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Making the switch to Peds

Discussion in 'Pediatrics' started by pedhopeful, Apr 12, 2018.

  1. pedhopeful

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    Hello All, I have a question that I see has been posted a few times before but not in the past 3-4 years it seems.

    Can I make the switch from a non-Peds residency to Peds?

    About me:
    Currently in a rising PGY-2 in a 5 year EM/IM program- Had aspirations to do EM shifts and hospitalist weeks but now find myself completely turned off by this career path. I was between current residency and Peds in medical school but obviously went the route I did.

    I am in good standing with my current program and have already spoken with my PD about the possibility of re-entering the match for Peds and would have their support.

    I am scared though that I 1. won't match or 2. won't be competitive for very many programs.
    Does anyone have insight on how much re-matching hurts your application? Would I be turned down by all major university sites and big name peds programs? I would likely want to do PICU or Cardiology if possible.

    Some other things to consider: big step1/2 discrepancy low 210s=step 1 and mid 270s=step 2
    I honored most of third year but high passed peds but the comments are glowing for my eval.
    I didn't do a peds sub-i but did do 2 other core rotations exclusively at a peds hospital. I have tons of extracurriculars during medical school revolving around kids: tutoring, clinic volunteer, etc.

    Give it to me straight, do I have any hope? I am just so happy when working with kids and my peds em shifts are the only shifts I find myself enjoying. I feel like the ship has sailed on me being able to match peds but if I have any shot I want to take it.
     
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  3. Oso

    Oso

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    I'll let others comment on the feasibility of switching residencies (as I know nothing about this). But if you're ok with EM, you could always do a peds EM fellowship after finishing residency and work in a dedicated peds ED -> work exclusively with kids.
     
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  4. pedhopeful

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    Thank you for the reply. I have considered this and it appealing in that I would get to work with kids but I think I'd rather have a longitudinal relationship with my patients. The lack of this is one of my biggest regrets with doing EM.
     
  5. physicsnerd42

    physicsnerd42 Member

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    We have a Peds intern who was a gen surg intern last year at another institution. A gen surg intern from my institution also matched to Peds elsewhere last year. If you really want to switch, apply broadly. Also talk to the Peds PD at your institution to see their thoughts.


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  6. pedhopeful

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    I would definitely be applying broadly. Did these residents have much say in where they ended up?
     
  7. GonnaBeADoc2222

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    You should really think long and hard about the lifestyle and financial implications of this. You are PGY2 now - if you apply for this upcoming cycle, you will still complete your EM/IM PGY3 year before switching to Peds. Then it's 3 years of peds residency followed by 3 years of fellowship.

    I can see how Peds Cardiology would satisfy your desire for continuity, but PICU isn't about continuity. It's about stabilizing and getting them to the floor. Very procedurally heavy. Your "continuity patients" are typically "rocks."

    Not only would you be throwing away the three years you already spent on EM/IM, but you would essentially be committing financial suicide by making this switch. You will also work waaaaayy more hours in any peds field than in EM. The hourly compensation in EM is higher than most other specialties.

    You say you like your PEM shifts. Why not try to do PEM? Don't believe the lies that you have to do a fellowship either. I have a colleague who is EM boarded who works almost exclusively in an (academic center) peds ED.

    Residency sucks. Stick with it, you'll be an attending soon enough and it gets soooo much better.
     
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  8. SurfingDoctor

    SurfingDoctor "Hooray, I'm useful"
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    Seen it happen, though not commonly. And nothing you said hurts your chances. You matched to EM/IM, there's no reason for you not to Match to Pediatrics. Obviously, you will get asked about why you initially chose the residency you did and why you are now trying to switch, so just be prepared answer it truthfully. But overall, I don't think it would be a problem.

    Also as mentioned above, there are EM people who later go to do PEM. Typically do you have to do a fellowship to work at an academic center, though I bet there are position at private children's hospital that don't care if you are Pediatric trained or not. You have to being willing to find a fellowship program that either supports or is willing to take EM people, but it isn't that uncommon from what I recall. Given that you'd have 2 years left of your current residency and pediatric residency is 3 years, your time commitment would be about the same either way.
     
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  9. mvenus929

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    Can you make the switch? Yes. But you'll have to start over--there's next to nothing you can get to count as 'credit' from an EM/IM program. Your best chances will be at your home institution.

