Peds ER

[Dryacku]

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Hi... Can somebody please enlighten me on this field... Correct me If I am wrong... Its either ER and then Peds ER which is 5 years
or peds then er which is 6 years

Also what is the pay for something like peds/er...

also this is prob also answered but what is the avg number of shifts an er doc can expect to work a month, how many hours, and what is the salary this is for just er

also is it a good field for women who are looking raise children...

thanks

 

[EctopicFetus]

Hi... Can somebody please enlighten me on this field... Correct me If I am wrong... Its either ER and then Peds ER which is 5 years
or peds then er which is 6 years

Also what is the pay for something like peds/er...

also this is prob also answered but what is the avg number of shifts an er doc can expect to work a month, how many hours, and what is the salary this is for just er

also is it a good field for women who are looking raise children...

thanks

Ill take a stab since I am interested in the field. 1) there is also the option of doing a combined Peds/EM residency (only 3 places offer them Indy, Maryland and Arizona).
The difference between doing EM then Peds and Peds then EM is more than just 1 yr. If you do EM then Peds you are more marketable since you can see adults. The Peds then EM guys can not legally see adult patients.

From those I spoke with Peds EM makes a little less money but the hours are a little better. Fewer overnights etc.

 

[Dr. Wexler]

The Peds then EM guys can not legally see adult patients.

Is it really a "legal" thing? I was under the impression that a licensed physician could legally treat any medical condition (and by extension, any person). I thought the barriers to treating conditions/people you haven't been residency-trained to treat were more practical (malpractice insurance, insurance reimbursement, hospital privileges) than legal.

 

[OSUdoc08]

Is it really a "legal" thing? I was under the impression that a licensed physician could legally treat any medical condition (and by extension, any person). I thought the barriers to treating conditions/people you haven't been residency-trained to treat were more practical (malpractice insurance, insurance reimbursement, hospital privileges) than legal.

Since FP's can practice emergency medicine, it is obviously not a legal thing.

It may be hard to find a job in a good hospital, however.

 

[mysophobe]

I can see how it may turn into a legal thing if you screw up, and a patient claims you misrepresented yourself as someone with adult ER training.

 

[OSUdoc08]

I can see how it may turn into a legal thing if you screw up, and a patient claims you misrepresented yourself as someone with adult ER training.

Since a majority of ER's in the nation employ non board-certified EM physicians, I do not see this as a problem.

 

[BKN]

Since a majority of ER's in the nation employ non board-certified EM physicians, I do not see this as a problem.

It will be. . .It will be. (Yoda grimaces)

Do the EM first. Then, if you must, do the fellowship.

 

[deleted6669]

Since a majority of ER's in the nation employ non board-certified EM physicians, I do not see this as a problem.

but these folks are mostly fp docs who have training in seeing adults and kids. a peds doc who worked in a regular er would be basing all his decisions on stuff he learned his ms3 yr and hadn't seen since....scary......how many 65 yr old with mi's or disecting aaa's does an avg pediatrician see during their residency(hint: zero...I'm sure the lawyers know that too).even more benign stuff like copd exacerbations are completely outside the training of a pediatrician...might as well have a ortho doc looking at them.....and don't get me started on surgeons and ortho guys covering er shifts....talk about a nightmare......

 

[OSUdoc08]

but these folks are mostly fp docs who have training in seeing adults and kids. a peds doc who worked in a regular er would be basing all his decisions on stuff he learned his ms3 yr and hadn't seen since....scary......how many 65 yr old with mi's or disecting aaa's does an avg pediatrician see during their residency(hint: zero...I'm sure the lawyers know that too).even more benign stuff like copd exacerbations are completely outside the training of a pediatrician...might as well have a ortho doc looking at them.....and don't get me started on surgeons and ortho guys covering er shifts....talk about a nightmare......

I don't think I would have much greater trust in a Family Physician seeing me than a Pediatric Emergency Medicine Physician.

Either way, I'll be heading to a hospital with BC EM physicians.

