Peds Emergency Medicine

[coldflare]

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I have always wanted to do pediatrics, and I fell for peds emergency in med school. I decided to do a pediatrics residency (rather than an emergency residency), and then a fellowship, for a couple of reasons: I wanted a strong pediatrics background going into fellowship, and I wanted general peds as my backup plan in case I ever burn out of emergency medicine (as many EM doctors do).

I was talking to my advisor this morning about my life goals and whatnot, and she suggested that I should consider the option of doing a second residency in EM instead of a fellowship in PEM. The advantages, as she stated, are the following: same time commitment (3 years), more pay after training, greater job market versatility (because many areas don't have the volume to support an EM doc who ONLY sees kids, but those areas are REALLY looking for an EM doc with peds experience). The disadvantages she listed: less training in academics/research, longer hours during a second residency, and less pay during the second residency.

So, there is a faculty member in my program who went this route and is now triple-board certified in Pediatric Emergency Medicine, Pediatrics, and Emergency Medicine. However, I read the eligibility requirements on the ABP and ABEM websites, and apparently, only those who completed their training in EM and Peds prior to 1999 are eligible to sit for the subspecialty boards; everyone else has to do a fellowship.

So the question is, is it better to be certified in Peds EM, but be unable to see adults, and thus be limited in the areas I can find employment? Or is it better to be certified in pediatrics AND EM, but not in the subspecialty, and thus keep my peds options open but possibly limit myself if children's hospitals start requiring doctors board certified in PEM?

Does anyone else have a take on this?

 

[oldbearprofessor]

Over the years, a few folks have weighed in on this:

http://forums.studentdoctor.net/showthread.php?t=331399

http://forums.studentdoctor.net/showthread.php?p=5731730

are two of the threads on this.

Personally, I recommend not getting in the middle of this difficult decision and just doing a neonatology fellowship.😛

j/k...

Really, decide how you feel about taking care of adults as well as kids and about your interest in academics and similar issues and go with what seems right to you.

 

[bks524]

It is a dificult decision. I have friends who have done both.

EM and Peds: all the things you said above are true

Peds EM: limited areas to work in. Must have dedicated Peds ER which means larger cities. You do have some experience with the fellowship, but not enough. Also, compensation is less

Other caveat is that Peds EM is a very difficult board. I have heard as low as 40% so I don't think passing the board exam is that important. Now, eligibility between Peds EM and combo doesn't make much difference in my view.

The other limitation is the lack of dedicated Peds EM training in the combo. I work in a peds ER and only have board cert in peds. The medicine is fairly different-so I would like to have that dedicated training. But i would also like the flexability to live in a smaller town.