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Neonatology?

Discussion in 'Pediatrics' started by Gator05, Nov 27, 2002.

  1. Gator05

    Gator05 Resident
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    Hey everyone,

    Was wondering the forum's thoughts on neonatology. What are your personal experiences on the specialty and its future?

    I'll go first; incredibly interesting and very progressive. Neonatologists seem quite satisfied with their profession. However, burnout is definately an issue, leading to situations where some/most of the year is actually spent out of the NICU in some Level III's I know of.

    Any other thoughts/observations/opinions?
     
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  3. Neonatology is a great career,
    you can do academic or private practice or a hybrid of both which is what I am doing since completing my fellowship in July

    Burnout is possible but my experience is that most jobs afford a fair amount of time off.
    For the average academic job ( non research track ) you will do one or 2 months in a row on service, with one or 2 months in a row on research or teaching, so you can definately get time off and not get burned out.
    the private practice job I do involves doing a week at a time on service, with several weeks to recover with very limited duty.
    if you choose a private practice job with no or few partners and every other night call, then yes you might get burned out.
    then there is the research track with 10 months a year of research where I think you might work harder than when you are on service!

    In terms of job satisfaction, I love it. I am so happy that I chose this career. my friends from residency are all doing general peds and seeing 60 red ears and constipated 2 year olds a day, and making less money than I am, where I don't even consider what I do as work.
    If you like physiology, doing procedures in small people and in general learing cutting edge medicine, then for sure neonatology is a great career choice.

    as a matter of fact, my job gives me so much time off, I am postingt his from a little moonlighting job that I do where I basically get paid to play on the computer and sleep, and just hang out in case they need me to resusc a newborn, which almost never happens.
     
  4. Gator05

    Gator05 Resident
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    HiFi,

    THanks for your reply! A question for you; what are your thoughts about call schedules? I've seen in-house anywhere from q4-q15 as an attending, or home once a week. Also, how widespread are job opportunities?
     

  5. sorry for the delay in my reply.
    go to neonatology.net and you can see a small sample of job postings.

    the job market is HUGE in academic medicine ( lower paying ) and pretty good in private practice.

    call schedules are highly variable.

    In an academic center, when you are the attending on service that month, expect to be on call Q3-5 (from home usually ) but expect to come in when there are new fellows, or for very bad patients, like those going on ECMO. Also expect to work 1-3 weekends per month.
    in short, your month on service is long.
    Depending on your academis job ( research or clinical track ) expect anywhere from 2-10 months a year on clinical service.
    Those docs that do primarily research spend a lot of time in their lab, and you are expected to have a good grant or other source of funding by your 3-5th year as jr faculty. To me this seemed like a much more stressful job because producing quality research and securing funding takes an awful lot of work and talent ( crap research abounds...but that's another story ! )

    Private practice is VERY variable.
    My job involves me doing a solid week on service with 24 hr shift on Fri and Sat. I do this week every 4-5 weeks. The rest of time I cover night call ( all in house ) in our NICU 5Pm-8AM, and there are about 4-5 of these per month...and THAT's ALL. you do the math. I work about 12 days a month, and since our call is IN HOUSE and one of us is always here, when I am off, I am off.

    My friend works for PEDIATRIX medical group ( the nations largest private neonatal practice ) and she works pretty hard, covering a vaariety of hospitals from Home, and also doing 4-6 nights a month in their level 3, in addition do daily rounding respinsibility at the level 3 ( on her own patients )

    Basically, you have a different lifestyle in neonatology. To me it's like a residency that never ends ( only that it pays a Hell of a lot more ) in that you spend all of your time in the hospital, and when there is nothing going on, you watch TV or hand with the nurses ( or take home call depending on your practice )
    you do procedures, and hone skills that amaze your fellow physicians. people can't believe I can put a 24 guage peripheral a-line into the post tib artery of a 500 gram patient with almost no blood pressure, or do a PICC line in an old cardiac patient with no access. Procedures are a big part of your job, so you do need to enjoy them.
    I couldn't do the whole shirt and tie office thing seeing diaper rash all day, or adult medicine looking at obese chain smokers that want a pill to fix their hypertension.
    I prefer high intensity, high reward medicine where most of your patients get well, and you are an expert at a type of medicine that scares the living daylights out of the rest of the physicians in the hospital

    best of luck. don't base the decision to or not to do neonatology on your first NICU rotation as an intern, because it is quite overwhelming. I hated it and used to throw up almost every morning when I smelled the scrub sinks because I was so terrified of my patients
     
  6. Gator05

    Gator05 Resident
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    HiFi,

    Rereading your thread, and I'm curious; what are your thoughts about neonatologists and home call?

