Rheumatology

[bowlofmushypeas]

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So I've been one of the few interested in peds rheum for awhile now, but recently had a conversation with a peds rheum attending who shed some light on the field and I am now hesitating more and would love to hear what others think. I've known for awhile that salary-wise, it's probably the least practical thing you can do since you're paid less than gen peds despite a fellowship. However, it's really the next few points that worry me.

In terms of lifestyle, I've heard both ends -- it rocks, you're in clinic or doing research OR you're way overworked because you'll probably be one of the only (if not the ONLY) peds rheum person in a state.

I've also heard that doing peds rheum essentially ties you to academics for the rest of your life--i.e., no private practice freedom, no working in a cutesy clinic not in a university hospital probably based in a metropolitan area. Everyone seems to say there's a "shortage" but at the same time, the diseases are so rare, you can expect to be out of a job if you're not at a big referral center.

Finally, I like research..but I don't love it, and I don't see myself wanting to participate in it for the rest of my life. I know adult rheum doesn't have the same obligations, but I was also told that it's difficult to get a peds rheum attending level position without participating in research, similar to peds hem-onc.

Can anyone contribute what they've found out about the above points? Also, has anyone been exposed to both adult and peds rheum and can comment on the differences? Thanks!!

 

[oldbearprofessor]

I've also heard that doing peds rheum essentially ties you to academics for the rest of your life--i.e., no private practice freedom, no working in a cutesy clinic not in a university hospital probably based in a metropolitan area. Everyone seems to say there's a "shortage" but at the same time, the diseases are so rare, you can expect to be out of a job if you're not at a big referral center.

Well, first of all, I'm not sure I agree with the implication that academics is more restrictive in any way than private practice for most pedi specialists. It is true that you won't be a full time exclusively practicing pedi rheumatologist in a small town. That is simply a function of the patient volume. However, if you really don't want academics, there are non-academic children's hospitals and plenty of children's hospitals that hire private practicing attendings in all sorts of specialties. There are lots of pedi rheum docs that don't do research too, including those in academic hospital practices. Some are doing research only by being part of multi-center drug trials. This occurs in all settings. Is that so onerous?

Pedi rheum is VERY different than adult rheum. Do what you love.

 

[Socrates25]

So I've been one of the few interested in peds rheum for awhile now, but recently had a conversation with a peds rheum attending who shed some light on the field and I am now hesitating more and would love to hear what others think. I've known for awhile that salary-wise, it's probably the least practical thing you can do since you're paid less than gen peds despite a fellowship. However, it's really the next few points that worry me.

In terms of lifestyle, I've heard both ends -- it rocks, you're in clinic or doing research OR you're way overworked because you'll probably be one of the only (if not the ONLY) peds rheum person in a state.

I've also heard that doing peds rheum essentially ties you to academics for the rest of your life--i.e., no private practice freedom, no working in a cutesy clinic not in a university hospital probably based in a metropolitan area. Everyone seems to say there's a "shortage" but at the same time, the diseases are so rare, you can expect to be out of a job if you're not at a big referral center.

Finally, I like research..but I don't love it, and I don't see myself wanting to participate in it for the rest of my life. I know adult rheum doesn't have the same obligations, but I was also told that it's difficult to get a peds rheum attending level position without participating in research, similar to peds hem-onc.

Can anyone contribute what they've found out about the above points? Also, has anyone been exposed to both adult and peds rheum and can comment on the differences? Thanks!!

Wow you are certainly a rare breed, I havent met a single peds resident yet interested in rheum. I believe it is one of the most sought-after peds subspecialties.

I cant comment specifically on rheum except for one concern that you wont have neough patients because the rheum diseases are "rare."

I did a month long rheum rotation, and it was clear from day one that a big part of clinical rheumatology is that you get TONS of consults for joint pain that clearly do not have a "rheumatological" cause. PCPs are too lazy to do any kind of workup for joint pain, so they just send everybody to rheum. You will have PLENTY of patients.