Pediatric Radiology

[txguy]

At my school's teaching hospital, there is a paucity of pediatric radiologists, so I was just wondering what the pros and cons were for doing a pediatric radiology fellowship? Reimbursement? Salary? The work itself? Hours? Job opportunities? Length of fellowship? or availability of fellowship positions?

Thanks in advance! (I am also going to post in the AM forum, but wanted to get some feedback here as well)

-tx

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[hans19]

At my school's teaching hospital, there is a paucity of pediatric radiologists, so I was just wondering what the pros and cons were for doing a pediatric radiology fellowship? Reimbursement? Salary? The work itself? Hours? Job opportunities? Length of fellowship? or availability of fellowship positions?

Thanks in advance! (I am also going to post in the AM forum, but wanted to get some feedback here as well)

-tx

The demand is high for peds rads for the reasons that mammo is in high demand. You have high liability and low reimbursement => nobody in their right mind went into those fields leading to a severe shortage. Even though those people do not bring in the RVU's, they perform the 'dangerous work' so the high RVU people (neuro, msk, IRs) don't have to. In turn those people can crank out the RVUs for the radiology group, instead of tiptoeing around in the minefields. Its a win-win situation for everyone. Most hospital contracts want groups to cover peds and mammo, so somebodies got to do it. Its comparative advantage. Sure plain films don't bring in RVUs, but the efficient old-timer plain film reader can crank them out, so that the MRI reading rads don't waste anytime on non-MRI studies.

Bottom line, do what you like. If you like peds, do it. But don't do it just because it'll get you a job. By the time you start fellowship, the pendulum might swing the other way.

MRI based fellowships were en vogue 5-10 years ago, because not many old timer rads had experience in it, and MRIs were a cash cow for the group. MRI trained rads were a hot commodity. Consequently everyone did this fellowship. Now adays you should get some decent MRI experience in residency. What we are seeing now is an oversupply of MRI (neuro or msk) manpower.

Most jobs out there are still for 'general' Radiologists. The highest subspecialty needs seem to be in Mammo, Peds and then IR. Again by the time you MSIVs finish residency this could (and probably will) completely change.

 

[txguy]

The demand is high for peds groups for the reasons that mammo is in high demand. You have high liability and low reimbursement => nobody in their right mind went into those fields leading to a severe shortage. Even though those people do not bring in the RVU's, they perform the 'dangerous work' so the high RVU people (neuro, msk, IRs) don't have to. In turn those people can crank out the RVUs for the radiology group, instead of tiptoeing around in the minefields. Its a win-win situation for everyone. Most hospital contracts want groups to cover peds and mammo, so somebodies got to do it. Its comparative advantage. Sure plain films don't bring in RVUs, but the efficient old-timer plain film reader can crank them out, so that the MRIs don't waste anytime on nonMRI studies.

Bottom line, do what you like. If you like peds, do it. But don't do it just because it'll get you a job. By the time you start fellowship, the pendulum might swing the other way.

MRI based fellowships were en vogue 5-10 years ago, because not many old timer rads had experience in i, and MRIs were a cash cow for the group. Consequently everyone did this fellowship. Now adays you should get some decent MRI experience in residency. What we are seeing now is an oversupply of MRI (neuro or msk) man power.

Another solid post. Thanks, as always, for the information.

-tx

 

[atelectasis]

The demand is high for peds rads for the reasons that mammo is in high demand. You have high liability and low reimbursement => nobody in their right mind went into those fields leading to a severe shortage. Even though those people do not bring in the RVU's, they perform the 'dangerous work' so the high RVU people (neuro, msk, IRs) don't have to. In turn those people can crank out the RVUs for the radiology group, instead of tiptoeing around in the minefields. Its a win-win situation for everyone. Most hospital contracts want groups to cover peds and mammo, so somebodies got to do it. Its comparative advantage. Sure plain films don't bring in RVUs, but the efficient old-timer plain film reader can crank them out, so that the MRI reading rads don't waste anytime on non-MRI studies.

Bottom line, do what you like. If you like peds, do it. But don't do it just because it'll get you a job. By the time you start fellowship, the pendulum might swing the other way.

MRI based fellowships were en vogue 5-10 years ago, because not many old timer rads had experience in it, and MRIs were a cash cow for the group. MRI trained rads were a hot commodity. Consequently everyone did this fellowship. Now adays you should get some decent MRI experience in residency. What we are seeing now is an oversupply of MRI (neuro or msk) manpower.

Most jobs out there are still for 'general' Radiologists. The highest subspecialty needs seem to be in Mammo, Peds and then IR. Again by the time you MSIVs finish residency this could (and probably will) completely change.

This might be too broad of a question but can you describe what takes up most of the peds rads time? Is it mainly oncology, abuse, and fx's? Or is it congenital stuff? And is pediatric radiology itself any more complicated, per se, compared to other subsets of rads?

This question is not about lifestyle, malpractice risk, or salary.

Thanks!

 

[PeepshowJohnny]

This might be too broad of a question but can you describe what takes up most of the peds rads time? Is it mainly oncology, abuse, and fx's? Or is it congenital stuff? And is pediatric radiology itself any more complicated, per se, compared to other subsets of rads?

This question is not about lifestyle, malpractice risk, or salary.

Thanks!

At my place, the pediatric radiologists basically read every film with a kid, regardless. From the NICU to PICU to hem/oncology to outpatient peds offices.

From what I've been able to gather talking to other people though, it depends on where you work (which is a cop-out answer, I know). My sense, if you work at big time academic institution/Children's hospital you're going to spend a lot of time helping work up zebras in kids. That's the specialized training you get in your fellowship.

There's other bread and butter stuff in peds like upper GI's and fracture/abuse stuff, however (while the peds guys at my place definitely do this) it's not so complicated that it can't be handled by a general radiologist with his basic peds training. So if you're at a big academic place you may skew more toward zebras because they get referred to you while the mundane stuff may stay at their outside facilities the majority of the time.

 

[ScooterBanks]

The severe shortage of pediatric radiologists results in much worse work hours and call than the average radiologist. For this reason alone, I will not do peds because it contraindicates the primary reason I went into radiology to begin with = limited, predictable hours with lots of vacation time.

That being said, I like peds in the sense that it's a good variety and you get to see a little of everything in terms of specialty and modality. Peds guys are more of true generalists than their adult counterparts in this respect.

I personally would only consider peds if I found a large group in an ideal situation and location that needed a "peds guy", however I was not limited to only pediatrics and more importantly was treated the same as everyone else in terms of work hours/weekends/call. This is much different than my view of mammo, of which I will never do again under any circumstances after oral boards, not because of the legality or reimbursement, but because of the shear boredom of it.

 

[mig2k]

Problem with peds is that you really need to practice in a big peds hospital. This is a deal breaker for myself and others.

 

[sestamibi]

What's wrong with practicing in a big peds hospital?

 

[mig2k]

What's wrong with practicing in a big peds hospital?

Nothing if thats what you like. If you prefer the private practice/outpatient setting, Peds won't help you.