    I really appreciated your previous posts; quite valuable!
     
  7. Adcadet

    Adcadet Long way from Gate 27
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    hey all - was wondering if I could bug you for some advice.

    I'm finishing my MPH in epidemiology, and am starting an MD/PhD program (in pharm) in the fall. I'm currently in a lab doing fetal toxicology work, and am pretty sure I'll sick with this lab for my thesis. I've been thinking about medical specialties, and it seems neonatology would be a great fit with my research interests and background (which includes some mucosal immunity/gut ion transport stuff, which I hear is a big issue in neonatology). My lab does a lot of rat surgery, and I seem to get a particular kick out of doing them in rats far too small for my co-workers to handle. I like doing procedures, but am not sure surgery is for me. I love pharm and tox, and think doing pharm/tox work in those with poorly functioning livers and kidneys would be even more fun. I like the idea of being an expert in an area, and working on patients that, as one poster mentioned, scares the living daylights out of others. I want a challenging job, but also want a job that includes time for research, which neonatology does. I also like the fact I could just stick with peds if I decided primary care was the thing for me.

    I realize that I've got a long while before I have to make any firm decisions, but I was wondering if anybody who's in the neonatology track would recommend shadowing a neonatologist. I've shadowed a colorectal surgeon, which was OK, and I'm currently spending time in a tobacco dependence clinic. Are neonatologists "shadowable," or does the nature of their job make this difficult? If you were starting med school soon, would shadowing a neonatologist be a wise investment of time?

    Any comments, help, or suggestions would be greatly appreciated.

    Adcadet
     
  8. Are you referring to attending or fellows?

    I do in house call....same as I did as a fellow.
    I like being able to get out of bed and look at a patient rather than decide over the telephone if I should go in or not.

    lots of attendings do home call, having a fellow in house...or sometimes just a peds resident...or an NNP in house.

    I like in house call because when I am on call, I am on, and when I leave the hospital, I shut off my pager and can lead a normal life.
     
  9. very shadowable.
    We used to get high school and college students in from time to time.
    A few hours in a busy tertiary care center, following a fellow around on a night call should do it.
    you can also come for rounds and discuss various patients.

    my advice is to go through the local medical school and see what options are available, in terms of shadowing somebody during night call or hanging out on rounds for a few days.

    is it valuable?
    well, it's a small investment in time, so it cartainly can't hurt.
    Do an elective when you're a 4th year in medical school

    remember you need to do a peds residency first ( in which time you'll get some time in the NICU ) followed by a 3 yr fellowship, so you do have lots of time to decide if you like it or not.

    PS: I HATED neonatology when I did my first rotation as an intern.
    I wanted to puke every time I smelled the scrub sinks at the entrance. I was too scared of my patients
     
  10. Gator05

    Gator05 Resident
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    HiFi,

    Was referring to both; I intentionably left the answer as open-ended as possible. I've heard similiar replies from other fellows, as well, about the "rather take in-house call".

    Thanks again!
     
  11. Adcadet

    Adcadet Long way from Gate 27
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    HiFi -
    thanks for the info! Any thoughts on how practice differs (especially for somebody just shadowing a neonatologist) between a county hospital, an academic hospital, and a private practice? My research and many of my connections are here at the county hospital, but I also have connections at the local university and medical school - just wondering if I should look into shadowing somebody at one or the other, or both.

    Any thoughts on MD/PhDs in neonatology? Given the "cutting edge" nature of neonatology I would guess there are many.

    Thanks,
    Adcadet
     
  12. journalistdoingscience

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    Thanks for sharing your experiences HiFi! I'm really interested in going into neonatology but have been worried about the lifestyle so this is super helpful and encouraging to read.
     

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