Pediatric subspecialty

[makesomerheum]

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Which are the most competitive peds fellowships? Are these as competitive as IM?

 

[14022]

Which are the most competitive peds fellowships? Are these as competitive as IM?

This is from last years match data listed by... number of positions offered in match- number of US applicants (number of total applicants)

Cardiology: 94-70(114)
Critical Care: 96-53(74)
Emergency medicine: 70-88(118)
Heme-Onc: 120-79(119)
Sports Medicine: 5-13(17)

These are the only specialties for which I could find this data. Based on this, EM is by far the most competitive since it is the only one that had more US applicants than spots (with the exception of sports medicine, which I believe is more commonly a fellowship after family medicine. But you can go into sports med fellowship from peds, ER, family, and IM residencies. Peds would be a less popular residency to do for sports med because most of your pts will be young adults, of which peds does not see.) Next competitive would be cards. But it is still relatively noncompetitve since there are more postions than US grads.


Compare this to comparable IM cardiovascular diseases fellowship.
Cardiology: 630-565(1193)

For the most part, peds specialties are easier to get into because there is not a large pay increase between general peds and subspecialists. Some specialists (eg, ID, endocrine, rheum) will make less than a general pediatrician because most general peds are in private practice and most specialists are in academics.

 

[bizcuit241]

Where did you get those statistics and do they have the same type of statistics for the IM and other specialty fellowships?

 

[14022]

Where did you get those statistics and do they have the same type of statistics for the IM and other specialty fellowships?

it is at the careers in medicine website for the aamc... go to www.aamc.org then to "popular links" i think and then "careers in medicine"...your school should be able to supply you with a pin

they have stats for some but not all specialties...they also have salary stuff...i think this would be most accurate of all the salary surveys

 

[makesomerheum]

Scholes, thanks for the answers. I am rather surprised at how non-competitve subspecialties are for pediatrics. Do you know where the best peds cards programs are on the West Coast? I am guessing UCLA, UCSF, UW but have no way to know.

 

[Leukocyte]

I am rather surprised at how non-competitve subspecialties are for pediatrics.

Sub-specialities in Peds are un-attractive beacuse:

-Money is almost the same (sometimes even lower) compared to General Peds which is already low compared to all other medical specialities.

-Practice limitations to large acedemic centers.

-Research is a must.

 

[14022]

I am sorry, I do not. To be honest, I really haven't heard about any programs west of Texas being mentioned as among the top for peds cards. I have heard great things about places like CHOP, Boston, Baylor, UMichigan, Cincinatti, Columbia, Atlanta, Wisconsin. I would assume all the places you mentioned are decent programs and would add Stanford to that list. I know Children's Hospital of LA and Child Hosp Oakland are often discussed in high regard for Peds in general but I do not know their academic affiliations.

Scholes, thanks for the answers. I am rather surprised at how non-competitve subspecialties are for pediatrics. Do you know where the best peds cards programs are on the West Coast? I am guessing UCLA, UCSF, UW but have no way to know.

 

[fingerstick]

Can anyone tell me why peds specialists are mostly in academic centers? Endo, for example. I know from experience how hard it is to see a peds endo, and think that many smaller communities could easily support one (espescially with the rise of both T1 and T2 diabetes). It is so hard on families to have to be near these places, or travel when they have a chronically ill child. I would really like to limit my practice as much as possible to T1s, and handle peds and adults. Any input on how to go about this would be greatly appreciated.

 

[bluebirdie]

Can anyone tell me why peds specialists are mostly in academic centers? Endo, for example. I know from experience how hard it is to see a peds endo, and think that many smaller communities could easily support one (espescially with the rise of both T1 and T2 diabetes). It is so hard on families to have to be near these places, or travel when they have a chronically ill child. I would really like to limit my practice as much as possible to T1s, and handle peds and adults. Any input on how to go about this would be greatly appreciated.

I know that in bigger cities, you can specialize in only treating one disease within your specialty. I'm thinking if you want to treat both peds and adults you may have to do a med/peds residency then an endo fellowship.

