Process of becoming a general pediatrician

[cluelesscollarbone]

I have been accepted to an MD school and am excited but also am suddenly a bit overwhelmed. For many years I have wanted to become a general pediatrician and now that the dream is turning to reality, I am feeling a bit of doubt. I think I am just nervous about the path ahead and before I truly commit myself to this I want to know exactly what I'm getting into. Can someone please clearly lay out the process of becoming a general pediatrician and also comment a bit on how the process is different if I chose a subspecialty within pediatrics?

I understand the process through medical school and residency but am confused about the steps after that. Does everyone do fellowship? What is the process of becoming board certified? What is the process to keep board certification up? I've heard every 10 years you re-take boards, but I have also heard this process may be changing to an open book module. Is this true for all physicians or only certain specialties? Can someone lay out the whole process for me? Much appreciated!

@Goro @LizzyM @Med Ed @gonnif @gyngyn

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[BigRedBeta]

1)Med school - keep an open mind about specialty choice as a 3rd year...most people don't know what the OR is like, or what inpatient medicine is like and as such change their mind about specialty choice.

2) Residency in general pediatrics that will include 3-4 months (or 4 week blocks) of NICU, 2 months of PICU, 3-5 months on the wards, 1-2 months of newborn nursery, a month of behavioral/developmental pediatrics, a month of adolescent medicine, time in the general pediatric clinic, the pediatric emergency department, and variable blocks of time in subspecialty services (either inpatient, outpatient or combination). Again, keep an open mind as you may find a subspecialty that really appeals to you and decide to pursue fellowship.

3)Once complete with residency, you are eligible to take the board exam in general pediatrics (administered once per year in October).

4)If you really just want to do outpatient general pediatrics in the community, that does not have any fellowship training associated with it. If you were thinking of becoming a general pediatrician in an academic center or a pediatric hospitalist, there are fellowships available to become more specialized in those fields - not so much as a way to gain clinical knowledge, but to become better at doing research, quality improvement and advocacy.

5)Maintenance of certification is a hot topic across all specialties right now, and as an pre-M1 student, it's very unclear what the requirements will be 8 years from now (if you did general pediatrics) or longer (if you did another field) when it would actually impact you.

 

[cluelesscollarbone]

1)Med school - keep an open mind about specialty choice as a 3rd year...most people don't know what the OR is like, or what inpatient medicine is like and as such change their mind about specialty choice.

2) Residency in general pediatrics that will include 3-4 months (or 4 week blocks) of NICU, 2 months of PICU, 3-5 months on the wards, 1-2 months of newborn nursery, a month of behavioral/developmental pediatrics, a month of adolescent medicine, time in the general pediatric clinic, the pediatric emergency department, and variable blocks of time in subspecialty services (either inpatient, outpatient or combination). Again, keep an open mind as you may find a subspecialty that really appeals to you and decide to pursue fellowship.

3)Once complete with residency, you are eligible to take the board exam in general pediatrics (administered once per year in October).

4)If you really just want to do outpatient general pediatrics in the community, that does not have any fellowship training associated with it. If you were thinking of becoming a general pediatrician in an academic center or a pediatric hospitalist, there are fellowships available to become more specialized in those fields - not so much as a way to gain clinical knowledge, but to become better at doing research, quality improvement and advocacy.

5)Maintenance of certification is a hot topic across all specialties right now, and as an pre-M1 student, it's very unclear what the requirements will be 8 years from now (if you did general pediatrics) or longer (if you did another field) when it would actually impact you.

Thank you!

 

[Aerus]

As an MS1, I also recommend shadowing physicians from many different specialties to test your interest. Contrary to the popular idea that shadowing is only for the undecided or unsure or for premeds, I believe that shadowing is incredibly useful for the early medical student if you've narrowed down your choice specialty, since you want to make sure you will happy to commit to the field, so test out (and rule out) other potential interests.

Unlike in undergrad where you had to beg to be considered as a shadow, many physicians are more than happy to let med students shadow them. See if your school has a program or list of volunteering physicians.

 

[TypeADissection]

Outside of keeping an open mind, isn’t the process of becoming a general peds:
1. Matching into peds.
2. Graduating peds.
3. Doing general peds?

But my good friend was the captain of the peds club all through first and second year. Then did OBGYN and fell in love with it and that’s what she ended up pursuing. So things change. Have fun. Cheers.

 

[mvenus929]

1)Med school - keep an open mind about specialty choice as a 3rd year...most people don't know what the OR is like, or what inpatient medicine is like and as such change their mind about specialty choice.

2) Residency in general pediatrics that will include 3-4 months (or 4 week blocks) of NICU, 2 months of PICU, 3-5 months on the wards, 1-2 months of newborn nursery, a month of behavioral/developmental pediatrics, a month of adolescent medicine, time in the general pediatric clinic, the pediatric emergency department, and variable blocks of time in subspecialty services (either inpatient, outpatient or combination). Again, keep an open mind as you may find a subspecialty that really appeals to you and decide to pursue fellowship.

