Made mistake and chose wrong specialty?

[dudedoc]

I'm currently in a Pediatric Residency, and just started my peds EM rotation. I didn't really think i would enjoy the work environment and atmosphere this much. I was always EM in medical school, however when was doing my medical clerkships, had some reservations and just felt peds was a safer long term bet ( also at the time, I was going through personal challenge which might have also contributed to me wanting a less intense Residency/ lifestyle).

However since starting peds , I have not felt much enthusiastic about it, more just the feeling of needing to get by. My program also at some point decided I wasn't doing well enough and put me through academic discipline/ struggles ( remediation etc). As a side point I didn't agree with this and felt i was working hard and doing as well as any resident should be in a training program, but seems also the program im in is a more intense environment which makes me also appreciate EM more. I feel much more at ease, comfortable and the feeling of being able be myself without being judged or having to constantly worry.

Now I'm just thinking out loud and wondering what my options are. I can consider peds em ( which seems easier/ less stressful life style than adults) , but i know peds em fellowship is really competitive and would also be missing out on the adult aspect.

On the other hand applying into em at this point would mean would lose the first 2 yrs of peds (earliest would start next yr) which at this point would only be be an extra year to finish it unless I'm given credit...also would be likely my PD would disclose the Residency performance issues/ struggles to other programs.

I was just slso wondering if this is just a short term gratification? Where eventually I'll get burn out, which was my worry at the first place and hesitancy of applying EM.

Thank you for listening and any advice is appreciated!

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[BorntobeDO?]

I would try to finish this residency and maybe apply peds em fellowship. If you only have a year left, just make it work so you can be boarded. Then you have much better options with regard to going back for an EM residency or just practicing on your own etc. No matter what I would make sure to get letters from the current EM attending who like you for future EM prospects if you think your going that route via fellowship or reapplying to adult.

 

[dudedoc]

I would try to finish this residency and maybe apply peds em fellowship. If you only have a year left, just make it work so you can be boarded. Then you have much better options with regard to going back for an EM residency or just practicing on your own etc. No matter what I would make sure to get letters from the current EM attending who like you for future EM prospects if you think your going that route via fellowship or reapplying to adult.

thanks, i calculated that based on it being only a year left from earliest when would technically start, ( year from now, which would be 2 yrs in)

 

[rokshana]

If you want EM, you are better off trying to work harder at your current program and do EM fellowship...

But the bigger issues really is your perception...your program didn’t decide you weren’t doing well enough... you weren’t doing what was needed...blaming others is not going to get you anywhere...and without a good letter from your PD and taking ownership of your problems, no adult EM program is going to really consider you...and EM is more competitive than gen peds.

 

[Moose A Moose]

Even if your performance is on par with your peers it seems your lack of enthusiasm has the higher ups forming their own subconscious- or conscious- bias. Internal medicine and pediatric residents are notorious geeks that will oust your if they sense your obsession is not what they deem appropriate.

I would weather the storm and hammer through and then shoot for pediatric emergency medicine, or even redo and apply straight emergency medicine.

 

[ThoracicGuy]

I'm currently in a Pediatric Residency, and just started my peds EM rotation. I didn't really think i would enjoy the work environment and atmosphere this much. I was always EM in medical school, however when was doing my medical clerkships, had some reservations and just felt peds was a safer long term bet ( also at the time, I was going through personal challenge which might have also contributed to me wanting a less intense Residency/ lifestyle).

However since starting peds , I have not felt much enthusiastic about it, more just the feeling of needing to get by. My program also at some point decided I wasn't doing well enough and put me through academic discipline/ struggles ( remediation etc). As a side point I didn't agree with this and felt i was working hard and doing as well as any resident should be in a training program, but seems also the program im in is a more intense environment which makes me also appreciate EM more. I feel much more at ease, comfortable and the feeling of being able be myself without being judged or having to constantly worry.

Now I'm just thinking out loud and wondering what my options are. I can consider peds em ( which seems easier/ less stressful life style than adults) , but i know peds em fellowship is really competitive and would also be missing out on the adult aspect.

On the other hand applying into em at this point would mean would lose the first 2 yrs of peds (earliest would start next yr) which at this point would only be be an extra year to finish it unless I'm given credit...also would be likely my PD would disclose the Residency performance issues/ struggles to other programs.

I was just slso wondering if this is just a short term gratification? Where eventually I'll get burn out, which was my worry at the first place and hesitancy of applying EM.

Thank you for listening and any advice is appreciated!

Much like others have said, with your likely letters you would be getting based on what you have said here, your chances of matching into an EM program are low. Your chances of Peds EM is also not good with your current attitudes and performance. You need to step it up and make yourself the resident that all the attendings want on their service. You need to change their entire perception of you, which is going to be very hard to do.

