Peds, IM, or something else?

[MelMcT2009]

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[SurfingDoctor]

Sounds like you like IM more. If you are really that undecided, you can do Med/Peds and give yourself more time to figure it out, but you will generally end up picking one or the other, and you sound like you've already convinced yourself to me. At the end of the day, pick which one you can see yourself doing 10 to 20 years down the road. That may seem hard given how far away that is, but when it something you really want to do, the choice isn't that hard.

Just as a side note, children can get very sick too and require procedures (though procedures too can get routine so don't do something procedurally based just for that. You have to find the disease interesting too). You could always try a PICU rotation (or ask a PICU physician in your institute if you can shadow them for a couple of days if you can't schedule a rotation) to see what it is like to take care of really sick children.

 

[MelMcT2009]

Sounds like you like IM more. If you are really that undecided, you can do Med/Peds and give yourself more time to figure it out, but you will generally end up picking one or the other, and you sound like you've already convinced yourself to me. At the end of the day, pick which one you can see yourself doing 10 to 20 years down the road. That may seem hard given how far away that is, but when it something you really want to do, the choice isn't that hard.

Just as a side note, children can get very sick too and require procedures (though procedures too can get routine so don't do something procedurally based just for that. You have to find the disease interesting too). You could always try a PICU rotation (or ask a PICU physician in your institute if you can shadow them for a couple of days if you can't schedule a rotation) to see what it is like to take care of really sick children.

All very true. I guess anything over time will become kinda routine. I think if I do Peds, PICU may be right up my alley, so I'll definitely look in to this! Thanks for the suggestion!!

 

[WheezyBaby]

Im doing med peds. I would have very similar feelings after rotations if I only had gotten to do gen peds. I fortunately got to do peds heme/onc, picu, and peds cards as a student though. Peds can be just as cerebral as medicine (the differentials are often actually broader as just by virtue of age you can rule out a lot of disease), and you can still take care of really sick patients. I'd think about what was pointing you to peds in the first place, what specifically about gen peds didn't meet those expectations, and what did. Agree with getting the exposure to peds subspecialties however you can. It's not the worst thing in the world to do med peds out of indecision, but it's not the best reason either, and interviewers will definitely want you to have a better answer to "why med peds"

 

[MelMcT2009]

Im doing med peds. I would have very similar feelings after rotations if I only had gotten to do gen peds. I fortunately got to do peds heme/onc, picu, and peds cards as a student though. Peds can be just as cerebral as medicine (the differentials are often actually broader as just by virtue of age you can rule out a lot of disease), and you can still take care of really sick patients. I'd think about what was pointing you to peds in the first place, what specifically about gen peds didn't meet those expectations, and what did. Agree with getting the exposure to peds subspecialties however you can. It's not the worst thing in the world to do med peds out of indecision, but it's not the best reason either, and interviewers will definitely want you to have a better answer to "why med peds"

Thanks! I'll definitely try to schedule something over my summer, or at the start of fourth year. What made you decide on Med Peds?

 

[mvenus929]

Have you just done general clinic, or have you done inpatient as well?

 

[MelMcT2009]

Have you just done general clinic, or have you done inpatient as well?

Mostly clinic. We admitted one patient last week, but I still pretty much just tagged along with the doctor and shadowed.

I think that may be a big part of the problem. In IM I was seeing my own patients from day 1, writing my own assessments and plans, then the residents would review it with me and tell me what was good/bad about it. So far in peds I stand in the corner all day and am not writing notes or anything. I have gotten asked zero questions either...so I literally do nothing. Finally got to see a few patients on my own on Friday, so maybe that will change things a bit.

I want to ask my preceptor if there is anything more I can do, but I'm not sure how to do that in the best way.