Actually, you only have to do 2 months of NICU to graduate a Peds residency. And there are programs that adhere to that rule. Plus one month of well baby time. Blows my mind since I did 2 months NICU, 4 months level 2 and 1 month well baby, but I knew I went into a very baby heavy program.

OP, keep an open mind as you move through Med school. people change their mind all the time (though those interested in Peds tend to stay with Peds). You will get more information on what it takes to be a certain type of physician as you move through school. But generally, if you just want to be a general (surgeon, pediatrician, internist, ob/gyn, etc), then you just have to get through residency.

If you decide to do something specialized, you will eventually have to do fellowship, though the timeline for doing said fellowship varies widely.

 

[BigRedBeta]

Actually, you only have to do 2 months of NICU to graduate a Peds residency. And there are programs that adhere to that rule. Plus one month of well baby time. Blows my mind since I did 2 months NICU, 4 months level 2 and 1 month well baby, but I knew I went into a very baby heavy program.

4 months of level 2? Good lord.........................................................

Did your program just use that as a replacement for general wards months? I can't for the life of me figure out how that benefited your education after the second month. My program did 4 months of NICU, at least one of which was at the surgical NICU at the children's hospital - but the NICU at the delivery/university hospital could do everything else short of needing a surgeon. That 4th month was pretty superfluous in terms of learning (though I did get to take part in the delivery of conjoined twins that month!). I probably would have lost it midway through the third month of relatively healthy babies.

 

[mvenus929]

4 months of level 2? Good lord.........................................................

Did your program just use that as a replacement for general wards months? I can't for the life of me figure out how that benefited your education after the second month. My program did 4 months of NICU, at least one of which was at the surgical NICU at the children's hospital - but the NICU at the delivery/university hospital could do everything else short of needing a surgeon. That 4th month was pretty superfluous in terms of learning (though I did get to take part in the delivery of conjoined twins that month!). I probably would have lost it midway through the third month of relatively healthy babies.

Yeah, I didn't get much out of it beyond the second month. Our level 2 took a lot of babies that would otherwise go to the NICU though--it was basically our non-surgical NICU (we took down to 28 weeks and 800 grams, so the micropreemies went to the NICU). We had a lot of feeders and growers, some RDS/TTN, sepsis evals, and NAS. Third month just had a lot of volume because I did it in June (three twin deliveries in a day while we were also trying to orient the new interns--that was fun). In the NICU, we didn't attend deliveries, but we did on level 2, and we have a pretty high volume delivery hospital, so I got really good at resuscitations. But, the month I served as senior was useful in just learning to be a senior, so I guess the fourth month was useful.

We also have a lot of ward time, so while we occasionally use it as a ward replacement (all our interns do 5 months of wards, but some got stuck doing an extra month of level 2 instead of the 5th wards month), we meet the wards requirements in other ways. *shrug*

 

[Tenk]

Slow down there champ or you’ll pop an aneurysm. Literally none of what you want to know matters at your stage of the game. None. All you need to do is do well in med school by studying hard and maybe join some sort of pediatric club to gain some exposure and see if that’s what you want to do. I can tell you with 100% certainty that whatever you believe a pediatricians life and job is like is wrong. Unfortunately you don’t really know what you’re getting into until you’re an attending but that’s ok. I originally wanted to be a pediatrician but now I wouldn’t be caught dead doing it. Maybe a NICU or PICU but def not general. Just study hard, gain some mild exposure and keep an open mind. You’ll do great if you do those three things. Board certification and credentialing and all that boring paperwork is the least of your concern. Trust me.

 

[cluelesscollarbone]

Thank you all for your responses! I have had a lot of experience in pediatrics and know I love it, but have had only a few experiences in other areas of medicine so I am definitely keeping an open mind. Still, I am glad to know what the general process to become a pediatrician entails.

I know it is not necessary to think so far ahead, but knowing what to expect takes a lot of anxiety off for me, so here is a new question: I have heard peds is a less competitive residency, but I am sure within peds there are comparatively more competitive and less competitive programs. Who knows what the future holds, but I suspect I will end up wanting to do a peds residency somewhere in a big east coast city, particularly New York, Boston or Philadelphia. I am curious what it takes to be competitive to match in a place like this other than strong board scores, grades in clinicals and LORs. Do extracurriculars matter much? Do experiences summer before medical school count? Thanks!

 

[Tenk]

Thank you all for your responses! I have had a lot of experience in pediatrics and know I love it, but have had only a few experiences in other areas of medicine so I am definitely keeping an open mind. Still, I am glad to know what the general process to become a pediatrician entails.

I know it is not necessary to think so far ahead, but knowing what to expect takes a lot of anxiety off for me, so here is a new question: I have heard peds is a less competitive residency, but I am sure within peds there are comparatively more competitive and less competitive programs. Who knows what the future holds, but I suspect I will end up wanting to do a peds residency somewhere in a big east coast city, particularly New York, Boston or Philadelphia. I am curious what it takes to be competitive to match in a place like this other than strong board scores, grades in clinicals and LORs. Do extracurriculars matter much? Do experiences summer before medical school count? Thanks!

