pediatric anesthesiology vs. neonatology

[rina33]

Did anyone else face this decision? I am attracted to both fields and need to decide asap (I'm a fourth year) whether I'm applying in peds or anesthesia. Any advice you would give to someone in my position? How do you feel that lifestyles differ? Are there any pedi anesthesiology jobs that require less call? (as the frequent call is the greatest drawback of neonatology to me). For pedi anesthesiology call, is it usually in-house or from home? How do you see the field of pediatric anesthesiology changing in the future? I have searched the forum but would love to get some more insight specifically on the neonatology vs. pedi anesthesiology issue. If anyone else decided between peds critical care fields and anesthesiology, I'd love to hear how you made your decision, and to gain some insight in general from anesthesiologists in the trenches!
Thanks in advance.

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[me454555]

You're thinking too far ahead. First figure out whether you like peds or anesthesia.

Questions to ask yourself

Do I want to work exclusively with kids or do I just want to work with them occasionally?

Do I like the more traditional medicine role of being a pcp or would I rather apply my medical knowlege in a more theoretical basis?

How much direct contact do I want with patients? What physician role would make me happiest? Consultant or Primary

They are both very different fields and you shouldn't have much trouble deciding on which to pursue. Once you figure that out, then you should figure out where you want to specialize in.

 

[Masseter Spasm]

It sounds like you are commiting yourself to a fellowship pathway (at least 5 years of postgraduate training). I think you need to explore the significant differences between pediatric anesthesia and neonatology. Making a poor decision could be costly.

Neonatology (and pediatric critical care) involves extended care of sick children. You will follow these kids over weeks to months. At times it can be intense trying to manage a critically ill child. Most kids these days get better. Some will spend months in the ICU and die (or transfer out with a disabling illness). The lifestyle is demanding. To be happy in a critical care field you need to come to terms with the lifestyle. It is hard to plan a schedule when you are responsible for the care of critically ill patients. Talk to practicing intensivists in different environments about the hours. If the commitment sounds too rough, you should question your interest in a critical care field.

Pediatric anesthesia focuses on episodic care of healthy and ill children. You may get to care for some children repeatedly but usually just short-term. Anesthesia can be a fast paced environment with complex decision-making. I enjoy caring for sick kids, but I also enjoy not having long-term responsibility for their treatment. I would say that overall my lifestyle is somewhat better than that of an intensivist (financial and schedule). I do, however, work some nights, weekends, and holidays. I take both in-house and call from home. (This will vary by hospital or group)

The pathway to either field will be different. I think neonatology is a 3 year fellowship (in addition to a 3 year peds residency). Anesthesia Residency is 3 years (in a addition to a prelim/intern year). Most of anesthesia training will focus mainly on adults. Pediatric anesthesia fellowship requires one year after which you could be exclusively a pediatric anesthesia provider.

If you think 5-6 years of residency/fellowship training is not enough, consider this next pathway. I know many pediatric anesthesiologists who actually did a pediatric residency followed by anesthesia residency and/or pediatric anesthesiology fellowship. Some even practice both anesthesia and critical care.

If you are really undecided, perhaps you should pursue a pediatric residency. This would allow you more exposure to the NICU and PICU. Then do a pediatric anesthesia elective. Perhaps you decision would be easier with more experience.

 

[LHCF]

I was in your same shoes last year and I choose neonatology. The similarities between the two are that they are both hospital based and involve critical care of children. Both also allow flexible shift-like schedules depending on where you work. Anesthesia is a lot more about sedation (for procedures and the o.r.), pain management and airway managament. Neonatology is more about delivery room resuscitation and critical care for newborns in the nursery. Whatever you choose, both are very much needed!