 

[fingerstick]

Would it matter if the fellowship was IM or Peds? Or would either suffice?

 

[oldbearprofessor]

Can anyone tell me why peds specialists are mostly in academic centers? Endo, for example. I know from experience how hard it is to see a peds endo, and think that many smaller communities could easily support one (espescially with the rise of both T1 and T2 diabetes). It is so hard on families to have to be near these places, or travel when they have a chronically ill child. I would really like to limit my practice as much as possible to T1s, and handle peds and adults. Any input on how to go about this would be greatly appreciated.

There are several reasons for this. First of all, pediatric specialty training involves research and therefore those who choose research-oriented careers will stay in academic centers. Also, with the principal (but not solo) exception of neonatology, it is relatively difficult to make a group private practice succeed in pediatric subspecialties. Reimbursements are relatively low and patient volume is not high enough. The solo private practioners do exist though, especially in GI, allergy, and pulmonary, but this has all of the limits of solo private practice and is mostly in the larger cities.

Now then as to the issue of pedi endo. Traditionally, this has been among the most research-oriented peds specialties with a long history of basic and clinical science focused in academic centers. Furthermore, there are relatively few people doing this fellowship as it is not a particularly easy one and the reimbursements are particulary low. It does not have much widespread appeal among pediatric residents, although I think this is changing a bit. You are correct, however, that the rapid increase in Type 2 DM has led to a rapid increase in demand for this specialty.

In terms of who can see what, this is in a bit of flux. Right now, pedi endocrinologists are primarily seeing pediatric patients, Type 1 and Type 2 and adult endocrinologists, adult patients. I am aware of some crossover though and I expect more to occur. In particular, I expect that adult endos will be seeing more teenage type 1's and especially type 2's. I don't think that there are enough pedi endos to handle the new avalanche of Type 2's.

I am not certain if there are any organized combination med/peds pedi/adult endo fellowships as there are in some of the other fields, but it could certainly be created if one wanted and there may be such programs in place or starting soon that I don't know about. Right now, if Type 1 was your primary interest, most people would go the pedi side and eventually turn them over to adult endos, but you could certainly consider med/peds and either a pedi endo fellowship or try to create a double fellowship. Actually, I rather suspect that a med/peds residency with a pedi fellowship would give you a good basis to keep your Type 1's through adulthood. It would be a bit tricky to arrange either an academic or private practice to do this, but not impossible.

Regards

OBP

 

[makesomerheum]

Some excellent answers have been given on this thread. Many references have been made to the low compensation for peds physicians. Do you know a web site for subspecialty average incomes?

 

[makesomerheum]

Scholes,
I just read a previous post that answered my above question. I still have not been able to find the link on the aamc website that you mentioned. I love kids and want to be in a job that excites me when I get up in the AM. I do not come from an affluent background and could care less if I make 1/3 less than an adult cardiologist. The variety is what I love!!! I am married, and the family life aspect is important to me. Will I still have time outside of my job with peds cards? Do you know what the average hours are?

 

[14022]

Scholes,
I just read a previous post that answered my above question. I still have not been able to find the link on the aamc website that you mentioned. I love kids and want to be in a job that excites me when I get up in the AM. I do not come from an affluent background and could care less if I make 1/3 less than an adult cardiologist. The variety is what I love!!! I am married, and the family life aspect is important to me. Will I still have time outside of my job with peds cards? Do you know what the average hours are?

Careers in medicine site... http://www.aamc.org/students/cim/

If your school has a password for you, you can look for more specific info regarding specialities and subspecialties http://services.aamc.org/careersinmedicine/login1.cfm

From what I have read and seen, peds cards typically put in the most hours at the hospital among the peds specialists. Call depends on the number of docs in your group. I really can't tell you how much time you will have. I would like to know this myself, because this will have a huge bearing on whether I ultimately will pursue this, or pursue something like NICU where hours a bit more predictable and groups are larger, allowing wider distribution of call.