Step scores > clinical grades > preclinical grades > letters and who you know >>>>> ECs and other stuff. Like I said. Just focus on getting good grades and studying hard. It will provide the biggest pay off and give you a lot more options if you decide against peds.

 

[Ismet]

Thank you all for your responses! I have had a lot of experience in pediatrics and know I love it, but have had only a few experiences in other areas of medicine so I am definitely keeping an open mind. Still, I am glad to know what the general process to become a pediatrician entails.

I know it is not necessary to think so far ahead, but knowing what to expect takes a lot of anxiety off for me, so here is a new question: I have heard peds is a less competitive residency, but I am sure within peds there are comparatively more competitive and less competitive programs. Who knows what the future holds, but I suspect I will end up wanting to do a peds residency somewhere in a big east coast city, particularly New York, Boston or Philadelphia. I am curious what it takes to be competitive to match in a place like this other than strong board scores, grades in clinicals and LORs. Do extracurriculars matter much? Do experiences summer before medical school count? Thanks!

I agree with the post above mine that scores and letters matter most, especially for the competitive programs, but I'd also say that I think meaningful extracurriculars tend to matter more in applicants to pediatrics than to some other specialties. A lot of times you'll be told that extracurriculars don't really matter for residency but I believe pediatrics is one of the exceptions. The bulk of my interviews were spent discussing things on my application that were non-academic. All of the interviews would touch on my research but the big money was in other things. Step scores are very very important, but don't be a studying drone who gets a 270 on Step 1 and does nothing else with your life. Leadership roles (meaningful ones where you actually lead people in doing something), medical education, mentorship, outreach/advocacy, volunteering...all good things to get involved in if you're interested.

 

[cluelesscollarbone]

I agree with the post above mine that scores and letters matter most, especially for the competitive programs, but I'd also say that I think meaningful extracurriculars tend to matter more in applicants to pediatrics than to some other specialties. A lot of times you'll be told that extracurriculars don't really matter for residency but I believe pediatrics is one of the exceptions. The bulk of my interviews were spent discussing things on my application that were non-academic. All of the interviews would touch on my research but the big money was in other things. Step scores are very very important, but don't be a studying drone who gets a 270 on Step 1 and does nothing else with your life. Leadership roles (meaningful ones where you actually lead people in doing something), medical education, mentorship, outreach/advocacy, volunteering...all good things to get involved in if you're interested.

What are some examples of advocacy experience?

It seems to me there's not a lot of time in med school to be very involved extracurricularly. I know I will use the summer break after first year but that seems like the last time I will have a big gap of free time. If I got involved in something significant this summer just before starting med school would that count on a resume for residency apps?

 

[Hala Alsofi]

I am a general pediatrician in UK, and it is kind of different here than over there across the Atlantic 🙂... but I can definitely advice you to follow your dream, it worth it, and working as a pediatrician is a fun life journey that worth the hardworking .

Good Luck!

 

[The Knife & Gun Club]

Thank you all for your responses! I have had a lot of experience in pediatrics and know I love it, but have had only a few experiences in other areas of medicine so I am definitely keeping an open mind. Still, I am glad to know what the general process to become a pediatrician entails.

I know it is not necessary to think so far ahead, but knowing what to expect takes a lot of anxiety off for me, so here is a new question: I have heard peds is a less competitive residency, but I am sure within peds there are comparatively more competitive and less competitive programs. Who knows what the future holds, but I suspect I will end up wanting to do a peds residency somewhere in a big east coast city, particularly New York, Boston or Philadelphia. I am curious what it takes to be competitive to match in a place like this other than strong board scores, grades in clinicals and LORs. Do extracurriculars matter much? Do experiences summer before medical school count? Thanks!

Grades, boards, and some research. Generally, Peds is one of the least competitive specialities, so it doesn’t take much from my understanding.

I’d imagine with avg or a bit above boards + a few decent research projects you could write your ticket wherever you desire...of course providing you’re not a weirdo.

 

[Oso]

I’d imagine with avg or a bit above boards + a few decent research projects you could write your ticket wherever you desire...of course providing you’re not a weirdo.

Well that's not true ...

Pretty much anyone can match into a peds program, likely a solid peds program. But to go to the top places though you need to be very competitive, ie good boards, research, and good grades and letters -- similar to going to a top tier IM program.

 

[MSTPlease]

Grades, boards, and some research. Generally, Peds is one of the least competitive specialities, so it doesn’t take much from my understanding.

I’d imagine with avg or a bit above boards + a few decent research projects you could write your ticket wherever you desire...of course providing you’re not a weirdo.

Peds overall is not competitive - i.e. it's very easy to match somewhere, but top tier peds is still very competitive.

 

[MSTPlease]

Step scores > clinical grades > preclinical grades > letters and who you know >>>>> ECs and other stuff. Like I said. Just focus on getting good grades and studying hard. It will provide the biggest pay off and give you a lot more options if you decide against peds.

I'd argue letters/whom you know are more important than preclinical grades, and probably just as, if not more important than some of your clinical grades (e.g. surgery)