Which to do First..Need Advice!! (repost from EM Site)

[Pegasus]

Ok, I know this has been asked before, but I have to make a decision soon.

If I do EM 3 years and a Peds fellowship, how long total? AND I will ony be able to do Peds EM right?

If I do Peds then EM fellowship, is it 6 years total and I can do Peds, EM or Peds EM?

Please help me clarify this. I cannot decide between the two, and I had to take a month off in 3rd year, so I will have to continue 3rd year until August, then take Step II in August, putting my FIRST 4th year rotation in Sept, and that needs to be what I am going into so I can get a LOR.

I need some advice please!!

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[docmartin]

As I understand it Pegasus, the better route is Emergency residency then do a Peds Fellowship which I believe is 2-3 yrs. We had a Peds/ER guy come and talk to our school re: the matter. He is currently at Loma Linda University in CA. If you choose to do the Peds/ER route, then it's 6 years total. Ergo: this route is more of an academic route, I believe you are expected to do research during those 3 ER fellowship years. I think you have to figure out which is more IMPORTANT to you. Kids or adults. If kids is your passion and you like research do the PEDS/ER, if you like adults, do the other. He said it was a long road, getting paid 40K for 6 years, but he said his last year his stipend jumped to 65K. And I think he now gets paid $125/hr and only works 60 hrs/wk (3-4 days)....Nice lifestyle.

Good Luck.

 

[Ponyboy]

If you do EM then a Peds EM fellowship, you can do Adult and Peds EM but no general peds.
If you do Peds then a Peds EM fellowship, you can do general peds and Peds EM but no adult EM (most fellowships include 2-3months of Adult EM, just in case an adult in the Children's Hospital gets sick or something but not enought to be comfortable to treating adults full time).
The advice as to which to do first depends on who you talk to. Pediatricians will say that it's better to do Peds first because the large majority of patients in a Peds ED come in with pediatric problems (eg. gastro, URTI, fever, etc.) as opposed to EM problems (trauma, etc.). Additionally, the peds fellowship is three yeas with more time for research while the EM fellowship is two years with less time for research. I've chosen to do Peds because I like kids much more than adults and might want to do Peds ICU instead of PEM. By doing peds, I leave this option open in the future.

 

[Meeko1452]

I don't have much to add to the discussion except a little about the difference in job offers you'll have after finishing either of these paths.

If you do EM then a PEM fellowship, or a combined EM/Peds residency, you'll be very attractive to EDs in medium to large size towns that aren't affiliated with a Children's Hospital. These hospitals may not have a large enough PEDS volume to jusify hiring a straight PEM person, but in hiring you they will have someone who can take care of adults AND who has advanced training in taking care of kids. So if you want maximum flexibility and you don't mind taking care of adults, this is not a bad path to take.

However, if you are like me and can't stand the thought of seeing even ONE more adult with low back pain, doing Peds then PEM is probably a good choice. You won't have quite as much leeway on a job when you are done--you will be looking at mostly Children's Hospitals (I know a FEW large, non-academic hospitals that hire PEM people, but you will most likely be looking at a job in an academic institution).

PEM fellowships are fairly competitive, so if you decide to do Peds first, ask the programs you interview at about their fellowship placement track record.

Hope this helps.