Neonatal Surgery/Neonatology.

[_ Aquarius _]

Hey! Im a current student and new to the forums. I thought it was time for me to try and get a little insight on some of the future career paths I am currently interested in. So to start, I was wondering if there were any neonatal surgeons or neonatologists on the forums who would be willing to give me a little insight on their careers. I.E.: Is your career fulfilling and are you happy? What kind of job duties are involved in your job? etc... Involve anything else you would think would be helpful.
Thank You!

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[gyngyn]

Hey! Im a current high school freshmen and new to the forums. I thought it was time for me to try and get a little insight on some of the future career paths I am currently interested in. So to start, I was wondering if there were any neonatal surgeons or neonatologists on the forums who would be willing to give me a little insight on their careers. I.E.: Is your career fulfilling and are you happy? What kind of job duties are involved in your job? etc... Involve anything else you would think would be helpful.
Thank You!

Neonatology is a subspecialty of Pediatrics. You might want to start by asking pediatricians first as they are more plentiful and it is a prerequisite to fellowship training.
Pediatric surgery is a subspecialty of General Surgery. You might want to start with the requisite there too!

 

[_ Aquarius _]

. ∞

 

[gyngyn]

I understand what it is, it's just that the one thing I enjoy the most about peds is the babies. I really don't think working with teens or young children is really something that would motivate me to become a pediatrician or peds surgeon. I understand that I will have to work with them during a peds residency and even during general surgery, but it's just I would prefer not to do that for my whole career. Also to become a neo-surgeon do you have to do a peds-surgery fellowship or are there neonatal surgery fellowships as well?
Thanks for the Help! Much appreciated.

Neonatal surgery is a sub-category of pediatric surgery. You do a 5 year general surgery residency followed by a two year fellowship in pediatric surgery.

Pediatrics is a 3 year residency. Neonatology is a 3 year fellowship after that..

 

[Levo]

I understand what it is, it's just that the one thing I enjoy the most about peds is the babies. I really don't think working with teens or young children is really something that would motivate me to become a pediatrician or peds surgeon. I understand that I will have to work with them during a peds residency and even during general surgery, but it's just I would prefer not to do that for my whole career. Also to become a neo-surgeon do you have to do a peds-surgery fellowship or are there neonatal surgery fellowships as well?
Thanks for the Help! Much appreciated.

A surgeon will never be able to find enough neonates in need of surgery to in order to sustain a practice if that's all they do. Pediatric surgery is already a tiny enough niche as it is.

 

[_ Aquarius _]

A surgeon will never be able to find enough neonates in need of surgery to in order to sustain a practice if that's all they do. Pediatric surgery is already a tiny enough niche as it is.

It may be slower than other specialties, but it doesn't seem too difficult considering how many premature babies are born with birth defects and other different possibly fatal conditions.

 

[gyngyn]

A surgeon will never be able to find enough neonates in need of surgery to in order to sustain a practice if that's all they do. Pediatric surgery is already a tiny enough niche as it is.

You are right that there is a need for very few of them.
They will need to work in a quarternary referral center in order to have enough cases.

 

[gyngyn]

Believe it or not, NICUs can get fairly overcrowded.

They are not overcrowded because of a need for surgery, though.

 

[_ Aquarius _]

They are not overcrowded because of a need for surgery, though.

Thanks! I edited that out. It took me a second to catch that after rereading the question again.

 

[gyngyn]

Thanks! I edited that out. It took me a second to catch that after rereading the question again.

You could look into prevention of prematurity and congenital defects if you like babies.
Pre-conception counseling, folate supplementation, diabetes prevention and reducing maternal smoking and recreational drug use without contraception would have a huge effect on outcomes that interest you.
There is a lot of need in these areas.

 

[Levo]

It may be slower than other specialties, but it doesn't seem too difficult considering how many premature babies are born with birth defects and other different possibly fatal conditions.

The vast majority of premature babies don't have anything that's amenable to surgical intervention. Then even if you look at the small subset of premies that have some sort of surgical problem, it's going to be split between general (usually intra-abdominal or esophageal) surgical problems, ear-nose-throat surgical problems, cardiac surgical problems, neurosurgical problems, urological surgical problems, ophtho surgical problems, and orthopedic surgical problems, all of which "belong" to different medical specialties, so no one surgeon will take care of all of those. So for any one type of surgeon, operations on newborns can only be a small percentage of their practice. I live in a big city with a catchment area that extends into several neighboring counties. We have only a handful of pediatric surgeons, and all of them see everyone, birth-to-18.

 

[_ Aquarius _]

The vast majority of premature babies don't have anything that's amenable to surgical intervention. Then even if you look at the small subset of premies that have some sort of surgical problem, it's going to be split between general (usually intra-abdominal or esophageal) surgical problems, ear-nose-throat surgical problems, cardiac surgical problems, neurosurgical problems, urological surgical problems, ophtho surgical problems, and orthopedic surgical problems, all of which "belong" to different medical specialties, so no one surgeon will take care of all of those. So for any one type of surgeon, operations on newborns can only be a small percentage of their practice. I live in a big city with a catchment area that extends into several neighboring counties. We have only a handful of pediatric surgeons, and all of them see everyone, birth-to-18.

Yeah, that seems accurate. Thanks for the insight.

 

[LucidSplash]

Neonatal surgery is a sub-category of pediatric surgery. You do a 5 year general surgery residency followed by a two year fellowship in pediatric surgery.

Pediatrics is a 3 year residency. Neonatology is a 3 year fellowship after that..