 

[OBfan]

This is from last years match data listed by... number of positions offered in match- number of US applicants (number of total applicants)

Cardiology: 94-70(114)
Critical Care: 96-53(74)
Emergency medicine: 70-88(118)
Heme-Onc: 120-79(119)
Sports Medicine: 5-13(17)

These are the only specialties for which I could find this data. Based on this, EM is by far the most competitive since it is the only one that had more US applicants than spots (with the exception of sports medicine, which I believe is more commonly a fellowship after family medicine. But you can go into sports med fellowship from peds, ER, family, and IM residencies. Peds would be a less popular residency to do for sports med because most of your pts will be young adults, of which peds does not see.) Next competitive would be cards. But it is still relatively noncompetitve since there are more postions than US grads.


Compare this to comparable IM cardiovascular diseases fellowship.
Cardiology: 630-565(1193)

For the most part, peds specialties are easier to get into because there is not a large pay increase between general peds and subspecialists. Some specialists (eg, ID, endocrine, rheum) will make less than a general pediatrician because most general peds are in private practice and most specialists are in academics.

These are good numbers. Does anyone know these same stats for this last year (2006)?

 

[medstudent99]

Sub-specialities in Peds are un-attractive beacuse:

-Money is almost the same (sometimes even lower) compared to General Peds which is already low compared to all other medical specialities.

-Practice limitations to large acedemic centers.

-Research is a must.

who cares as long as you're doing what you enjoy...i think any subspeciality in peds would be awesome

 

[14022]

These are good numbers. Does anyone know these same stats for this last year (2006)?

http://www.nrmp.org/fellow/match_name/index.html

This website has info on every fellowship that participates in the match through the NRMP and it has the match results for most specialties from the most recent match.

 

[dsherida]

Scholes,
I just read a previous post that answered my above question. I still have not been able to find the link on the aamc website that you mentioned. I love kids and want to be in a job that excites me when I get up in the AM. I do not come from an affluent background and could care less if I make 1/3 less than an adult cardiologist. The variety is what I love!!! I am married, and the family life aspect is important to me. Will I still have time outside of my job with peds cards? Do you know what the average hours are?

Hey saw your ?s. I did research in peds cardio before I started school and got to know my mentor and his family pretty well. It is definitely hard work. I would say about 55hrs a week (7am-6pm). That is probably on the high side. He had a nice life and was really involved in his family. Coached his son's bball team and made pretty much all of his children's sporting events and activities. His wife is actually a peds cardio as well and works 75% full time. I think it is completely doable with a family. They worked at a very busy children's hospital that does about 700 congenital heart surgeries a year and there are probably 7-10 cardiologists and 3 surgeons. Congenital heart surgery would be a horrible way for you to go if you want to see your family, but peds cardiology is definitely workable!
To answer someone else. What I have heard regarding the West Coast is UCSF(by far #1...among the top in the US), UCLA, USC (children's of LA), Stanford, and possible OHSU. UW actually doesn't have a peds cardio fellowship yet.

 

[arydolphin]

I'm in the process of applying for pediatric cardiology fellowships right now. After talking with one of the better attendings at my school, here's a quick rundown on cardiology programs. There are about 45 programs overall in the US. The big 4 in terms of prestige are Boston, CHOP, Michigan (Ann Arbor), and Baylor (aka Texas Children's in Houston). Like dsherida said, UCSF is the top dog in California, but my attending has also heard good things about Portland. Seattle Children's does not have a program yet, but will be starting one in July 2007. One of scholes's posts from 2005 is spot on in terms of the other programs that are held in good regard. PM me if you want some more info on programs to look at and programs to stay away from.

From what I've seen in residency, I'd say that Peds Cards vs. Peds Critical Care run neck-and-neck in terms of hours on the job, though I've also heard of Peds Heme-Onc attendings working crazy hours at some places. Really, if you find something that you love doing, the hours won't be that big of a deal, and basically anything in Peds can be balanced with a family and home life.