High unfilled numbers this year in pediatrics

[SurfingDoctor]

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I'm gonna bump this thread because looking at some of the match lists, it's gonna be another hilariously brutal year.

Also, and interesting (albeit not surprising) article...

Pediatrics Specialty Choice Among Matriculants of MD-Granting US Medical Schools - PMC

What is the prevalence of, and variables associated with, pediatrics specialty choice at graduation among US MD-granting school matriculants? In this cohort study of 7 US MD-granting school matriculant cohorts, 10% of matriculants chose pediatrics ...

pmc.ncbi.nlm.nih.gov

Finally, our observation that the odds of pediatrics specialty choice at graduation were lower for GQ respondents whose career plans included research suggests that students interested in research may not see pediatrics as a good “fit”; the physician-scientist workforce pipeline in pediatrics has been a concern nationally.

Certainly, the lack of scientific rigor and research acumen of pediatricians leaves A LOT to be desired (especially when you read the hot garbage that is published in the journal "Pediatrics"), but I guess we are specifically attracting that pool. Bummer.

 

[HemeOncHopeful19]

Surely ABP will respond by dropping the board pass rates another 10%

 

[SurfingDoctor]

Surely ABP will respond by dropping the board pass rates another 10%

Well, I think the US healthcare system is essentially driving all these metrics. There's a lack of interest, coupled with relatively (though still high-earning) lower pay and a shift in the demographics of who pursues pediatrics.

I don't know how one can correct for the fact that children are generally healthy, thus their healthcare needs and by proxy, insurance reimbursement is low. And of course, given that 1/2 of kids are on Medicaid, but kids don't pay taxes and can't vote, there's no interest in improving government payments. And even if there was loan forgiveness (which is a hot button topic) for people pursuing pediatrics, I don't think that would significantly change the number entering the field.

Maybe there is a solution, but I don't think it exists without feeding more money into the system, and too many people in this country aren't altruistic enough to ever support something like that. I mean, there's a good reason that non-cognitive, operative specialities continue to do well, because that's what the US healthcare system picked as its winner.

Aw well.

 

[Oso]

Until pediatric salaries go up and are comparable to the rest of medicine, this will just continue to get worse

We had a sub-I this past week deciding between anesthesia and peds… I encouraged her to consider anesthesia -> peds anesthesia

 

[SurfingDoctor]

Until pediatric salaries go up and are comparable to the rest of medicine, this will just continue to get worse

We had a sub-I this past week deciding between anesthesia and peds… I encouraged her to consider anesthesia -> peds anesthesia

At some point, there will probably be a market correction with not enough jobs in operative fields and not enough personnel in cognitive fields. When that will actually happen? Who knows, but the system will have to correct for the fact that it preferentially rewards some fields over others.

I also still think, beyond salary though, pediatrics has an optics problem.

 

[Splenda88]

At some point, there will probably be a market correction with not enough jobs in operative fields and not enough personnel in cognitive fields. When that will actually happen? Who knows, but the system will have to correct for the fact that it preferentially rewards some fields over others.

I also still think, beyond salary though, pediatrics has an optics problem.

Can you elaborate on that?

I remember during my residency graduation as a internist, there were a couple of pediatric residents who were gonna do a 2-yr pediatric hospitalist fellowship. I thought that was a crazy concept. Why would such fellowship exist? This is insanity.

I already got job lined up while these people gonna do a 2-yr fellowship learning the same thing over again to make a little over half of what I was going to make.

 

[SurfingDoctor]

Can you elaborate on that?

I remember during my residency graduation as a internist, there were a couple of pediatric residents who were gonna do a 2-yr pediatric hospitalist fellowship. I thought that was a crazy concept. Why would such fellowship exist? This is insanity.

I already got job lined up while these people gonna do a 2-yr fellowship learning the same thing over again to make a little half of what I was going to make.

I think it suffers from the same problem as family medicine. Both are perceived (I think) as low acuity, low diversity of path (and by proxy, low intellectualism) specialities. I’m not saying that’s what they are, just as that is how they are perceived.

And, kids, by design are pretty resilient. This resilience is so that they can live long enough to replicate and have children by age 20. I’m not saying that’s when people have children, just evolutionarily, that was the design. And again, from an evolutionary standpoint, once you’ve replicated, your child bearing value goes to zero and you are just a resource consumer. So adults have illnesses to trim the herd. Of course, modern medicine has created temporary solutions for most of these problems, so adult doctors get to see and do more stuff, that don’t exist in children. I think this is why research and scholarship are low in pediatrics. There are less things to study and because there are less things to study, it attracts a less inquisitive crowd.

The pay issue just compounds this. I think pediatrics is more of a calling than any other speciality, but that doesn’t translate to anything because people want 1) higher pay and/or 2) more pathology. I generally think most people who become doctors aren’t altruistic, or at least, that doesn’t motivate them. So that’s why I’m not sure even throwing money at the problem, even if it did ever happen, would entirely fix the issue.

 

[HemeOncHopeful19]

I think it suffers from the same problem as family medicine. Both are perceived (I think) as low acuity, low diversity of path (and by proxy, low intellectualism) specialities. I’m not saying that’s what they are, just as that is how they are perceived.

