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Peds Anesthesia 2017

Discussion in 'Anesthesiology' started by Justice4all, Feb 8, 2017.

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  1. Justice4all

    Justice4all 2+ Year Member

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    Just wanted to start a thread for this year applicants. All inputs about programs appreciated by current fellows and past class of interviewees.
     
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  3. bababa

    bababa 2+ Year Member

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    Anyone who had interview invitations yet?
     
  4. IlDestriero

    IlDestriero Ether Man Physician Faculty 10+ Year Member

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    The ivory tower.
    Here's a question to ask the Fellowship Director. Find out how hard it is for the fellows to get good jobs. The word on the street is that it is becoming much harder, many children's hospitals expanded over the last few years and are not hiring, many fellows going into combined adult and peds jobs, discussions in the society about cutting the number of fellowships offered, etc. See if they blow smoke and then ask the current fellows how it's going with the job search and how happy they are with the results.


    --
    Il Destriero
     
    FFP likes this.
  5. Justice4all

    Justice4all 2+ Year Member

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    Thanks Ildestriero .What are the top ten programs regardless of location?
    Nationwide Childrens and Jackson Memorial interviews invitations so far.
     
  6. PonyUp

    PonyUp Physician 5+ Year Member

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    I matched into peds in the last cycle and start in July. I interviewed at 13 programs and there was only 1 program director in the lot that brought up your concerns. With that said, a coresident/friend that did fellowship at the same shop where the warning about the job market for peds was articulated during the interview day told me that 100% of their large number of fellows had no problems finding a job and she [and most of her colleagues] had multiple prospects/offers. The other contacts I've got that were CA3s at my program last year [meaning current peds fellows] all have jobs [got them in October-ish].

    Perhaps it's a regional issue? Is your comment based on your own program or based on what you've heard from other programs as well?
     
  7. PonyUp

    PonyUp Physician 5+ Year Member

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    There is no such list. Depends on your goals, where you want to work, what kind of practice you're looking to find, how many colleagues you want, and what you want to do in fellowship.
    You will hear many programs preach that the ACGME has been the great equalizer and that you are mandated to get similar training at most institutions. You'll be shown exactly what fellows accomplish in their year of fellowship when you interview there.
    The fellows will tell you what life is like, and then you pick the place that will make you happiest and allow you to accomplish your career goals.
     
    AdmiralChz likes this.
  8. ambiturner

    ambiturner ASA Member 7+ Year Member

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    This is a great point. Finding a job doing only peds has been very difficult the last few years, outside of the few places that are expanding heavily (Texas comes to mind). In general your best chance at getting one of those jobs is to stay where you were a fellow.

    If you want to do combined adults and peds you'll have no problem getting a job.
     
  9. kidthor

    kidthor meep 10+ Year Member

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    My impression is that private practice almost requires that you'll be doing combined peds/adults. Academia will allow for some combined jobs, and some pure peds jobs.
     
  10. Shinkansen

    Shinkansen 2+ Year Member

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    It'd he helpful if current fellows would chime in with the job types they were offered.
     
  11. ambiturner

    ambiturner ASA Member 7+ Year Member

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    One person's opinion, granted I was looking a couple years ago but now work in academics and it seems things haven't changed much:

    I looked for jobs at academic children's hospitals. I got bites from the places that were hiring externally, and did not from places that either 1) weren't hiring or 2) hired their own fellows first. This highlights an important point which is that being a fellow gets you the best chance to get a job at a particular place. I think being from a top program helps but is not essential. Doing a second year is often required at some of the top places, but they tend to waive that requirement if they get short staffed. A lot of it is luck (which depts are expanding, who in the group is retiring in a given year, etc).

    People in my class who looked for jobs in academic mixed practice got offers almost everywhere they applied - these groups are big (~100 anesthesiologists or more) and they are almost always looking to hire. Fellowship training is always welcome in big departments - if you're willing to do sick adults, OB, etc then they will be happy to have you.