    You don't have to go to a big name program to get into a PICU or cardiology fellowship, though it makes it easier because you have access to the subspecialty and research opportunities. If you've already spoken with your PD, go talk to the PD at your peds program and discuss how they would look at your application.
     
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  10. pedhopeful

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    Thank you for your reply. To clarify I am coming in to my second year this June when the new interns start.
    Your point about the pay difference is well understood and I appreciate you raising the issue. I know that my compensation would be much more appealing in EM but I am just questioning every reason I had for going in to EM and finding that it was a big mistake. I loved the EM rotations but that was because I was shielded from the unpleasantness of it all and just directed to do procedures and fun stuff.
    Being around pediatric patients just makes me feel extremely happy and I think that if I could pull ~200k that I would live a great and happy life.
     
  11. pedhopeful

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    I think my next step is definitely to talk to the Peds PD. A lateral transfer would be very appealing. Thank you for your input, I really appreciate it.

    I am still trying to work up the courage so if anyone has other input I would love to hear it!
     
  12. Marie0123

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    For the PD at my program, Peds is her second residency/career. She was in EM and was an attending for a bit, but ended up going back to do a Peds residency and is now PD at one of the top programs. She loves 'second career' applicants (former nurses, even finance people, etc.).

    At least at our program, switching wouldn't hurt you at all. Just make sure you are up front with your program and if you decide to apply to outside programs, you'll want to emphasize your reason for switching in your personal statement (and likely your LoR from your current PD). Best of luck!!
     
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  13. MEN2C

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    This is bad advice. I am sure you can find an exception, and people were grandfathered in, but I very highly doubt there are going to be many opportunities for a young physician to work at a standalone children's hospital without being PEM certified (by either pathway, whether EM-->PEM, or Peds-->PEM). My institution wouldn't even consider the person without PEM fellowship training, and neither would most others unless you are some kind of research superstar. And even then, there would be plenty of consternation.

    If I am wrong, show me the profiles on websites of new hires working at children's hospital who are not PEM BE/BC. Of course, some of the older guys may have been working forever or have been grandfathered in, but that doesn't help a young physician trying to find a job.
     
  14. xffan624

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    I know a two attendings that moonlight at the Peds EM I work at without a PEM fellowship. They're relatively new hires (ie young people). I'm not at a standalone, but I do work at an academic medical center.
     
  15. GoSpursGo

    GoSpursGo Allons-y!
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    One of my coresidents was able to work on the less acute side of the peds ED at our large academic stand-alone children's hospital straight out of a peds residency. I suspect someone boarded in EM would do fine finding a spot.

    Of course that doesn't really help with the OP's question, and it sounds like they want some continuity. Honestly, with a 270s score on step 2 I suspect you would do fine in the match, you're going from a more competitive to less competitive specialty. People switch residencies all the time for legitimate reasons, and while it's terrifying to take the leap and actually reapply, chances are you'll land OK. Apply broadly but only to locations that you would actually be willing to leave your current residency for. As others have said, getting in "in" with the program at your home institution would be the easiest and safest way of going about this.
     
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  17. MEN2C

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    Spot where? In the main side of a standalone children's hospital? I would be surprised.
     
  18. GoSpursGo

    GoSpursGo Allons-y!
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    You didn't specify main side. I don't pretend to be an expert on the hiring practices at every standalone children's hospital, but I was offering my n=1 experience. In any case, again, it's kind of a moot point if that's not what the OP wants to do.
     
  19. pedhopeful

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    Yeah you hit it on the head with calling it terrifying to take the leap. Honestly it has stressed me out beyond belief and I just wish I could be on the other side and in a pediatric residency. At this point though I know that a career with the path I’m on would be miserable.
     
  20. BigRedBeta

    BigRedBeta Why am I in a handbasket?
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    What do you have to lose at this point?
    I will have you note, it's April, it's after Match Day, people are rushing to make schedules for next year. Given the timing, if a lateral move is possible, each passing day diminishes the chance you could transition July 1 (which may be completely impossible anyway). You need to get in front of the Peds PD as soon as possible to map out what your options are. But out of courtesy to your current program, you need to determine if you're sticking around so they can make adjustments to their coverage schedule as well.
     

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