And, kids, by design are pretty resilient. This resilience is so that they can live long enough to replicate and have children by age 20. I’m not saying that’s when people have children, just evolutionarily, that was the design. And again, from an evolutionary standpoint, once you’ve replicated, your child bearing value goes to zero and you are just a resource consumer. So adults have illnesses to trim the herd. Of course, modern medicine has created temporary solutions for most of these problems, so adult doctors get to see and do more stuff, that don’t exist in children. I think this is why research and scholarship are low in pediatrics. There are less things to study and because there are less things to study, it attracts a less inquisitive crowd.

The pay issue just compounds this. I think pediatrics is more of a calling than any other speciality, but that doesn’t translate to anything because people want 1) higher pay and/or 2) more pathology. I generally think most people who become doctors aren’t altruistic, or at least, that doesn’t motivate them. So that’s why I’m not sure even throwing money at the problem, even if it did ever happen, would entirely fix the issue.

It’s the money, always has been and always will be.

I’ve always heard that in Europe where everyone gets paid like crap, Peds is one of the more competitive specialties

 

[Splenda88]

I think it suffers from the same problem as family medicine. Both are perceived (I think) as low acuity, low diversity of path (and by proxy, low intellectualism) specialities. I’m not saying that’s what they are, just as that is how they are perceived.

And, kids, by design are pretty resilient. This resilience is so that they can live long enough to replicate and have children by age 20. I’m not saying that’s when people have children, just evolutionarily, that was the design. And again, from an evolutionary standpoint, once you’ve replicated, your child bearing value goes to zero and you are just a resource consumer. So adults have illnesses to trim the herd. Of course, modern medicine has created temporary solutions for most of these problems, so adult doctors get to see and do more stuff, that don’t exist in children. I think this is why research and scholarship are low in pediatrics. There are less things to study and because there are less things to study, it attracts a less inquisitive crowd.

The pay issue just compounds this. I think pediatrics is more of a calling than any other speciality, but that doesn’t translate to anything because people want 1) higher pay and/or 2) more pathology. I generally think most people who become doctors aren’t altruistic, or at least, that doesn’t motivate them. So that’s why I’m not sure even throwing money at the problem, even if it did ever happen, would entirely fix the issue.

How people in peds leadership have justified that 2-yr peds hospitalist fellowship? in which you will be learning the same thing over again.

There was talk about hospital medicine fellowship for IM when I was in med school and it was shut down immediately by IM physicians

Even in FB (physician page) people get chastised and mocked when they post they are looking for physicians who want to do hospital medicine fellowship.

 

[SurfingDoctor]

How people in peds leadership have justified that 2-yr peds hospitalist fellowship? in which you will be learning the same thing over again.

There was talk about hospital medicine fellowship for IM when I was in med school and it was shut down immediately by IM physicians

Even in FB (physician page) people get chastised and mocked when they post they are looking for physicians who want to do hospital medicine fellowship.

You’re asking the wrong person. I’m not in that space.

However, been in academic medicine for nearly 20 years… I’ll tell you, often leadership (not just pediatrics, but general) create programs and pathways not because there is an actual need, but because people in leadership think there is a need AND often need a reason to justify their own existence. So, that’s my guess.

 

[SurfingDoctor]

It’s the money, always has been and always will be.

I’ve always heard that in Europe where everyone gets paid like crap, Peds is one of the more competitive specialties

Yes, the most physicians are not altruistic

 

[Swack]

It’s the money, always has been and always will be.

I’ve always heard that in Europe where everyone gets paid like crap, Peds is one of the more competitive specialties

Absolutely. Money and lifestyle. This is why Psych has gotten more popular. Peds is still underpaid and notoriously overworked. It is just very unpopular right now.

 

[Oso]

I think it suffers from the same problem as family medicine. Both are perceived (I think) as low acuity, low diversity of path (and by proxy, low intellectualism) specialities. I’m not saying that’s what they are, just as that is how they are perceived.

And, kids, by design are pretty resilient. This resilience is so that they can live long enough to replicate and have children by age 20. I’m not saying that’s when people have children, just evolutionarily, that was the design. And again, from an evolutionary standpoint, once you’ve replicated, your child bearing value goes to zero and you are just a resource consumer. So adults have illnesses to trim the herd. Of course, modern medicine has created temporary solutions for most of these problems, so adult doctors get to see and do more stuff, that don’t exist in children. I think this is why research and scholarship are low in pediatrics. There are less things to study and because there are less things to study, it attracts a less inquisitive crowd.

The pay issue just compounds this. I think pediatrics is more of a calling than any other speciality, but that doesn’t translate to anything because people want 1) higher pay and/or 2) more pathology. I generally think most people who become doctors aren’t altruistic, or at least, that doesn’t motivate them. So that’s why I’m not sure even throwing money at the problem, even if it did ever happen, would entirely fix the issue.

I agree with the optics thing and pediatrics being viewed as a single specialty.

There is an insane amount of diversity in acuity, work setting, pathology, etc between and even within the different pediatric subspecialties

For example, I hate how big websites like Medscape or White Coat Investor lump all of pediatrics into ‘Pediatrics’, meanwhile each IM specialty is listed separately.

Although, or course, at the end of the day all pedsfields get paid like **** compared to their adult counterparts and that also is leading to fewer students choosing to apply to pediatric residency