    Good private practice jobs are usually word of mouth - I did get a few personal emails from desirable PP groups, and got them solely based on relationships I had with faculty from residency/fellowship. There's always an abundance of average groups looking for pedi folks. I think doing the fellowship gives you an advantage and you will get lots of emails from groups looking for people who can do pediatrics.

    So the bottom line is you will get a job, but it takes a combination of luck, academic ambition, and flexibility to do 100% academic peds. Feel free to PM if you have specific questions.
     
  12. kidthor

    kidthor meep 10+ Year Member

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    Agreed... I'm currently looking and have very good offers from both academic and PP jobs... and I have a very limited job search due to my personal city interests. Per some colleagues, the market last year in my city was tighter. So yeah, luck, ambition, and flexibility are key - and you WILL get a decent job.
     
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  13. IlDestriero

    IlDestriero Ether Man Physician Faculty 10+ Year Member

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    The ivory tower.
    No it's not a regional issue. Our fellows all get jobs. I'm not aware of anyone in any field of anesthesia that can't get an ok job, even if it's "just" 350 at the AMC on the beach in Florida.
    The good 100% peds jobs are definitely harder to find and more selective, the post recession boom is over. Places that were planning to expand have already for the most part. It's not clear to me that one needs a peds fellowship at all for many combined adult/peds practices. It's likely not adding much value, complex peds skills are quickly lost, and you lose a year of income.
    These are not my concerns, they're the concerns of many at the SPA. I'm definitely in favor of cutting fellowships. You don't need to train 200 people a year for 100 real jobs and assist in artificially creating some false barrier to entry exploited by PP groups and administrators that hurts residents and offers little or nothing to the patients.


    --
    Il Destriero
     
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  14. WholeLottaGame7

    WholeLottaGame7 10+ Year Member

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    Right here.
    Bolded/italicized points above are the key. Just like with fellowships taking residents, if there's a tie (or near-tie), it's always the safer bet to take the homegrown applicant whose flaws are known, rather than the wild card.
     
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  15. amp3r5and

    amp3r5and 10+ Year Member

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    MDApps:
    I also received one from Nationwide - didn't get a confirmation though after I emailed back my preferences. you?
     
  16. Justice4all

    Justice4all 2+ Year Member

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    Feb 19, 2014
    it took approx 3-4 days for confirmation email
     
  17. amp3r5and

    amp3r5and 10+ Year Member

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    curious as to how many places people applied to and are aiming to interview with...
     
  18. PonyUp

    PonyUp Physician 5+ Year Member

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    I applied to 13 and interviewed at 13 last cycle. I wouldn't apply somewhere you wouldn't go. I wouldn't apply to more than you are "aiming to interview with" because that would be a huge waste of money.
    The average for my coresidents was 6-7 for peds, one interviewed at 9 or 10 and one interviewed at 4-5. I was definitely at one of the extremes [had a very particular goal in mind] but I'm glad I was able to see each of the departments. It certainly helped to make my decision.
     
  19. Shinkansen

    Shinkansen 2+ Year Member

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    I'd love to hear any input/first impressions/case load/variety/happiness/call schedule regarding Loma Linda, Johns Hopkins, CHLA, University of Chicago, WashU. Heck, any current input on any programs would be welcome!
     
  20. amp3r5and

    amp3r5and 10+ Year Member

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    Anyone heard back from DC children's or CHOP?

    Sent from my SM-G930V using SDN mobile
     
  21. Shinkansen

    Shinkansen 2+ Year Member

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    I have not heard from either of those. Anyone heard from UW Seattle Childrens or Colorado?

    If it helps anyone, Ive heard from WashU, Miami, Yale, NYU, Michigan, Texas Childrens, Arkansas, Wisconsin, U Chicago, CHLA, Loma Linda, Hopkins, Mayo Jax, Nationwide.
     
  22. amp3r5and

    amp3r5and 10+ Year Member

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    In addition to what you posted, I've heard from OHSU,Cincinnati, Boston, MCW. I just heard from UW this afternoon.