 

[Amygdarya]

OP, I think a big part of why you're not enjoying your peds rotation is how it's organized. Plus you sound like a hospitalist or critical care kind of person, and you're not getting this kind of experience on your peds rotation. It's ok to change your mind about your future specialty as you go through MS3 (many if not most students do), but, just as was already suggested, get some peds inpatient or critical care exposure before ruling out pediatrics entirely.

 

[Amygdarya]

I want to ask my preceptor if there is anything more I can do, but I'm not sure how to do that in the best way.

Just ask him/her! There is nothing wrong about (sincerely) asking to do more - if anything, it shows that you're interested and us viewed very positively.

 

[vendtex]

Mostly clinic. We admitted one patient last week, but I still pretty much just tagged along with the doctor and shadowed.

I think that may be a big part of the problem. In IM I was seeing my own patients from day 1, writing my own assessments and plans, then the residents would review it with me and tell me what was good/bad about it. So far in peds I stand in the corner all day and am not writing notes or anything. I have gotten asked zero questions either...so I literally do nothing. Finally got to see a few patients on my own on Friday, so maybe that will change things a bit.

I want to ask my preceptor if there is anything more I can do, but I'm not sure how to do that in the best way.

As a medical student even in the clinic situation you should be permitted to go in and evaluate the patient then present to the attending. Perhaps if you just started it would start by shadowing but you should soon be going in first.....at least that's how I've always done it with 3rd year medical students.

 

[MelMcT2009]

As a medical student even in the clinic situation you should be permitted to go in and evaluate the patient then present to the attending. Perhaps if you just started it would start by shadowing but you should soon be going in first.....at least that's how I've always done it with 3rd year medical students.

Yeah, I've heard this preceptor is very picky, and that its best to just stay quiet and let her warm up to you. On the first day I asked what I could do, and she said she just wanted me to watch for now. She is very very nice though, and I understand that she may want to be protective of her patients.

Im hopeful that things may pick up this week! If not, I'll just have to figure out a way to be proactive about it

 

[MelMcT2009]

OP, I think a big part of why you're not enjoying your peds rotation is how it's organized. Plus you sound like a hospitalist or critical care kind of person, and you're not getting this kind of experience on your peds rotation. It's ok to change your mind about your future specialty as you go through MS3 (many if not most students do), but, just as was already suggested, get some peds inpatient or critical care exposure before ruling out pediatrics entirely.

Thanks. This past week I had been feeling that if I REALLY liked peds, I should like it regardless of where I was, and was pretty anxious about my feelings toward this rotation. So these posts have been super helpful and I will definitely be contacting some people to try to squeeze something in this year before thinking too much more about this!

 

[vendtex]

Yeah, I've heard this preceptor is very picky, and that its best to just stay quiet and let her warm up to you. On the first day I asked what I could do, and she said she just wanted me to watch for now. She is very very nice though, and I understand that she may want to be protective of her patients.

Im hopeful that things may pick up this week! If not, I'll just have to figure out a way to be proactive about it

Just a few more comments. Success in pediatrics is to an extent very dependent upon having good observational skills. Not rarely you may suspect a diagnosis upon simply observing the child. For me it was interest in the diseases of children, e.g. metabolic, genetic,etc., the impact of age on the differential diagnosis and the lack of variety I saw with most adult rotations, CAD, HTN, DM, etc. that led to the decision.

 

[mvenus929]

I agree with the others. There are a lot of people who go into Peds and hate clinic. It's one of the things that drew me to Peds, but I hate how our clinic is run in residency. You should get more experience on the inpatient side of things before you make a decision one way or the other.

 

[WheezyBaby]

Thanks! I'll definitely try to schedule something over my summer, or at the start of fourth year. What made you decide on Med Peds?

Briefly, I loved medicine and peds, the education from each complements the other, am big on continuity of care and longterm relationships, and I think there's a big need in transitional care for a variety of disease processes (sickle cell, CF, congenital heart, developmental delay, etc). My primary clinical interest is PICU so I'm still trying to reconcile those divergent interests, but yea