luckysharm411
New Member
- Joined
- Feb 7, 2025
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Hello,
Hoping to elicit some feedback about how best to go about my current situation and how to consider opportunities. I am a recent graduate of PICU fellowship. As has already been stated multiple times in this forum, PICU job market is terrible. My co-fellow graduated without a job and later took a position at a 4 bed unit because geography was paramount to her. I was not in the same situation, and took a position at a community PICU in the midwest (an unfamiliar region to me), that does have a pediatric residency and academic affiliation, but certainly not a quarternary care center. We do have a transport team, able to perform CRRT (though I have never done it), and very large top 10 childrens hospitals in our backyard where many of our patients are plugged in with specialists.
Although I genuinely love the people here, I have a few concerns. 1) There is low acuity here. Even with the lack of ability to care for some very sick kids, I was initially told the unit is usually filled with intubated patients, high procedures, etc. Not sure if it is this season or what, but I've rarely had a full unit, have closed the unit multiple times, and personally feel that I am not using my skills to the best of the ability to grow as a new attending. Perhaps I underestimated my abilities coming out of fellowship, was too tired, or needed to prove to myself I could do it. But I am finding I genuinely love critical care now that I am not a downtrodden fellow and I want to do good clinical work, take care of patients, and be challenged. Not just ship everyone out after stabilizing and take care of asthmatics. 2) I really don't enjoy where I am geographically. I prioritized the type of job/unit over geography and I'm realizing maybe I overshot. This community is very small and close knit and outside of work I am struggling to occupy my time. So I have taken on hobbies and am pursuing education related activities such as becoming the site PI for NEAR4KIDS and PEDIRESQ, giving Grand Rounds, joining Admissions Committees, but even with that there is a lot of downtime. 3) I took this position as a plan for staying 1-3 years while growing my skills and looking for other opportunities, but the more I keep an eye out, the fewer jobs there are for general PICU and am seeing how genuinely impossible it is to find a job in a location I would prefer to be in given the competition.
On a low day I emailed an old mentor about a CICU position at a top children's hospital in the northeast. They have a spot, they interviewed me for it. The job market for CICU seems to be much better in the moment and doing this one year would be challenging, but potentially open up doors and provide a network who could vouch for me when the time comes. I am seriously considering it. We can manage it financially, the location is ideal, and know that in a year we may have to move again. CICU was not my first love, but things do change and if it provides me with more education and a chance to get a job in a type of center that I can thrive in and in a location my family enjoys, I feel it is worth it. I do feel badly about leaving the current position, again because people are wonderful. But I am concerned about staying here longer and getting farther out and then not being able to move or not being able to maintain my skills enough to make a switch to a larger place.
Do any of you more senior folks have advice on this? Should I stick out the current situation as long as I can, knowing that my personal life will take a hit? An alternative to CICU would be trying to enroll in a masters program at the current institution in medical education and trying to obtain that degree while working to use it as a bargaining chip, although I have brought that goal up in interviews and it doesn't seem to draw any attention.
I know in the end this is a personal decision, however it is very confusing coming out of training to understand what is the better option. I feel fortunate to have a job and am working at making the best of a situation here. But isn't life outside of medicine important too?
Thank you for your thoughts.
Hoping to elicit some feedback about how best to go about my current situation and how to consider opportunities. I am a recent graduate of PICU fellowship. As has already been stated multiple times in this forum, PICU job market is terrible. My co-fellow graduated without a job and later took a position at a 4 bed unit because geography was paramount to her. I was not in the same situation, and took a position at a community PICU in the midwest (an unfamiliar region to me), that does have a pediatric residency and academic affiliation, but certainly not a quarternary care center. We do have a transport team, able to perform CRRT (though I have never done it), and very large top 10 childrens hospitals in our backyard where many of our patients are plugged in with specialists.
Although I genuinely love the people here, I have a few concerns. 1) There is low acuity here. Even with the lack of ability to care for some very sick kids, I was initially told the unit is usually filled with intubated patients, high procedures, etc. Not sure if it is this season or what, but I've rarely had a full unit, have closed the unit multiple times, and personally feel that I am not using my skills to the best of the ability to grow as a new attending. Perhaps I underestimated my abilities coming out of fellowship, was too tired, or needed to prove to myself I could do it. But I am finding I genuinely love critical care now that I am not a downtrodden fellow and I want to do good clinical work, take care of patients, and be challenged. Not just ship everyone out after stabilizing and take care of asthmatics. 2) I really don't enjoy where I am geographically. I prioritized the type of job/unit over geography and I'm realizing maybe I overshot. This community is very small and close knit and outside of work I am struggling to occupy my time. So I have taken on hobbies and am pursuing education related activities such as becoming the site PI for NEAR4KIDS and PEDIRESQ, giving Grand Rounds, joining Admissions Committees, but even with that there is a lot of downtime. 3) I took this position as a plan for staying 1-3 years while growing my skills and looking for other opportunities, but the more I keep an eye out, the fewer jobs there are for general PICU and am seeing how genuinely impossible it is to find a job in a location I would prefer to be in given the competition.
On a low day I emailed an old mentor about a CICU position at a top children's hospital in the northeast. They have a spot, they interviewed me for it. The job market for CICU seems to be much better in the moment and doing this one year would be challenging, but potentially open up doors and provide a network who could vouch for me when the time comes. I am seriously considering it. We can manage it financially, the location is ideal, and know that in a year we may have to move again. CICU was not my first love, but things do change and if it provides me with more education and a chance to get a job in a type of center that I can thrive in and in a location my family enjoys, I feel it is worth it. I do feel badly about leaving the current position, again because people are wonderful. But I am concerned about staying here longer and getting farther out and then not being able to move or not being able to maintain my skills enough to make a switch to a larger place.
Do any of you more senior folks have advice on this? Should I stick out the current situation as long as I can, knowing that my personal life will take a hit? An alternative to CICU would be trying to enroll in a masters program at the current institution in medical education and trying to obtain that degree while working to use it as a bargaining chip, although I have brought that goal up in interviews and it doesn't seem to draw any attention.
I know in the end this is a personal decision, however it is very confusing coming out of training to understand what is the better option. I feel fortunate to have a job and am working at making the best of a situation here. But isn't life outside of medicine important too?
Thank you for your thoughts.