    Sent from my SM-G930V using SDN mobile
     
  23. JK61587

    JK61587

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    as far as places asking for Basic exam report...do they want a copy of the letter that was mailed? because i tossed that. anyone know where i can get a copy? anyway it seems like a pretty good way of them getting a "score" for a test that was never meant to be used to set a bar for fellowship-they just count up your key words. :/
     
  24. amp3r5and

    amp3r5and 10+ Year Member

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    Aug 19, 2007
    MDApps:
    Not the letter with your key words but the one that says pass

    Sent from my SM-G930V using SDN mobile
     
  25. amp3r5and

    amp3r5and 10+ Year Member

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    Aug 19, 2007
    MDApps:
    Does anyone have any insight or opinions of nationwide Columbus or Texas children's? Looking for thoughts on program,reputation, location,quality of life

    Sent from my SM-G930V using SDN mobile
     
  26. PonyUp

    PonyUp Physician 5+ Year Member

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    Nationwide seemed like a diamond in the rough when I interviewed there. Well funded, nice interviewers, continually building. PD was very affable. Definitely on the smaller size as far as # of fellows relative to the amount of cases they do, you are clearly there for maximum fellow benefit as opposed to being a workforce. I got the impression the fellows were doing babies/the best cases each day. I'm not from the midwest nor do I know much about Columbus other than there are a ton of companies headquartered there if you have a spouse not in medicine as I do. Only perceived flaw I had coming away was catchment area - seems like a lot of good programs [Cincy, Rainbow, Nationwide] all on the same block, but Nationwide is brand spanking new and flush with $$$$.

    TCH is a top tier program in the nation's largest medical center. There is not much more to say. Houston is great, it's where I hail from originally. I have several friends that matched there previously, a current fellow, and 2 in the incoming class, and the only gripes I have heard have been about the # of mandatory/QI/research projects you are expected to perform relative to the time given to accomplish them. Other than that, they all want to stick around. TCH is expanding their department at remote sites, the PD mentioned hiring something like 14 people in the next several years to staff up the woodlands, but with the caveat that if you are hired to work at the woodlands or katy campus that is where you will stay. The prospect of sticking around after training seemed good. You wont miss out on anything training there.

    Obviously these are just my opinions after interviewing last year/based on what my friends/colleagues have shared, and everyone will have different feelings about different places. If you've got ??s about Boston, CHOP, Northwestern, Emory, Stanford, Vandy, Cincy, UTH, UTSW, WashU, Hopkins I can give my .02 if needed.
     
  27. Shinkansen

    Shinkansen 2+ Year Member

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    Jan 4, 2014
    I would love all your cents on Hopkins, WashU, Cincinnati, Vanderbilt, and Emory!
     
  28. PonyUp

    PonyUp Physician 5+ Year Member

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    Hopkins - A coresident matched there- 2 of the 4 of us that applied from my program really liked the place and ranked it super highly, I however had it further down my rank list. Program director there was fantastic and charismatic. She was super high-energy and enthusiastic during an otherwise fairly low-energy interview day. The fellow that toured us around kind of gave the impression "come here if you want to be at hopkins" but didn't really sell the program or any strengths other than talking about high-bloodloss spines that they do a lot of. I got the feeling a lot of their cardiac volume went to DC childrens when I asked about it, didn't seem like a problem if you aren't planning on doing pedi-cardiac with your life, but for me that was a dealbreaker [kinda weird since Blalock and Taussig were at Hopkins but whatever]. Everyone was nice at the program. It was the only place I interviewed where the pedi hospital is integrated into the adult hospital.

    WashU - got the impression that "like dissolves like" and they take a lot of their own. Outside the department meeting the AM of our interview while walking around the hospital with the PD, it was clear that it was a very very personal program where everyone at Children's was on a first name basis with everyone else which really appealed to me. It was one of these situations where I loved interacting with the PD but some of my other interviewers didn't really feel like warm and fuzzy pediatric anesthesiologists, and kind of felt like they were being forced to go through the motions. Got the impression that they do a lot of sick kids which I was looking for in a training program. Not sure what the status of their Cardiac surgeons is currently but their main guy left for Cardinal Glennon [SLU] which means their volume dropped substantially. Hopefully he's been replaced by now.