Just FYI Pediatric surgery is a 3-year fellowship. Also it is highly competitive and almost uniformly requires having some substantial research time in residency. So expect your general surgery residency to have 2 years of research plus the 5 clinical years.

Pediatric surgeons operate on neonates without having to do a superfellowship. But except in specialized centers, they will also have older children and teens as patients.

There are superfellowships for more specialized training in perinatal surgery that are usually 2 years in length. But not necessary unless you have a specific interest in some of the more rare conditions.

 

[gyngyn]

Just FYI Pediatric surgery is a 3-year fellowship. Also it is highly competitive and almost uniformly requires having some substantial research time in residency. So expect your general surgery residency to have 2 years of research plus the 5 clinical years.

Pediatric surgeons operate on neonates without having to do a superfellowship. But except in specialized centers, they will also have older children and teens as patients.

There are superfellowships for more specialized training in perinatal surgery that are usually 2 years in length. But not necessary unless you have a specific interest in some of the more rare conditions.

That's odd. The ones in the NRMP Match are 2 years.
Depending on the program many fellowships have a research year, so I would not be surprised, though.

 

[gyngyn]

I'm more into neonatal and perinatal medicine anyway, but if I did do something in surgery it would most likely be neo or ob/gyn for obstetrics even though that barely counts as surgery to most people.

When we are operating on you (or your wife, mother or sister), it turns out to actually be surgery after all...

 

[Toutie]

it's just that a lot of people don't consider it to be very special or admit that an OB is actually a surgeon after all.

Really? And what people would these be? Aquaruis, sweetie...I will give you little leeway because you are still in high school. But...you have no idea what you are talking about.

gyngyn IS a gynocologist...and has been for at least a million years (right, @gyngyn ). Your post is not only incorrect, but also very insulting. Just stop.

 

[gyngyn]

Really? And what people would these be? Aquaruis, sweetie...I will give you little leeway because you are still in high school. But...you have no idea what you are talking about.

gyngyn IS a gynocologist...and has been for at least a million years (right, @gyngyn ). Your post is not only incorrect, but also very insulting. Just stop.

No worries, @Toutie.

 

[gyngyn]

I know it's surgery and I very much consider it so, it's just that a lot of people don't consider it to be very special or admit that an OB is actually a surgeon after all.

Don't let this be an influence on your exploration.
A lot of people can come to an unfounded conclusion.

 

[_ Aquarius _]

Really? And what people would these be? Aquaruis, sweetie...I will give you little leeway because you are still in high school. But...you have no idea what you are talking about.

gyngyn IS a gynocologist...and has been for at least a million years (right, @gyngyn ). Your post is not only incorrect, but also very insulting. Just stop.

I mean I kind of assumed they were a gynecologist and I'm sorry if I offended him I don't really know how, but I'm just speaking from experiences I've had with people on other forums. If you want to talk to the people who are really insulting ob/gyn talk to them because I happen to really love AND respect the practice which is why it's something I would really love to do in the future. Do you really think I would be the one insulting my own dream career. I don't think so. Some people just don't understand.

 

[mw18]

Really? And what people would these be?

While I obviously find Ob/gyn's to be surgeons, seeing that they perform surgery, Aquarius isn't making this up. This is a fairly pervasive feeling. Not a majority, but I've seen/heard many people speak on this topic in that way. It's not offensive to say that some people don't consider something surgery. That's a true statement. Aquarius was even stating his/her interest in the field. I agree there wasn't really a need to mention how some people feel about it, because that makes it seem like he or she is easily influenced and it introduces a negative connotation. If you've never heard people discussing the surgeon status of Gyn's disparagingly, that's a good thing. Maybe it's not happening as much or everywhere, but between Aquarius saying that people say that and your response - it was you who was being ignorant.

 

[_ Aquarius _]

@gyngyn I don't feel like creating a new thread so I'm just going to ask this question here. When you train to become a neonatal or fetal surgeon do you do a general surgery residency to a neonatal/fetal surgery fellowship, or a general surgery residency to a pediatric surgery fellowship? I've read about neonatal surgery fellowships and perinatal surgery fellowships before so I'm just wondering. If it's the second option how do you go from pediatric surgeon--->neonatal surgeon?
Thanks.

 

[gyngyn]

@gyngyn I don't feel like creating a new thread so I'm just going to ask this question here. When you train to become a neonatal or fetal surgeon do you do a general surgery residency to a neonatal/fetal surgery fellowship, or a general surgery residency to a pediatric surgery fellowship? I've read about neonatal surgery fellowships and perinatal surgery fellowships before so I'm just wondering. If it's the second option how do you go from pediatric surgeon--->neonatal surgeon?
Thanks.

After medical school and a general surgery residency one would apply to a pediatric surgery fellowship.

Neonatal fellowships are available to Maternal Fetal Medicine specialists (Ob-Gyn) and pediatric surgeons. See this example from Baylor: Perinatal Surgery Fellowship

 

[_ Aquarius _]

After medical school and a general surgery residency one would apply to a pediatric surgery fellowship.

Neonatal fellowships are available to Maternal Fetal Medicine specialists (Ob-Gyn) and pediatric surgeons.

So you do two fellowships?

 

[gyngyn]

So you do two fellowships?

It is often necessary if you don't have a sufficient depth and breadth of cases in your first fellowship.
There isn't sufficient need for more than a very few of such sub-specialists.

 

[_ Aquarius _]

It is often necessary if you don't have a sufficient depth and breadth of cases in your first fellowship.
There isn't sufficient need for more than a very few of such sub-specialists.

Thanks for your help!