Peds and CCM fellowships

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ToKingdomCome

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What would the application process be like since You apply in different CA years? Has anyone done both these fellowships before? Would one theoretically see a boost in salary in academics after doing both these fellowships? I know I’m going to get chastised and be told “I’m wasting my time” by doing both
 
ToKingdomCome said:
What would the application process be like since You apply in different CA years? Has anyone done both these fellowships before? Would one theoretically see a boost in salary in academics after doing both these fellowships? I know I’m going to get chastised and be told “I’m wasting my time” by doing both
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No, you're not wasting your time. We need trainees, even for life. You may even need 2 years of CCM, just to be able to take care of your peds patients. I only had one month of PICU during my year of fellowship, definitely could have used two.

You're basically getting into peds plus geriatrics. Your breadth of passion and future competence is beyond admirable. I am sure every employer will be just speechless. You'll be more respected than the IM-Peds people. The academic hospitals will gladly pay you extra for being the pediatrician in the adult ICU and the adult intensivist in the pediatric ORs; imagine how much you could teach in both places about the other.

We need more real doctors like you, especially in rural Alaska. You will give a new meaning to "well-rounded physician", more than just being obese.
 
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FFP said:
No, you're not wasting your time. We need trainees, even for life. You may even need 2 years of CCM, just to be able to take care of your peds patients. I only had one month of PICU during my year of fellowship, definitely could have used two.

You're basically getting into peds plus geriatrics. Your breadth of passion and future competence is beyond admirable. I am sure every employer will be just speechless. You'll be more respected than the IM-Peds people. The academic hospitals will gladly pay you extra for being the pediatrician in the adult ICU and the adult intensivist in the pediatric ORs; imagine how much you could teach in both places about the other.

We need more real doctors like you, especially in rural Alaska. You will give a new meaning to "well-rounded physician", more than just being obese.
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Brutal...

...but accurate.
 
vector2 said:
Just to be clear, you know you're not going to be able to work in a PICU after doing peds anesthesia and adult CCM, right?
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Exactly. In the last year I think there was an editorial about this in Anesthesiology. The only way to sit for PCCM boards (and get hired in PICU) is to do it through Peds currently with a 3 year fellowship I believe (might be 2 with an extra year for cardiac ICU if desired?). The era of Anes CCM attending those units is ending if it hasn’t already (most were leftover from the 1980s). There is allegedly a need for more PICU docs but there is no interest by their board to allow us a bridge.

I did a month of Peds cardiac in fellowship and there were some quadruple (!!) boarded folks there who did it all - Peds Cardiac, CCM and Cardiac ICU - they were amazing rock stars but had spent more than a decade in training. I don’t know specifics but I am positive their salary did not reflect that much training.
 
ToKingdomCome said:
What would the application process be like since You apply in different CA years? Has anyone done both these fellowships before? Would one theoretically see a boost in salary in academics after doing both these fellowships? I know I’m going to get chastised and be told “I’m wasting my time” by doing both
Click to expand...

Anyway to more directly answer your question - you apply for CCM about halfway through CA-2 year around Christmas/New Years and Peds still in CA-2 but more like April-June.

Doing both won’t get your PCCM boarded and won’t get you into the unit so I doubt there are any out there that have done both through anesthesiology. More salary? Also no.
 
Agree that you can’t work in a PICU without peds residency —> peds CC (6 more years)..... so I’m not sure what you would achieve with anes residency, peds fellowship, CCM fellowship. If you’re trying to find a hybrid job where you could work in an adult ICU and still do peds anes, this seems really difficult to find and unlikely to work out.
 
2010houston said:
If you’re trying to find a hybrid job where you could work in an adult ICU and still do peds anes, this seems really difficult to find and unlikely to work out.
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Nah, plenty of academic gigs where you could do it.
 
Are you a medical student or a resident? What’s your goal? Adult ICU or pediatric ICU. You can carve out whatever niche you want. Whether or not that maximizes your earning potential is a different story. If you are a medical student i would highly recommend finding an attending who does something similar to what you are interested in before starting down a very long training path with high opportunity cost. I think it would be very hard for me to keep up to date as a specialist in multiple fields with different boards.


Division of Critical Care Medicine | Meet Our Team | Boston Children's Hospital

Division of Critical Care Medicine at Boston Children's Hospital - Meet our Team
www.childrenshospital.org www.childrenshospital.org

 
There was a med student who shadowed me when I was a resident who did this. He did peds residency (3 yrs), anesthesia residency (3 yrs), peds CCM (2 yrs), and peds anesthesia (1 yr). NINE YEARS of post-grad training. He now splits time in PCCM and the OR at a major academic center. I started practice the same time he started his (first) residency, and I had 2 million in retirement savings by the time he became an attending. Money isn’t everything, but that is friggin’ nuts.
 
Where I am there are several multiple-boarded people that attend in either the adult ICUs or the PICUs along with anesthesia OR time. Everyone fellowship trained in my department makes about the same no matter how many "extra" fellowships they did. The only people who make a slight bit more are the OR peds cardiac folks, and I don't think it's much more (make 10k if that). If anything the people who do both OR time and ICU time (whether it's adult or peds) note it's hard for them to find jobs elsewhere that allow for the combo because this is just not a desired at most places.