 

[Squad51]

Is it really a "legal" thing? I was under the impression that a licensed physician could legally treat any medical condition (and by extension, any person). I thought the barriers to treating conditions/people you haven't been residency-trained to treat were more practical (malpractice insurance, insurance reimbursement, hospital privileges) than legal.

"Legal" in the sense of the law? No, there you are correct. "Legal" in the sense of regulations - maybe. Two bodies could be involved here. First, some states require only BC/BE EPs in trauma centers. An FP or a peds trained pediatric EP would violate this by seeing adult patients within the department. Second, the hospital's med-mal carrier might specify only BC/BE EPs (as there are oft quoted studies "proving" they are less likely to be sued). Again, a pediatric trained peds EP might violate this by seeing adults in the ED.

But you are correct, it would not be the practice of medicine without a license (but IMNSHO) it would be the practice of medicine without common sense.

 

[SoCuteMD]

One thing that I was told (by a Peds EM doc at a major medical center on the East Coast) is that the training for Peds EM docs varies by region. On the East Coast it is primarily pediatrics turned EM through a Peds EM fellowship. On the West Coast it is often EM turned peds through a fellowship. The people on the West Coast are often required to cover the adult ER as well during slow times.

He basically said that if I wanted to do peds academic EM in the Northeast that a peds residency followed by an EM fellowship would be my best choice. I've decided that I'll probably file that advice away and review it in third/fourth year and most likely disregard it, but it did come from a valid and valuable source.

 

[deleted6669]

I don't think I would have much greater trust in a Family Physician seeing me than a Pediatric Emergency Medicine Physician.

Either way, I'll be heading to a hospital with BC EM physicians.

Fair enough ...just don't get sick or injured outside of a major metro area and you should be fine.....a lot of the rural em in this country is still done by fp docs( and em pa's) and will be until there are enough residency trained/boarded em docs who have the desire to work in moosebreath, maine at a critcial access hospital seeing 12 pts/24 hrs.

 

[DeLaughterDO]

Ill take a stab since I am interested in the field. 1) there is also the option of doing a combined Peds/EM residency (only 3 places offer them Indy, Maryland and Arizona).
The difference between doing EM then Peds and Peds then EM is more than just 1 yr. If you do EM then Peds you are more marketable since you can see adults. The Peds then EM guys can not legally see adult patients.

From those I spoke with Peds EM makes a little less money but the hours are a little better. Fewer overnights etc.

EF;

Yes, there are these lovely Peds/EM combined residencies; however, one cannot be board certified in Pediatric Emergency Medicine by completing one of these residencies. At one time, this was possible, but this track was closed in the 1990s. By completing the combined residencies, one can be dually boarded in Pediatrics and Emergency medicine, but not Pedi EM.

Check out the links:

American Board of EM Requirements:
http://www.abem.org/public/_Rainbow/Documents/2-05 Revised PEM EC.pdf
(page 3 and 4)

American Board of Peds Requirements:
http://www.abp.org/certinfo/subspec/eligibil/emerelig.htm

 

[DeLaughterDO]

If your goal is to practice strictly Pediatric Emergency medicine, then you will most likely be working in the ED of a Children's hospital, and will be confined to larger metropolitan areas.

Otherwise, if you want to practice pedi and adult EM or pedi EM and pediatrics, then choose the appropriate GME program to fulfill your needs. It can work either way.

 

[EctopicFetus]

I don't think I would have much greater trust in a Family Physician seeing me than a Pediatric Emergency Medicine Physician.

Either way, I'll be heading to a hospital with BC EM physicians.

I fully assume you are kidding right? Honestly for all the flack FP gets those guys do know a lot. A peds person hasnt even heard of 1/2 the medicines 80 yr old granny is on from the nursing home. just because EM follows their name doesnt mean the Peds EM (peds first) person knows how to treat an older patient.

 

[EctopicFetus]

Is it really a "legal" thing? I was under the impression that a licensed physician could legally treat any medical condition (and by extension, any person). I thought the barriers to treating conditions/people you haven't been residency-trained to treat were more practical (malpractice insurance, insurance reimbursement, hospital privileges) than legal.

So when the psychiatrist does a CABG you let me know. Its all about liability.