    Cinci- always a perennial favorite on SDN and for good reason. A former senior resident was one of my interviewers and the program had clearly served her well [she got the job that she wanted early in her fellowship year]. All of my other interviewers were highly accomplished personable people. I ranked it highly and the only reason it was lower than other spots was because I had no ties to Cincy. I really appreciated that the PD basically levels with you during the interview day and is very open about job market, fellowship tasks, etc. Felt like he had being a PD down to a science. No BS.

    Vandy- coresident matched there. I loved everything about it except for case complexity seemed to be on the less-sick side of things [and when I asked a friend from med school at Vandy for residency about it at ASA this year, he confirmed I might want sicker kids as a fellow], and for someone that wants to pursue advanced pedi cardiac training they basically told me they don't to a whole ton of hearts, which is fine. I would LOVE to get a job in this department someday. The hospital/department/faculty were all extremely affable, and the city is amazing.

    Emory- It's another place where I would love to get a job someday. I feel like it doesn't get enough love. Tons of sick kids. Tons of cardiac volume [moreso than a lot of the big names actually]. Excellent transplant volume. I think it would prepare you well for a career in academics because Egleston has a huge catchment area and the weird stuff that comes through the door is kind of insane. The interview day was way laid back [a bit too much in my opinion], the only place where you pop scrubs on and get to meet residents/fellows/see the inside of an OR. I think they are working on their pain experience and have recently hired several new staff members to augment that.

    Hope that helps. Once again, this is all my opinion - and my experience and beliefs may not reflect what you see/feel on your interview day. Go with wherever feels right and you wont be disappointed.
     
  29. amp3r5and

    amp3r5and 10+ Year Member

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    I'd love to hear thoughts on Boston ,CHOP , and northwestern. Also which program did you end up at?

    Sent from my SM-G930V using SDN mobile
     
  30. michigangirl

    michigangirl Physician Faculty 10+ Year Member

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    PonyUp is correct in that our cardiac volume was lower the 2 years ago but not anymore. At the time we had a total of 1.5-2 full time peds cardiac anesthesiologists and no dedicated PCICU. Now we have 4.5 full time pediatric cardiac anesthesiologists and a physical space dedicated to PCICU. So very different now. Being integrated into an adult hospital, IMHO, is a very cool thing. Happy to share more by DM. good luck.
     
    PonyUp likes this.
  31. SgtThunderfistMD

    SgtThunderfistMD 2+ Year Member

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    As someone about to start residency wanting to do peds, what are the most important things for fellowship placement?

    Residency prestige, resident evals, ITE's, AKT's, ABA's, LOR's, connections?
     
  32. PonyUp

    PonyUp Physician 5+ Year Member

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    Great to hear! One of my good friends/coresidents will be with you starting in July!
    Re: part of a bigger hospital - I bet it's nice to have some of the less common ancillary services that an adult hospital provides in house - wasn't meaning to be critical!
     
  33. michigangirl

    michigangirl Physician Faculty 10+ Year Member

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    I know you weren't being critical! :)
     
  34. WholeLottaGame7

    WholeLottaGame7 10+ Year Member

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    Right here.
    How do you have a half, full-time peds cardiac anesthesiologist??? "Meet Dr. X. 50% of the time, he works 100% of the time..." :laugh:
     
  35. PonyUp

    PonyUp Physician 5+ Year Member

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    PM'd. Hoping to maintain some anonymity.
     
  36. bababa

    bababa 2+ Year Member

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    Yes please. I would like to hear your opinion about CHOP.
     
  37. amp3r5and

    amp3r5and 10+ Year Member

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    Last edited: Mar 27, 2017
  38. PonyUp

    PonyUp Physician 5+ Year Member

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    I'm going to mention Boston in here too because the programs sell themselves as similar, and they both offer top tier training, but with some tradeoffs.

