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What about child abuse fellowship?

gus7826

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Jul 1, 2020
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  1. Pre-Health (Field Undecided)
    I am currently a hispanic pgy 2 Pediatric resident in SUNY Downstate and I was wondering if someone here is a current child abuse fellow. I would want to know if it is competitive to get into a child abuse fellowship. Is it worth it? I don't have any publications yet but I am working on a cohort study but I don't think I will publish my test by the time I apply.
     
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    Stitch

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    1. Attending Physician
      I'm married to the child abuse pediatrician. :)
      I'll let her know you posted, but I can answer some of this.

      It's not competitive at all. Half of the programs go unfilled each year and there are plenty of jobs out there for attendings.

      As to whether it's worth it, that depends on you and what you want out of a career. What appeals to you about the specialty?
       

      gus7826

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      Jul 1, 2020
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      1. Pre-Health (Field Undecided)
        Since I started residency I have always been interested in child abuse cases from the correct diagnosis and treatment. For me it's a very interesting field and it must be very satisfying to make sure a child abuse pediatrician puts a child/teenager in a safe place. I am wondering though, what is the lifestyle as a child abuse pediatrician. Like if they spend most of the time in the ER, clinic, courts?
         

        Stitch

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          One of the things people tend to like about child abuse pediatrics is the variety of settings and patients. There's no real 'typical day' but I can describe some aspects of what my wife does.

          She sees out patients for abuse and neglect in a clinic setting. Some of these are outside non urgent referrals, some are follow ups.

          She spends a fair amount of time in court testifying as an expert witness about injuries and the mechanisms of those injuries. This aspect of her job takes the most prep time so she can be ready for the lawyers questions. She can testify for either prosecution and for defense (depending on the findings and the charges) and basically outlines the medical findings either way for the jury. Sometimes she is able to make the determination that 'this is clearly abuse,' sometimes 'this is clearly not abuse and is due to [insert medical condition]' and sometimes she has to say that she can't really tell if the injuries are inflicted or not.

          You should note that she is not employed by state social services or the police or the DA. She is paid for her time as an expert witness but this fee goes to the institution. She is salaried. Her job isn't to say 'who did it,' but instead focuses on type of injury, likely mechanisms of injury and, when possible, the age of the injury. Essentially it boils down to 'does the history given by the caretaker explain the injuries we see?'

          She takes pager call regularly, but pretty much never has to go in after hours unless there's an inpatient consult on the weekend. Most calls are specific questions about mechanisms of injury or advice on how/when to report injuries to child welfare services. If the child is admitted she will see them and write an extensive note usually the next day. Your knowledge of general pediatrics has to be very good to do this job, and she is able to sort through and consider rare genetic issues that might look like abuse but aren't.

          Inpatient consults generally take a lot of time to coordinate with multiple team members and get a whole picture of what's going on. She reviews her own x rays and other radiology imagine, but works closely with the radiologists as well as the surgeons and ICU teams when necessary. This coordination extends post mortem in her communications with the medical examiners/pathologists, as well as law enforcement, DA's office.

          The ED isn't usually a frequent place to physically go, but there's a lot of calls and discussion with them.

          There's also a community aspect to the job and she spends time lecturing to outside adult facilities how to notice and evaluate abuse from a medical stand point. This teaching also extends to teaching law enforcement signs of abuse and signs of NOT abuse.
           
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          zeppelinpage4

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          May 17, 2009
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            I interviewed for a child abuse pediatrician job and when they talked about the fellowship it sounded like they were pretty desperate for applicants. Apparently many of the fellowship positions go unfilled, so I imagine it should be pretty easy to get into if you have an interest in it.
             

            BocephusTim

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            Mar 30, 2020
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            1. Resident [Any Field]
              I honestly had no idea there actually was such a thing as a child abuse fellowship, but it seems like something that is important to have.

              On a personal level, I find moderate to severe child abuse one of the most repulsive things in human behavior. I honestly believe torture and other un-Constitutional type punishments should be only used for truly sick monsters like child rapists and child abusers. Sorry, I just had to vent because I've seen some things in my life regarding these things that scar me to this day.
               
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