If you really must be an ultra subspecialist it's best to do it in one very specific field within a field (e.g. peds cardiac, adult CVICU) because maybe you could get into an academic niche doing that. The combination of multiple parallel subspecialties is just not valued or practical.

Even one subspecialty is almost too much these days. because many places want a warm "provider" body to do generic adult OR cases without complaining too much.
 
B-Bone said:
There was a med student who shadowed me when I was a resident who did this. He did peds residency (3 yrs), anesthesia residency (3 yrs), peds CCM (2 yrs), and peds anesthesia (1 yr). NINE YEARS of post-grad training. He now splits time in PCCM and the OR at a major academic center. I started practice the same time he started his (first) residency, and I had 2 million in retirement savings by the time he became an attending. Money isn’t everything, but that is friggin’ nuts.
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That seems not too uncommon. There were/are several pediatric intensivists at our local children’s hospital who did the same. They also split time between PICU and OR.
 
nimbus said:
That seems not too uncommon. There were/are several pediatric intensivists at our local children’s hospital who did the same. They also split time between PICU and OR.
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It’s common enough to do pediatrics, anesthesia, and pediatric anesthesia +/- pediatric icu, but I don’t think it’s common at all for that to be your plan or to do anesthesia then peds. I suspect that almost all of those people did peds first then anesthesia + peds fellowship. I also think that if they had it to do over again, almost none would do peds residency.
(Not that peds isn’t a great specialty but given the subset of pediatricians who later did an anesthesiology residency, I bet they’d take the 3 years back vs any added competency they gained from pediatrics residency as future pediatric anesthesiologists.)
 
vector2 said:
Just to be clear, you know you're not going to be able to work in a PICU after doing peds anesthesia and adult CCM, right?
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I think there’s an attending at university of Michigan who did CCM and Peds and splits time between PICU and Peds OR.
 
Where I am, you get an extra $2000/yr for fellowship training. So if you work for 150 years, you make up the opportunity cost!

Obviously more complicated than that, maybe the job you want requires a fellowship, maybe you have more mobility, maybe your position is more resilient in the case of a downturn. Lots of reasons to do fellowships, money probably not being one of them.
 
zevilempire said:
I think there’s an attending at university of Michigan who did CCM and Peds and splits time between PICU and Peds OR.
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Every now and then you'll find someone who was grandfathered in. One of our faculty in residency was Peds-PCCM-Anes-Peds Anes trained and she told us that pretty much outside of a very occasional community shop, you won't be able to staff a PICU in any kind of tertiary center nowadays without peds/pccm boards.
 
Peds anesthesia fellowship director at my shop is also dual peds and anesthesia trained. Told me clearly. Peds anesthesia makes more money than picu, why go through those extra years?
 
The combined peds anesthesia & peds critical care faculty make less because PICU attendings make less than anesthesiologists. Though their clinical time commitment is less also. There are a few at my shop. They’re a special breed.
Why not break new ground and do a NICU fellowship and anesthesia. I’d love to dump some of my NICU septic NEC washouts and TEF and CDH repairs on you, I mean give you all of these complex patients that you are far more capable of managing than a dumb gas guy like me:
 
IlDestriero said:
The combined peds anesthesia & peds critical care faculty make less because PICU attendings make less than anesthesiologists. Though their clinical time commitment is less also. There are a few at my shop. They’re a special breed.
Why not break new ground and do a NICU fellowship and anesthesia. I’d love to dump some of my NICU septic NEC washouts and TEF and CDH repairs on you, I mean give you all of these complex patients that you are far more capable of managing than a dumb gas guy like me:
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NICU+anesthesia has been done. During residency, one of my classmates was a neonatologist. He set up a CA-3 NICU elective for us which was a very good (educational) experience. Part of the rotation included doing the anesthesia for all the NICU babies that went to the OR. The bad part was 5-6 hours of rounding after q3 24 hours on duty. Those pediatricians worked hard.
 
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nimbus said:
NICU+anesthesia has been done. During residency, one of my classmates was a neonatologist. He set up a CA-3 NICU elective for us which was a very good (educational) experience. Part of the rotation included doing the anesthesia for all the NICU babies that went to the OR. The bad part was 5-6 hours of rounding after q3 24 hours on duty. Those pediatricians worked hard.
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Me rounding in the SICU:

Me: are the tube feeds to goal?
Resident: yes
Me: ok, next.


Me as a med student in the NICU:

attending: is the baby getting enough nutrition?
Me: yes
Attending: I’m gonna need you to measure the baby’s formula, free water, MIVF, piss, sht, insensible losses, and expired CO2 with a mass spectrometer
 
nimbus said:
Yup
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I’ve posted this before but, favorite Greeny moment:

At Rady children’s. Premie neonate on the table. Getting progressively more difficult to ventilate. Greeny concerned about pneumo. Calls for X-ray.

Greeny (to X-ray tech): I need you to take a chest x-ray of this baby right now.

X-ray tech: OK. I need the baby’s name and medical record number.

Greeny: The name is dead f**king baby if you don’t take an x-ray right now.
 
Don't you just love all these suckers nice sincerely helpful people, while the OP doesn't even bother to say Thanks? 🙂

THIS is why I prefer not to give advice to generation Y or Z in real life.
 
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