    I was told by a friend at that finished at children's in June that if you werent a known quantity/resident that rotated through boston childrens as a resident that you didnt get trusted for a few months when cases are assigned, so you're kind of treated as a second class citizen as an outsider with a different learning curve. It makes sense, and I'm sure it's the same way at other programs [known quantity from in the program versus new to the hospital, etc.] With that said, he couldn't sell it any harder, and he absolutely loved it. He had job offers starting in October based on the very fact that he was a fellow there [without having met him], and he got a badass gig coming out. When you interview, I would ask a fellow how the post-call days are handled [when I interviewed, you spent it in preop clinic], and that was something everyone wanted to change.

    Boston and CHOP are awesome hospitals with sick as can be patients and offer premier training, and nobody will dispute that. With that said there are a TON of residents in Boston that are constantly rotating through, so the prospect of not being given the awesome cases as a fellow up front seemed upsetting [I confirmed it with the fellows that came to the interview dinner when I interviewed]. With that said I LOVED the cardiac faculty and they are probably #2 for pedi cardiac behind TCH. I ranked Boston highly [and I think most people do].

    As far as CHOP - sold themselves as a workhorse program, with the most badass surgeons around [they sell how quickly their pump runs are in their interview day]. Tons of their fellows got academic jobs straight out of fellowship [northwestern, Cornell, UCSF IIRC as far as last year's class]. I ranked them highly as well but didn't have any friends in the program or ties to the city so I ranked them just below Boston. It certainly wont limit you, they offer top of the line training.

    I will say again, that fit is the most important thing about a fellowship.
    None of the ones I interviewed at would put me at a disadvantage when looking for an academic job, but the upper echelon might get you jobs sight unseen as I had mentioned. I did due diligence while interviewing to seek out the departments I would want to land in after fellowship. Most people only interview at 6 or 7.

    I really don't have many negative things to say about any of the programs to which I applied, and for the most part only regretted that I didn't go take a look at UW, Denver, and CHLA. I didn't know to apply but those are also programs worth mentioning in the same category as my other interviews based on what other applicants/interviewees noted during our discussions on interview days.
     
  39. pgg

    pgg Laugh at me, will they? Moderator 10+ Year Member

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    Home Again
    The USMLE was never "intended" to be used for ranking residency applicants either ...
     
  40. JK61587

    JK61587

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    Any ideas which programs start July 1 and which will be Aug 1, or which are flexible on start date?
     
  41. amp3r5and

    amp3r5and 10+ Year Member

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    Nearing the end of interviews, thankfully (so tired and so broke)
    Any thoughts from folks out there who have completed training -- how important is it really for anesthesia fellows to be doing the central lines on cardiac cases? esp if you don't think you'll be doing cardiac
     
  42. ambiturner

    ambiturner ASA Member 7+ Year Member

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    Central lines are a rare part of peds practice. We usually do picc lines for non cardiac cases that we think will need central meds (complex spines, transplants) or long term access, and surgeons place tunneled lines in onc kids. That said, I think it's essential to be able to do a quick ultrasound guided fem or IJ line in small kids, but any good training program will get you that, especially if they have a picu rotation.
     
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  43. 2010houston

    2010houston Resident Physician 7+ Year Member

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    The lack of lines did concern me at some programs. Doing lines with IR is not the same as doing them in the OR. Whether or not this matters in the long run, I don't know!
     
  44. IlDestriero

    IlDestriero Ether Man Physician Faculty 10+ Year Member

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    The ivory tower.
    It's not a hard skill at all. This is one time when kids really are just little adults, though you'll do them all after induction.
    You should get enough lines in your regular cases if cardiac doesn't do many.
    I wish they had the foresight to do more PICC lines up front before some complex cases.


    --
    Il Destriero
     
    2010houston likes this.
  45. amp3r5and

    amp3r5and 10+ Year Member

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    Congrats to everyone who matched. Hope people landed where they wanted!
     

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