 or 6 years in residency/fellowship to be a general pediatrician. Then you would have the option of both general and the chosen subspecialty, no?

 

[jackjinju]

Actually, my impression for going into academic general peds is one can:

1) Just be a person who likes administration or research, with some background in it on your CV. in this case it helps to have gone to a fancier-sounding residency program.
2) Do a year of chief residency (this is a pretty common path from what I can tell)
3) Do one of those general pediatric academic fellowships. I don't think they're more than 1 or 2 years max.

Andrew

 

[notstudying]

Actually, my impression for going into academic general peds is one can:

1) Just be a person who likes administration or research, with some background in it on your CV. in this case it helps to have gone to a fancier-sounding residency program.
2) Do a year of chief residency (this is a pretty common path from what I can tell)
3) Do one of those general pediatric academic fellowships. I don't think they're more than 1 or 2 years max.

Andrew

I was hoping to take advantage of #1, and I could certainly get a position at my current institution without a fellowship, however my case is a bit unique. Most institutions with well respected general peds divisions are only interviewing fellowship trained applicants; I have been advised that if I want to go somewhere else eventually, I'll improve my chances greatly by doing a fellowship.

Chief residency is not usually a route to general academic peds, although many chief residents end up in fellowships after their time. There is very little time as a chief for research.

There are no 1 year general peds fellowships that I am aware of, although I'm sure there are 1 year research training programs. There are 2 year fellowships (which are rare in pediatrics, and in fact the ABP has recently rejected the idea of shortening the traditional 3 year fellowship rule. There are peds fellowships, such as adolescent medicine, that allow a 2 year fellowship for internal medicine or family practice trained physicians, but not pediatricians), and 3 year fellowships, with the 3 year fellowships geared towards those who want to do more research (2 year fellowships are geared more towards clinical faculty with some clinical research).

 

[notstudying]

Thanks for the reply. Forgive the question if it sounds ignorant, but if you have to do a fellowship anyway to get into academics, why not specialize? Even if it's roughly the same salary, it just makes more sense to me, rather than essentially spending all 5 or 6 years in residency/fellowship to be a general pediatrician. Then you would have the option of both general and the chosen subspecialty, no?

If the salary is the end goal, and most pediatric subspecialists are paid about what general pediatricians are, then why specialize at all? Or everone should do cards or NICU?

Honestly, I love the the broad scope of general peds, and at an academic practice we have many complicated kids, as well as healthy ones. I would get bored as a subspecialist. I like to know that when I see a child with a problem, I'm probably the first one to go through the differential. On top of that, I'm a weirdo who likes data, and writing papers and grants, and examining why people answer questions the way they do. And I get bored doing the same thing all the time. So, there's no reason for me to do a fellowship in something I'm not that interested in, and that will keep me on a resident schedule (like NICU) or close to it (renal), when I could do 1 month of attending on the general peds floors a year, instead.

What I love about medicine is that there is something for everyone.

NS

 

[jackjinju]

Interesting you say that, because in my residency program, I'd say >50% of the general peds attendings did a chief year in their life.....a lot of them tell me it's a road to academic medicine....though not necessarily a research career.

 

[pedsid]

so here's what I'm not clear on.

Some places everyone is a "chief" in their final year, right? Some places you stay for a 4th year to be a cheif ... what's the difference. What's the advantage of electing to be a resident for another year?

 

[jackjinju]

so here's what I'm not clear on.

Some places everyone is a "chief" in their final year, right? Some places you stay for a 4th year to be a cheif ... what's the difference. What's the advantage of electing to be a resident for another year?

Well in pediatrics, most places I know call the chief residents the people who stay a fourth year to do mostly administrative/scheduling, day-to-day residency organization. They're technically attendings, in the sense that they've completed residency, and take the ABP boards. At my program, they do 2-4 weeks of floor attending during their chief year, and also precept at clinic from time to time. Some people do this because they don't know what they wanna do yet. Some people because they want to stay on as an attending, or make themselves more marketable in fellowship application, or as an general peds academic attending. We also have a "Diagnostic Referral Service", which are basically the general peds guys who take on the very complex/hard to figure out cases, as well as the medical management of certain transplant patients. I think (literally) all 5 of these guys did a chief year at some point.

My dad, who is a surgeon, on the other hand, refers to this year (my PL3 year), as my chief year, because in his day, that's what your senior year was called. I think several fields call the third year your chief year still. Not sure why some do and some don't.

Hope it helps a bit.

Andrew

 

[notstudying]

Our chief year is basically as he described above-they also do a lot of teaching, but they don't do any floor attending time,and though I think they technically have a faculty appointment, they can't bill as an attending.

A chief year does open many doors-it helps in getting fellowships, and in getting hired later on. It also is the door to getting hired in the best general peds practices in our town. It used to be enough for getting a faculty position is general peds, but we haven't seen that here in awhile, and the market is becoming much more competitive. You could probably get hired as a clinical faculty with only a chief year, but to be in a true tenure-track research position for many places you need a fellowship.

Other specialties-especially those with more than 3 years of residency, like surgery, call the last year the chief year, and I think it's quite program dependent.

 

[DPPM]

If the salary is the end goal, and most pediatric subspecialists are paid about what general pediatricians are, then why specialize at all? Or everone should do cards or NICU?

Honestly, I love the the broad scope of general peds, and at an academic practice we have many complicated kids, as well as healthy ones. I would get bored as a subspecialist. I like to know that when I see a child with a problem, I'm probably the first one to go through the differential. On top of that, I'm a weirdo who likes data, and writing papers and grants, and examining why people answer questions the way they do. And I get bored doing the same thing all the time. So, there's no reason for me to do a fellowship in something I'm not that interested in, and that will keep me on a resident schedule (like NICU) or close to it (renal), when I could do 1 month of attending on the general peds floors a year, instead.

What I love about medicine is that there is something for everyone.

NS

I totally understand that. I guess I was thinking along the line of more options: if you have a specialty, you can practice as both a generalist and as an expert in a certain area (for example, my pcp is also a cardiologist). But as you said, you work a lot harder in the specialty fellowships, so if you know you only want to be a generalist and not a specialist then a specialty fellowship would be pointless.

One more question:

Are other fields of medicine like this in that they require a fellowship to become an academic faculty member? For example, does a neurologist need to do a fellowship after residency, or can he/she easily join academic faculty right after residency?

 

[jackjinju]

I agree with notstudying that a chief year isn't really setting you up to be a tenure-track researcher...but for clinical faculty it's probably good.