Ped Cards vs Neo vs Ped GI

[heman466s]

So, I am having a hard time deciding between peds cards,neo and peds gi fellowships.
The top things that I am looking for after fellowship are good compensation,lifestyle and job opportunities.I like all of these but cannot decide on one.
Any suggestions?

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[Stitch]

I think there can be all of those things with each of the fellowships you mention, but what's more important is how you like the daily work. Do you love echos, and evaluating cardiac anatomy, working with cardiac surgeons and learning about electrophysiology? Or is abdominal pain, constipation and liver failure more your thing? How do you feel about neonates, nurseries, and premies who are at the edge of viability? All of those specialities have procedures, but all are quite different. Sorting those things out are going to make you much happier than anything else.

 

[Homunculus]

compensation/lifestyle/job opportunities would probably lead to neo/GI/cards.

what do you like about each? not that they are mutually exclusive but neo is a different world than the other two. resuscitating, intubating, all that adrenaline stuff from the NICU kinda falls away a bit with the others. typically GI/cards are consult services, and cards especially likes to espouse the "it's not in the box" and turf patients back to where they came from 😉 procedurally, cardiology has ekgs/echos and in some cases caths and ablations and such if you are an electrophysiologist. GI has EGD/colonoscopies, ARMs, liver biopsies, pH/impedance probes, PEG tube placements-- maybe a couple others. procedures = reimbursement in the current model as well, and i would suppose a GI would do a little better than the cards in this arena, but probably not nice level (unless you are private practice, scoping all the time and own part of the endoscopy unit).

personally, i didn't want to be coding tiny babies and tending to the "gerbil farm" (i kid) with feeder growers doing shift work and being in the hospital at night. so i knew i wanted a consult service. some consult services have call that they likely will never have to go in but with GI and cards it's always possible-- but not often. so from a lifestyle perspective it depends on what you want for your lifestyle. we'd need more info to help with this.

job opportunities i'm not as clear on. depends if you want academic or private practice and where you are willing to go. which is kind of a lifestyle question.

good luck whatever you decide-- unfortunately there's often not an easy answer to things like this.

--your friendly neighborhood peds GI caveman

 

[Siverhideo1985]

Hey Homonculus, I have found that our (very busy) peds GI service is about 3/4ths of a psych service as well...just by the nature that our feelings always seem to go through the gut the two appear to be very much related. In your experience, has that been a bigger component to your practice than you initially thought? Thanks for sharing your thoughts.

 

[Homunculus]

"functional" GI disorders are definitely complicated to deal with, but every specialty has some headache to deal with. NICU parent psychosis, syncope, headaches, cough, short stature-- everyone (except maybe renal) has their dump bucket of nuttiness. it's not more prevalent than i expected-- and to be honest, routine things like constipation, reflux, IBS-- they pay the bills. sometimes it's a matter of coming from GI instead of their pediatrician, other times it's knowing how to frame the workup from the first visit. it gives job security, i suppose. if your GI service seems to be 3/4 psych, i'd be interested in why this is-- lack of outpatient management, concierge/VIP attitudes, billing-- functional kids really need to stay out of the hospital. . .

-- your friendly neighborhood constipation has put a lot of kids through college caveman