Why did you choose pediatric anesthesiology?

[zack steel]

Ca-1 here who is currently on my pediatric ambulatory rotation and am really enjoying the peds regional and peds ent/uro cases. Still to do main hospital pediatrics. Wondering what drove current pedi guys into the subspecialty ?

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[linkin06]

i can tell you the terrifying NICU babies drove me away from pedi! i do enjoy a lot of peds, but it can be very stressful too...

 

[Mehd School]

Real peds is a different beast than healthy/ambulatory peds. I really enjoy healthy peds. The pedi hearts/heads/trauma/syndromic patients that I did every day as a senior resident at our children's hospital chiseled in stone that I was not cut out to be a pediatric anesthesiologist.

 

[26B]

Ca-1 here who is currently on my pediatric ambulatory rotation and am really enjoying the peds regional and peds ent/uro cases. Still to do main hospital pediatrics. Wondering what drove current pedi guys into the subspecialty ?

The cases you described aren't the ones that you need a Peds fellowship for. I do those types of cases as a generalist and enjoy them as well, but I wouldn't touch a pedi cards case with a 10 foot pole.

 

[Morzh]

"Why" anybody chooses a particular career path over another is kind of a surprisingly tough question to answer in a concise way. There are a lot of factors and each is weighted differently based on individual experiences and priorities.

It was clear to me after my first few months as a CA-1 that I had chosen the right specialty in anesthesiology. Residency was still brutal at times, but I genuinely enjoyed most of the day to day work. When I progressed into my pediatric anesthesia rotations I had this same feeling all over again. It was everything I liked about anesthesiology in general, but now even better. The simplest answer I can give to your question is that I chose pediatric anesthesia because the days when I was doing peds were the days I found it easiest to get out of bed in the morning.

I thought the unique diseases and challenges of infancy / childhood were interesting and rewarding - especially the challenges of NICU, very sick babies, and syndromic kids. I liked the thoughtfulness of the "precision anesthesia" that is required: attention to detail, exact dosing, sizes, minimal tolerance for errors, etc. I liked the psycho-social aspect of dealing with anxious parents, the fun little ways I get to build rapport with the kids, etc. I liked thinking that a well-designed anesthetic for a child can support a good outcome that will benefit them for an entire lifetime.

I also liked the culture of the pediatric ORs and Children's hospitals in general... the attitudes from surgeons to nurses to support staff were all just a little bit more pleasant and respectful. When taking care of kids I think people tend to be a bit more committed to "doing things the right way" instead of being lazy or taking short cuts. Like many specialists, pediatric surgery is very competitive to get into yet the pay is not much better (possibly even worse) than their adult counterparts. My theory is that this has a self-selecting effect that results in the people in this field really wanting to be there for non-monetary reasons.

I wanted to make pediatric anesthesia the primary focus of my career. In this century, that means doing the fellowship. A lot of healthier / older pediatric care does not necessarily require the fellowship, but if you are serious about working at a dedicated pediatric hospital then you really do need that extra board certification.

Bad reasons to do a pediatric anesthesiology fellowship: thinking it will pay off financially. I consider my fellowship year (and the lost income) as a "tax" I paid in order to be able to spend the rest of my career being the kind of anesthesiologist I really wanted to be.

 

[2010houston]

One of the things Morzh said above I really want to echo - the culture in pedi hospitals is just different. It is very very patient-centered, and it truly makes coming to work fun. I love who I work with - not just my fellow MDs, but the RNs, scrub techs, etc etc. It’s a much more pleasant environment.

Most of us don’t *love* taking care of NICU babies - it’s hard and terrifying! But fellowship makes it feel doable, and taking care of kids every day is truly immensely rewarding.

 

[BioChemDork]

I also liked the culture of the pediatric ORs and Children's hospitals in general... the attitudes from surgeons to nurses to support staff were all just a little bit more pleasant and respectful. When taking care of kids I think people tend to be a bit more committed to "doing things the right way" instead of being lazy or taking short cuts. Like many specialists, pediatric surgery is very competitive to get into yet the pay is not much better (possibly even worse) than their adult counterparts. My theory is that this has a self-selecting effect that results in the people in this field really wanting to be there for non-monetary reasons.

Strongly second this, as someone who works in a stand alone peds hospital. Your life is much easier when your surgeons are pleasant and not money hungry. It makes for happier OR staff, and your day goes by much faster.

In addition, 95% of my cases are bread and butter, and kids for the most part will choose life as long as you get out of their way. There's fewer "poorly-optimized ASA 3/4s", unlike in the adult world.

The remaining 5% are sketchy cardiac/syndromic kids - kids that surgeons won't be ok with a CRNA solo-ing the case. This provides job security.

Bottom line is: Things are happier, there's less chronic stress, and there's better job security in pedi world.

 

[2010houston]

Strongly second this, as someone who works in a stand alone peds hospital. Your life is much easier when your surgeons are pleasant and not money hungry. It makes for happier OR staff, and your day goes by much faster.

In addition, 95% of my cases are bread and butter, and kids for the most part will choose life as long as you get out of their way. There's fewer "poorly-optimized ASA 3/4s", unlike in the adult world.

The remaining 5% are sketchy cardiac/syndromic kids - kids that surgeons won't be ok with a CRNA solo-ing the case. This provides job security.

Bottom line is: Things are happier, there's less chronic stress, and there's better job security in pedi world.

Exactly this