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To pursue Peds EM Fellowship or not

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Colbert

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My conundrum is more of a passion vs logistic problem.

I'm only a few months into my PGY-1 year, but I strongly considering pursuing a peds EM fellowship. My shifts that I've done in our peds ED have been my favorite, I find the pathophys of peds really interesting, and in all honesty I almost applied for pediatrics before deciding on EM. The thing stopping me from really knowing that I want to pursue a peds EM fellowship, however, are the family/compensation issues.

Putting my family through another match process seems tough after looking in the rearview mirror at last year's uncertainty in the match process. Also, putting in an extra two years of training to make less money in the end seems crazy. So my questions are...

1. What is the compensation difference like, really? I've received a lot of off-the-cuff information about it that community-based EP average about $250K and peds-EP in peds EDs average about $200K. Giving up $50k/year seems like a lot to give up, especially after putting in 2 extra years of training. I'd appreciate any insight from people more in-the-know.

2. How favorable are EM people looked at in the peds-EM match? My family and I have a pretty specific area of the country that we want to live in after residency and there are only 2 programs there.

3. Anyone out there from the EM side go after a peds fellowship and mind offering some retrospective advice?
 

vengaaqui

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I'm just a med student so, of course, take what I say with a grain of salt.

I was talking with one of the EM-->Peds EM guys recently about going that route versus Peds-->Peds EM and he said a way around the compensation issue for him is dividing time between the local adult hospital and the peds one. Not sure if this would be an option everywhere you go, but definitely something to consider. He said this way he's able to break even instead of having as much of a pay cut. Of course then you'd have to be okay putting up with adults as patients not just parents of your patients.

Good luck!
 

EM_Rebuilder

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I very briefly considered this early in my career; this is the little information I learned which may or may not actually be correct.... so take it for what its worth. That is my disclaimer.

Going from EM to a Peds EM fellowship is super easy and a dime a dozen as far as competiveness. Its virtually a 'sign me up' situation. MOST of the EM Peds people trained in Peds FIRST then did the EM fellowship.

Most Peds EM fellowships are 3 years, mandatory for Peds trained people. For EM trained people, many are 2 years... but some are still three for them as well.

For Peds, its a pay increase, for EM, I understand its a huge pay decrease... That is why you rarely see EM people doing it. Its extra years of your life to make less money.
 

tkim

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You should only do it if you like peds EM, can tolerate the 2-3 year fellowship and the pay DECREASE.

There is only one true advantage and that is breaking into a saturated/tough market having done the fellowship. Guy I know got a great job in WA state splitting his time between the adult and peds ED because of his fellowship. Otherwise it would have been a no-go in that area. He still gets paid less than the straight adult EM guys, but he got into an area that he otherwise would not have had a chance since he had no network there.
 

ptarmigan

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Are you thinking about going into academics? Most Peds EM docs work in academic centers, and most academic centers don't pay as well as private jobs do. You can't compare the salary of a community EM doc to an academic peds EM doc - that's a little unfair. You're still going to make a lot of money either way. If you are going into academics then you need a niche anyway. If you want to do community medicine then the salary difference is going to more impressive.
 

Colbert

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Thanks everyone for the great responses.

Splitting my time between adult and peds EM is something I hadn't really thought about and is definitely something I'm going to consider. By no means do I despise adult EM, I enjoy it a lot. I think of the things I couldn't do, however, is work in an adult ED where the peds section is totally separate and you don't see anyone < 18 years old. I guess that leads me to community or splitting my time between adult and peds.

As far as community vs academics, I'm still not sure. I don't really get excited about doing research at all. I really like the teaching aspect though, and I like being in academic settings with journal clubs and other people to stay up to date with. I think I heard an EMRAP about guys at academic centers doing a teaching track which I'd enjoy a lot more than a research track.

Thanks again!
 
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