Good luck.

 

[FrkyBgStok]

I agree with rokshana. what would you be saying if you were in an EM program and struggling? and if you think that wouldn't be the case, why do you think that?

as someone who is in peds EM, it is very different than adult EM regardless of what people on the outside think. and there is nothing that gives me more displeasure than working with adults. I don't care if EM paid twice peds EM and I had a guaranteed spot, there is no way I would ever go back for that.

I think you need to look introspectively and really consider what the problem is and how you can get through residency with the best possible outcome. if everyone says you are struggling, it doesn't really matter if you disagree.

 

[Dave1980]

My program also at some point decided I wasn't doing well enough and put me through academic discipline/ struggles ( remediation etc). As a side point I didn't agree with this.

funny and concerning!l

 

[dudedoc]

I agree with rokshana. what would you be saying if you were in an EM program and struggling? and if you think that wouldn't be the case, why do you think that?

as someone who is in peds EM, it is very different than adult EM regardless of what people on the outside think. and there is nothing that gives me more displeasure than working with adults. I don't care if EM paid twice peds EM and I had a guaranteed spot, there is no way I would ever go back for that.

I think you need to look introspectively and really consider what the problem is and how you can get through residency with the best possible outcome. if everyone says you are struggling, it doesn't really matter if you disagree.

I enjoy adults as well, kinda miss the trauma codes, the adrenaline. Feel would do better if I'm more passionate about it.

It's not everyone my preceptor feels I'm doing fine, other residents seniors etc do too. But obviously med school to residency is a transition, and a learning curve. I just think some programs differ, can be more harsh on the residents etc without going into specifics..

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[chocomorsel]

I enjoy adults as well, kinda miss the trauma codes, the adrenaline. Feel would do better if I'm more passionate about it.

It's not everyone my preceptor feels I'm doing fine, other residents seniors etc do too. But obviously med school to residency is a transition, and a learning curve. I just think some programs differ, can be more harsh on the residents etc without going into specifics..

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What wert the reasons behind the remediation if you don’t mind my asking?
I am asking because I also was put on probation in residency and didn’t agree at all with how I was treated because it was all labeled “professionalism” which is such a gray area.

 

[chocomorsel]

If you want EM, you are better off trying to work harder at your current program and do EM fellowship...

But the bigger issues really is your perception...your program didn’t decide you weren’t doing well enough... you weren’t doing what was needed...blaming others is not going to get you anywhere...and without a good letter from your PD and taking ownership of your problems, no adult EM program is going to really consider you...and EM is more competitive than gen peds.

Sometimes, just sometimes, there are other issues that come into play that make programs decide that residents aren't doing well enough. Unfortunately on SDN, you are guilty until proven innocent.
We don't know the details, so how about we try to be open minded. I don't suppose you know anyone who's ever been treated unfairly by a program do you? I know plenty. One who got fired less than a year after reporting a case of sexual assault. And the person she accused went on to graduate and do a fellowship while she got railroaded.
Medicine is not immune to bad bosses, just like the real world. The difference though is in medicine, they have so much more power to ruin your life, and you are literally at their mercy.

 

[Dave1980]

Sometimes, just sometimes, there are other issues that come into play that make programs decide that residents aren't doing well enough. Unfortunately on SDN, you are guilty until proven innocent.
We don't know the details, so how about we try to be open minded. I don't suppose you know anyone who's ever been treated unfairly by a program do you? I know plenty. One who got fired less than a year after reporting a case of sexual assault. And the person she accused went on to graduate and do a fellowship while she got railroaded.
Medicine is not immune to bad bosses, just like the real world. The difference though is in medicine, they have so much more power to ruin your life, and you are literally at their mercy.

Sure...but almost 100% of the time if someone is on probation or getting terminated it's for a good reason. It is a huge hassle to put residents on probation and terminate them. They don't do it for fun.

 

[chocomorsel]

Sure...but almost 100% of the time if someone is on probation or getting terminated it's for a good reason. It is a huge hassle to put residents on probation and terminate them. They don't do it for fun.

Have you done the research? Where are you getting your numbers from?

 

[BoardingDoc]

Lord knows I've derailed my share of threads, but can we keep this one on topic? The last thing any of us need is another thread about residents getting fired. It invariably devolves into a list of cases that either have no available data or: "This guy was a saint! They fired him for no good reason!" ... "What about the whole snorting lines while in the OR thing?" ... "He went to rehab for that, that should have no bearing on this!"

Actually, now that I've written that... that does sound kind of entertaining. That said, for the sake of the OP, I reluctantly stand by my original comment.