 

[JackBauERfan]

So when the psychiatrist does a CABG you let me know. Its all about liability.

what? you've never seen a psychiatrist do a cabg?

haha, actually have you ever seen a psychiatrist wearing a stethescope. not me.

not a psych bashing, I wouldn't mind doing it, but they ARE specialists of the brain and seem not to worry about other stuff as much (just like most specialist fields).

 

[EctopicFetus]

Not a cabg but a heart transplant 🙂

 

[swaamedic]

just thought i'd throw this out there, since this forum obviously has a EM bias. If u are really interested in Peds EM, you may consider doing Peds then Peds EM fellowship, although confined to a Peds ED, you are not confined to EM as a specialty as are the fellows that did a peds EM fellowship after EM. Thus when you are 60 yrs old and would like to do general peds and have office hours from 10-2 you can. But remember in general anything have to deal w/ peds = pay cut, so do it because you love it.

my 2 cents

 

[EctopicFetus]

just thought i'd throw this out there, since this forum obviously has a EM bias. If u are really interested in Peds EM, you may consider doing Peds then Peds EM fellowship, although confined to a Peds ED, you are not confined to EM as a specialty as are the fellows that did a peds EM fellowship after EM. Thus when you are 60 yrs old and would like to do general peds and have office hours from 10-2 you can. But remember in general anything have to deal w/ peds = pay cut, so do it because you love it.

my 2 cents

👍 True...

 

[Dr. Wexler]

So when the psychiatrist does a CABG you let me know. Its all about liability.

I realize that liability is a big part of the equation. I was just trying to point out that there is nothing inherently illegal in a physician practicing a specialty other than the one he trained for in residency.

The idea of a psychiatrist doing a CABG is clearly absurd, but there are examples of physicians doing things they weren't trained for in residency. IIRC in Atul Gawande's book Complications he writes about a hernia repair center where the "surgeons" weren't neccessarily residency-trained in surgery(but maybe this was in Canada...not sure).

IMHO, the distinctions between (a) being legally allowed to practice medicine, (b) being qualified(in the sense of ability, not legally) to practice a particular specialty, and (c) being formally trained and certified to practice a particular specialty are particularly relevant in an EM forum where the practice of EM by non-BC/BE Emergency physicians is a regular topic of discussion.

 

[Dr. Wexler]

just thought i'd throw this out there, since this forum obviously has a EM bias. If u are really interested in Peds EM, you may consider doing Peds then Peds EM fellowship, although confined to a Peds ED, you are not confined to EM as a specialty as are the fellows that did a peds EM fellowship after EM. Thus when you are 60 yrs old and would like to do general peds and have office hours from 10-2 you can. But remember in general anything have to deal w/ peds = pay cut, so do it because you love it.

my 2 cents

I've heard this rationale for doing Peds then Peds EM fellowship before. I wonder though, is it realistic to think that your Peds residency will actually help you as a general peds doc if you are starting general peds when you are 60? It might be easier to get liability insurance and admitting prividleges for a doc trained Peds+Peds EM fellowship compared to a doc trained in EM+peds EM fellowship, but will the Peds+Peds EM doc really be better equipped to handle general peds? Is the residency training they did 30 years before going to matter in terms of clinical ability if they have both been practicing in the same enviornment (Peds ED) for three decades?

 

[Apollyon]

Forget "legal" - good luck getting credentialed in a hospital as a peds residency trained doc to see adults.

As for

Since a majority of ER's in the nation employ non board-certified EM physicians, I do not see this as a problem.

Since 62% of US ED's have at least 1 EM board-certified practitioner, your statement is false in one sense, and your post implies that the majority of ED's ONLY employ non-boarded EM docs.

The tide is certainly turning.

 

[OSUdoc08]

Forget "legal" - good luck getting credentialed in a hospital as a peds residency trained doc to see adults.

As for


Since 62% of US ED's have at least 1 EM board-certified practitioner, your statement is false in one sense, and your post implies that the majority of ED's ONLY employ non-boarded EM docs.

The tide is certainly turning.

My comment stated that a majority of ED's have at least 1 non-board certified EM physician.

It looks like you took my statement to mean completely opposite as it was intended.