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peds EM vs. neonatology

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rina33

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I'm close to applying for residency and strongly considering these two fields. They are both awesome in their own ways- I am just trying to sort out some of the finer details. How do you think these compare in terms of lifestyle-- schedule, income, and flexibility? Which one do you think is better in terms of family and kids? Is part time work just as feasible in either field ? I'm trying to decide how difficult shift work (rotating schedule and irregular hours) will be later on in my career as compared with the call schedule of neonatology would be worse. Is there an option to work fewer nights as you get more senior in peds EM and is there an option to have more control over your call schedule in neonatology after more years in practice? Do neonatologists ever do home-call or is it mostly in-house? Do neonatologists have the chance to do a fully clinical career after residency without research? I know I have a lot of questions- so thank you! Any opinions on any of these issues would be welcomed!
 

oldbearprofessor

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rina33 said:
I'm close to applying for residency and strongly considering these two fields. They are both awesome in their own ways- I am just trying to sort out some of the finer details. How do you think these compare in terms of lifestyle-- schedule, income, and flexibility? Which one do you think is better in terms of family and kids? Is part time work just as feasible in either field ? I'm trying to decide how difficult shift work (rotating schedule and irregular hours) will be later on in my career as compared with the call schedule of neonatology would be worse. Is there an option to work fewer nights as you get more senior in peds EM and is there an option to have more control over your call schedule in neonatology after more years in practice? Do neonatologists ever do home-call or is it mostly in-house? Do neonatologists have the chance to do a fully clinical career after residency without research? I know I have a lot of questions- so thank you! Any opinions on any of these issues would be welcomed!


http://forums.studentdoctor.net/showthread.php?t=132715&page=1&pp=25

Dear Rina33:

The above linked thread, especially after about post 40 or so, has some long discussions of this topic. I hope that some mod (I know that more than a couple read the pedi threads :p ) will eventually sticky one of these to make it easier to find this rather common discussion.

In terms of your specific questions relating pedi EM to neonatology, keep in mind that the usual route to a career doing only pedi EM, at least in Children's Hospitals, is via a residency in pedi followed by a fellowship in ER. Since neonatology goes through a pedi residency too, then, assuming you are starting your 4th yr of medical school now, you have at least 2-2.5 yrs before you'd have to decide between the two. Lots of time to see the fields up close.

In general, the two fields are very different. Although I like to take care of sick patients, I really didn't care much for the ER at all. In terms of shift work in neo, we've addressed this in several threads, but I think it's safe to summarize by saying that large NICU's have virtually all gone to in-house call, which means increasingly more shift work. For example, one of our fellows finishing up just got a job working 24 hrs every 5th day and that's it. As I've indicated before, with a family, I PREFER in-house call in neonatology when covering a busy NICU. The family gets woken up less and it's much less stressful to be there than to guide a trainee from home wondering if you should really go in to the hospital.

In terms of research, ALL NICU fellows must do a research project as part of their fellowship. Someday this requirement may get altered, but it hasn't yet. I don't know the specific rules for pedi EM, but I think that some research is required, although it tends to be more public policy and clinical than most NICU fellows do.

I would summarize by just saying that you should identify the career that you like the most. If it is EM and includes adults - then do an adult EM residency. If you only want to work with kids, then do a pedi residency and talk to a lot of people during your internship about these issues.

Regards

OBP
 
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