peds/em...

[nkme]

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Hi! Want to do peds for sure, but was curious about the peds/er program... Was wondering if anyone knew how competative it is? (how hard is it to get?) Anyone here doing peds/er?- would really appreciate any feedback/info about the program ... thanks!! 🙂

 

[TeleoDeum]

Greetings!

I am am Peds Emergency Medicine fellow (PGY4) at Arkansas Children's Hospital in Little Rock, AR. Peds EM is a great speciality for those of us who like acute care and pediatrics. No diagnosing ADHD here (but maybe managing that Adderall overdose!). I like it for the good mix of general peds with a smattering of ortho, critical care, toxicology, adolescent, psych, gyn, trauma, and surgical diagnosis. The money can be better than Gen Peds too. Anyway...
To answer you question, if you have a pulse, you can do general Peds somewhere. Peds EM is somewhat more competitive. There are roughly 130 PGY4 spots in the US this year, with about 2.5 people applying per spot. Anyway, those are the number estimates. Keep up the thread if you have more questions.

Peace,
Greg

 

[bjackrian]

Thanks for replying Greg. I was wondering if you had an opinion on the peds residency-->Peds EM fellowship v. EM residency-->Peds EM fellowship options. Also, do you know much about programs like Indiana and Arizona's combined 5 year residencies?

 

[TexasRose]

Thanks for replying Greg. I was wondering if you had an opinion on the peds residency-->Peds EM fellowship v. EM residency-->Peds EM fellowship options. Also, do you know much about programs like Indiana and Arizona's combined 5 year residencies?

I think one of the major difference is that doing EM res--> Peds EM fellowship means you will be training in adult medicine during your residency. That means you can work in both adult and peds EM. It might be easier to get a job that way?

If you only want to work with kids, and are willing to go where there are jobs for strictly Pedi EM docs, then you should go the Pedi res --> Pedi EM fellow route.

That's what I learned from asking around in the Pedi ED. I'm sure TeleoDeum will have more insight to offer.

 

[geekOCD]

I think the OP was actually asking about peds/em combined residencies, of which there are 3 in the country...

 

[Stitch]

I think the OP was actually asking about peds/em combined residencies, of which there are 3 in the country...

That was my impression as well.

It's competitive in the sense that there aren't many programs, but last I had heard there weren't tons and tons of applicants. Don't know if that's changed. But you do come out double boarded in peds and ER, so it looks pretty good on the resume.

If you're looking at it, I'd say ask on the EM forum as well as here and talk to a number of docs who do peds ER and general ER to see what they think. It helps to know people who know people.

 

[deleted109597]

If you do the 5 year Peds/EM program, you are double boarded in peds and EM, but you do not have a Peds/EM board. You would still have to do a fellowship to get that board.

 

[geekOCD]

And to be honest, I don't really understand why anyone, unless for research reasons, would want to do the combined peds/em residency. General Peds and EM are very different specialties, and I don't think that graduates of these programs actually work in both environments as opposed to just picking one. And if they do just pick one, then what's the point? If you want to do EM and have a Peds background, do the Peds EM fellowship...

 

[bjackrian]

And to be honest, I don't really understand why anyone, unless for research reasons, would want to do the combined peds/em residency. General Peds and EM are very different specialties, and I don't think that graduates of these programs actually work in both environments as opposed to just picking one. And if they do just pick one, then what's the point? If you want to do EM and have a Peds background, do the Peds EM fellowship...

How about this: the State Department hires doctors to work as foreign service specialists in a lot of third world-ish countries. While there, you are primary care for other foreign service people and their families, and you're responsible for responding to emergencies, bioterrorism threats, pre-hospital care, etc. You also give advice on a lot of the in-country issues facing these countries (many/most of which are pediatrics issues). For that program, it seems to me like the EM would cover you well for the lack of resources and acute care visits (and to a lesser extent, adult continuity care) while the peds would be helpful for the kids care and for advising on in-country problems.

On a (sort-of) side note, the program requires its applicants to be boarded in EM, IM, or FP (peds doesn't meet the requirement). It also requires give years of practice post residency before you can apply. I'm frankly not that interested in practicing adult EM in this country, but really enjoy peds and peds EM. The combined residencies would allow me to meet the program requirements while still pursuing my interest.

