Not prepared enough for peds fellowship?

[gggggg2]

I had my second peds anesthesia rotation recently (3 more to go). I really enjoyed it but our site is not very large - so only a few more major cases involving bowel resection, peeling kidneys off major vessels, and neuro case in neonate. A fellowship in peds seems appealing to me - but my prior paediatrics exposure is low. Clerkship was all outpatient and not much of it (no picu or nicu). My residency has been 2 weeks peds ER and then just Peds anesthesia. I just worry that my baseline pediatric knowledge won’t be enough to actually do pediatric anesthesia. I don’t feel even close to being comfortable dealing with sick neonates. For that reason something like cardiac anesthesia seems like a more appealing albeit more narrow fellowship to pursue - as so much of our training prepares us for it.

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[crash2500]

I had my second peds anesthesia rotation recently (3 more to go). I really enjoyed it but our site is not very large - so only a few more major cases involving bowel resection, peeling kidneys off major vessels, and neuro case in neonate. A fellowship in peds seems appealing to me - but my prior paediatrics exposure is low. Clerkship was all outpatient and not much of it (no picu or nicu). My residency has been 2 weeks peds ER and then just Peds anesthesia. I just worry that my baseline pediatric knowledge won’t be enough to actually do pediatric anesthesia. I don’t feel even close to being comfortable dealing with sick neonates. For that reason something like cardiac anesthesia seems like a more appealing albeit more narrow fellowship to pursue - as so much of our training prepares us for it.

Won't be a problem. That's why you do the fellowship. It won't take you more than a few weeks to get up to speed with other fellows.

Don't stress. If you want to do peds, do the fellowship.

 

[pocafx]

Agree with above your concern doesn’t make sense. Do the fellowship you want.

 

[GassYous]

People have been doing peds without fellowship for decades

 

[Beeftenderloin]

I had my second peds anesthesia rotation recently (3 more to go). I really enjoyed it but our site is not very large - so only a few more major cases involving bowel resection, peeling kidneys off major vessels, and neuro case in neonate. A fellowship in peds seems appealing to me - but my prior paediatrics exposure is low. Clerkship was all outpatient and not much of it (no picu or nicu). My residency has been 2 weeks peds ER and then just Peds anesthesia. I just worry that my baseline pediatric knowledge won’t be enough to actually do pediatric anesthesia. I don’t feel even close to being comfortable dealing with sick neonates. For that reason something like cardiac anesthesia seems like a more appealing albeit more narrow fellowship to pursue - as so much of our training prepares us for it.

Are you comfortable doing an off pump double lung transplants by yourself? Open thoraco-abdominal aortic aneurysm repair? CABG, double valve, w/ Arch reconstruction under circ-arrest? I suspect the answer is no. So by that logic you shouldn’t do CV fellowship either.

I’m not actually trying to talk you out of doing either. Any fellowship program worth their salt should be capable of taking any halfway decent, motivated anesthesiologist and turn them into a consultant in that sub-specialty.

 

[kidthor]

Actually, it’s a good sign that you don’t feel ready to take care of sick neonates. They stress most peds anesthesiologists out too (including myself).

You’ll be fine…. The whole purpose of a peds fellowship is to amp up your knowledge and experience with peds patients anyway. If you’re starting off from a decent spot in terms of overall broad clinical skills then you’ll be good.

 

[caligas]

I had my second peds anesthesia rotation recently (3 more to go). I really enjoyed it but our site is not very large - so only a few more major cases involving bowel resection, peeling kidneys off major vessels, and neuro case in neonate. A fellowship in peds seems appealing to me - but my prior paediatrics exposure is low. Clerkship was all outpatient and not much of it (no picu or nicu). My residency has been 2 weeks peds ER and then just Peds anesthesia. I just worry that my baseline pediatric knowledge won’t be enough to actually do pediatric anesthesia. I don’t feel even close to being comfortable dealing with sick neonates. For that reason something like cardiac anesthesia seems like a more appealing albeit more narrow fellowship to pursue - as so much of our training prepares us for it.

By day 3 you’ll be better at peds than me.

 

[woopedazz]

Neonates are just tiny adults

 

[nimbus]

Neonates are just tiny adults

Adults are just enormous neonates

 

[GassYous]

Adults are just enormous neonates

Some more enormous than others

 

[woopedazz]

To follow the tiny adult jibe... Had a weird convo a few years back. I told my old supervisor I'm not overly comfortable anaesthetising kids under 2; so that's my age limit in private for most cases.

He said it's good thing for people to know their limits with kids, but once they hit 2 they're basically just small adults and I shouldn't think of them as anything scary.

I laughed and said even 2 year olds can sometimes be a bit foreign to me.

And this fella looked me dead in the eye and said "2 YEAR olds?? ... I thought you were talking about 2 MONTH olds ... ... " And then he just sauntered off.