Peds/EM vs. EM/peds vs. joint residency

[EMDOC]

what is the difference in job description if you do a EM residency with peds fellowship or vice versa?? Or even the joint residency at U of Maryland or at University of Indiana at Purdue? Does anyone know how the different routes vary in competiviness, hrs, or $$$?? thanks for the feedback

EMDOC

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[Pelivar]

what is the difference in job description if you do a EM residency with peds fellowship or vice versa?? Or even the joint residency at U of Maryland or at University of Indiana at Purdue? Does anyone know how the different routes vary in competiviness, hrs, or $$$?? thanks for the feedback

EMDOC

You should do a search on Peds EM, we have discussed this before. Briefly, if you do Peds then a Peds EM fellowship you can only work in a dedicated peds ED. If you do EM then a Peds EM fellowship you can work in a dedicated peds ED or a normal ED (but you would be wasting 3 years on a fellowship if you did that). With the combined programs most graduates work in normal ED's that see children. Most academic Peds ED's want fellowship trained people, but their is a good market for EM people with extra peds training in the community setting. You will make less money in a Peds ED and you will not make any more in a normal ED with extra peds training. So don't do it for the money.
Since thier are only 2 Peds/EM combined places with 4 spot the competitiveness varies from year to year. Peds EM fellowship are very competitive (for peds). I would only consider doing the combined program or fellowship if you love the ED atmosphere but don't like treating adults and don't mind making less money while doing twice the training. You can do the standard 3-4 year EM residency and treat all the children you like as well as adults. Just my 2 cents.

Pelivar

 

[Seaglass]

Most people go Peds-> Peds EM because they a) don't like adult patients, b) decide they don't like office-based peds and c) they want to make more money.

Most people go EM -> Peds because a) they don't like office based medicine or inpt. medicine, b) they decide they don't like seeing drunk adult whinos every night, and c) they don't care as much about the money.

Most people go Peds/EM because they a) like adult medicine but like peds a lot more and also hate office based medicine and aren't sure what they want to do in life or want to subspec in Peds CC or something like that. Or they want to be a really damn good peds ED doc.

The type of medicine you can practice after each path is a little different. In peds/EM dual boarded you can practice straight EM in a mixed population ED, straight outpt. peds, a mix, or whatever. You have the most flexibility with this one.

In EM->Peds fellowship you can practice straight EM or in a Peds only ED. This training makes you qualified for positions as an attending in an academic Peds ED. It has little benefit elsewhere since regular boarded EM docs are already fully qualified to treat children in the ED. FYI the pathway for this is 3-4 years EM res then 2 year Peds EM fellowship.

The Peds -> Peds EM path is in many ways the most restricted. You can practice any variety of Peds or in a Peds ED. You may not practice in an ED that sees adult patients. This training makes you qualified for positions as an attending in an academic Peds ED. I hear the pay is slightly better than straight Peds. The track is 3 year Peds res -> 3 year Peds EM fellowship.

C

 

[EMDOC]

thanks for the speedy reply. What level of training and specialty are you guys at??

 

[EMDOC]

Is it the same genral rule in ER/Peds at a Peds only ED that as a attending at teaching hospital makes less than being a part of a group, etc. contracted out to the hospital. I apogize for my lack of formal knowledge about system because I am only a MS3 trying to figure all this out.

 

[Apollyon]

For all peds residents, peds fellowships are 3 years (mandated by AAP). For half the peds EM programs that take EM grads and peds grads, the EM track is 2 years, and peds is 3. The other half, everyone does 3. This sometimes engenders bad feeling, but, in others, there is a lot of research to round out 3 years, so, for those folks, that's great.

If you do EM/Peds, it's 5 years, you get board certified/eligible in EM and peds, but you can't sit for Peds EM boards, because you haven't done a PEM fellowship. Functionally, you're just as good, but you don't have the paper. As Seaglass says, if you're EM boarded, you are fully qualified to see all comers, prenatal to >100, psych to surgery.

 

[drcrusher]

For all the upper levels, thanks for your replies. This was a question I had been sitting on for a couple of months. DC

 

[Seaglass]

Is it the same genral rule in ER/Peds at a Peds only ED that as a attending at teaching hospital makes less than being a part of a group, etc. contracted out to the hospital. I apogize for my lack of formal knowledge about system because I am only a MS3 trying to figure all this out.

I don't know but I am going to guess yes, you make less, however EM/Peds has the option of moonlighting in a regular ED to make some extra cash.

C