Anyway, those are my two big reasons for considering these programs, even though I'm not overly interested in research. Does that make sense, or am I way off base?

 

[RuralMedicine]

And to be honest, I don't really understand why anyone, unless for research reasons, would want to do the combined peds/em residency. General Peds and EM are very different specialties, and I don't think that graduates of these programs actually work in both environments as opposed to just picking one. And if they do just pick one, then what's the point? If you want to do EM and have a Peds background, do the Peds EM fellowship...

I considered Peds-EM because I was inspired to do rural practice before medical school. During medical school I reaffirmed my commitment to rural practice and I finally admitted that Pediatrics was my calling (I fought if for a bit). At this point I felt like in a rural area although pediatrics was desperately needed providers capable of dealing with acute stabilization/critical care issues of children AND adults was as well. However, I was/am a NHSC scholar so I petitioned to do the combined program but was denied because "EM is not primary care" they did allow me to do Med-Peds and I intentionally picked a program that was EM/critical care heavy because of my intentions for rural practice.

 

[KidDoc29]

If you do the 5 year Peds/EM program, you are double boarded in peds and EM, but you do not have a Peds/EM board. You would still have to do a fellowship to get that board.

But who cares..... A combined program (Indy and U Maryland are the two established ones I know of) is really the best training you can get for Peds EM. First of all, you are trained in general EM. No question that you will have better skills at trauma, ortho, psych, gyn, and critical care than any Peds resident. Additionally you will be far more procedurally competent. You are also a fully trained Pediatrician - therefore know all the primarily outpatient medical stuff that is the bread and butter of a pediatric ED. I have always been skeptical as to what additonal skills one gains in a Peds EM fellowship, that you don't already possess after doing 6 months or so of Peds EM during your peds residency. I think what the fellowship provides you is dedicated time for research and academic training. This may or may not be important to you, depending on your career goals. If you want an academic appointment as a Pediatric EM physician at a Childrens Hospital, then you will likely need to do the fellowship route. If you want to be a rockstar clinician and have the skill and knowledge to treat congestive heart failure in a 90 year old post-MI patient AND an infant with a VSD, then the combined 5 year EM+Peds program is the clear choice. (And, by the way, opens WAY more doors in terms of career option, salary potential, and flexibility)

 

[oldbearprofessor]

But who cares..... A combined program (Indy and U Maryland are the two established ones I know of) is really the best training you can get for Peds EM. First of all, you are trained in general EM. No question that you will have better skills at trauma, ortho, psych, gyn, and critical care than any Peds resident. Additionally you will be far more procedurally competent. You are also a fully trained Pediatrician - therefore know all the primarily outpatient medical stuff that is the bread and butter of a pediatric ED. I have always been skeptical as to what additonal skills one gains in a Peds EM fellowship, that you don't already possess after doing 6 months or so of Peds EM during your peds residency. I think what the fellowship provides you is dedicated time for research and academic training. This may or may not be important to you, depending on your career goals. If you want an academic appointment as a Pediatric EM physician at a Childrens Hospital, then you will likely need to do the fellowship route. If you want to be a rockstar clinician and have the skill and knowledge to treat congestive heart failure in a 90 year old post-MI patient AND an infant with a VSD, then the combined 5 year EM+Peds program is the clear choice. (And, by the way, opens WAY more doors in terms of career option, salary potential, and flexibility)

Do you mean that you need 5 yrs to learn to give Lasix and call cardiology?😛

I don't agree that the best training for a career focused in pediatric emergency medicine is via a combined pediatric and emergency medicine residency, but I'll leave it for the others here to debate that issue. What I want to point out is that I have seen many folks start in pediatrics with an interest in emergency medicine and change their mind to other fellowship areas (including one recent resident whom I'm hoping has finally seen the light and will send in her neo fellowship application after this month in the ER😀 ) and of course, I've seen plenty who had no interest in pediatric EM decide on it while pediatric residents. So, for those who are less certain that some of the posters here about what they want to do, a combined program may be less than ideal. In other words, there is no single best route, although I still think that "most" would do best with pediatrics followed by pediatric EM fellowship.