Is Peds for Me?

[physicsnerd42]

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I apologize if this isn't the right place for this (mods, please feel free to delete if not).

I'm an MD/PhD student who finished a PhD in engineering in June. I've now come back to 3rd year of med school and I've completed medicine, peds and I'm almost done with surgery and I'm trying to figure out what to do with my life. So far I've liked parts of everything. I loved the people I worked with on medicine and the problem solving. I absolutely loved inpatient peds (working with pediatricians, taking care of sick kids, interesting illnesses and physiology) and thought outpatient peds was fine (loved my preceptors but thought that well child checks weren't my thing). I spent half my surgery rotation on trauma and really enjoyed taking care of ICU patients. The second half of my surgery rotation was spent on ENT and I had amazing residents and attendings and really enjoyed participating in the cases, sewing, being in the OR.

Basically, I much prefer kids to adults as patients. I prefer working with sick patients over healthy patients. I also think I would regret it if I didn't end up in a specialty without some procedural component. I don't know that I need to be removing acoustic neuromas or performing laryngectomies with neck dissections to be happy, but my ideal job would involve taking care of relatively sick patients and doing some procedures. Is there a place for a guy like me in peds? Perhaps in the NICU, PICU, cards? I'd appreciate any advice.

 

[oldbearprofessor]

I apologize if this isn't the right place for this (mods, please feel free to delete if not).

I'm an MD/PhD student who finished a PhD in engineering in June. I've now come back to 3rd year of med school and I've completed medicine, peds and I'm almost done with surgery and I'm trying to figure out what to do with my life. So far I've liked parts of everything. I loved the people I worked with on medicine and the problem solving. I absolutely loved inpatient peds (working with pediatricians, taking care of sick kids, interesting illnesses and physiology) and thought outpatient peds was fine (loved my preceptors but thought that well child checks weren't my thing). I spent half my surgery rotation on trauma and really enjoyed taking care of ICU patients. The second half of my surgery rotation was spent on ENT and I had amazing residents and attendings and really enjoyed participating in the cases, sewing, being in the OR.

Basically, I much prefer kids to adults as patients. I prefer working with sick patients over healthy patients. I also think I would regret it if I didn't end up in a specialty without some procedural component. I don't know that I need to be removing acoustic neuromas or performing laryngectomies with neck dissections to be happy, but my ideal job would involve taking care of relatively sick patients and doing some procedures. Is there a place for a guy like me in peds? Perhaps in the NICU, PICU, cards? I'd appreciate any advice.

Do an elective or sub-I type rotation, even if just for 2 weeks in a NICU or PICU or pedi CVICU and you'll have a better idea.

Welcome to pediatrics. Lots and lots of folks like you are here. There are plenty of procedures in NICU/PICU and CVICU, although, we're not surgeons and we do rounds, etc.

An alternative is something like pedi anesthesia, ENT, etc. The disadvantage is that you have to do "adult" residencies, and of course, you have to fundamentally prefer those fields.

 

[Slade]

Peds ED is the answer for you my friend 🙂

 

[umass rower]

Peds can be for almost anyone who wants to be in it, as far as I'm concerned. Based on your description, I would agree that looking at NICU, PICU, Peds ER would probably be good places to start, depending on how sick you want your kids and how involved the procedures. To broaden your options, you could also look into doing Peds surgery (they tend to be true "general" surgeons, and can have a very cool variety of cases). Just keep in mind that Peds surgery is an incredibly competitive field, and you will spend a looong time with adults to get there.

If your patients don't need to be universally that sick, you might also want to give some thought to some of the more procedure-oriented specialties, such as GI or Cards (if you can do it somewhere that they do caths or cardiac surgery). Cards people can do caths, echoes, and may be involved in pacers or congenital heart disease repairs. GI has endoscopies and associated procedures, liver biopsies, PEG placements, and sometimes join in surgeries. I'm a GI fellow now, and we spend nearly half our first year of fellowship doing nothing but procedures. But, keep in mind, with these specialties you will see relatively healthy kids in clinic too. I was with you, where I got bored fast with well visits, but by definition every clinic visit I see is problem-oriented and complex enough that a PCP doesn't feel comfortable managing it.

 

[Cookie Queen]

I had a similar group of interests and I'm interviewing for peds residency now! I've met a lot of people like us on the interview trail as applicants, residents, and attendings. Many of them end up in NICU, PICU, cards, or peds ED. I did a PICU sub-I and loved loved loved it! While I haven't seen a lot of cards yet, my limited experience is that outpatient cards may not be quite as exciting, but cardiac ICUs and interventional cards may be more my style. Some programs have an integrated PICU that includes cardiac kids, some programs don't do much cards in general, and some have a separate cardiac ICU which sounds very interesting.

So I'd agree with others, try to either do rotations in one of these fields to get a better feel if it's something you'd like to do. Good luck!!

 

[physicsnerd42]

Thank you all for the replies!

 

[generic]

Another plug for pediatrics--I'm now a very happy general pediatrician but I have had some of the same concerns you have along the way. For me, it was urology that was my favorite surgical subspecialty but I definitely wanted to do a pediatric version of everything I tried (but 6yrs of Uro then separate 1+ yrs pedi fellowship = ugh!).

I enjoyed GI and would say that although the reputation of pedi GI would suggest few procedures and less sick patients, there are certainly places with very sick Liver transplant or biliary/endoscopic bents that would suit a more intense/procedure-oriented type well.

As mentioned, Cardiology has lots of variety (EP, interventional...) as well and Peds EM is another thought, although I feel like the ER patients (even at TCH) don't tend to be as sick as the patients of a critical care doc, for example.

I also liked pedi anesthesiology and those guys seem like generally happy and self-fulfilled doctors. You can get patients as healthy as ear tubes and MRI sedations or if you're so inclined, you can put 'em under for 18-hour congenital heart surgery operations...

I think for myself I felt drawn to the people of pediatrics and that is what suggested to me that I wasn't a surgeon at heart--i.e. not the type to do an adult surgical residency first, then a short pedi fellowship. That just felt wrong somehow