Is Peds similar to IM?

[dj_smooth]

I am in the beginning of my third year and in IM right now, about 5 weeks done. IM really isn't very interesting to me; actually I loathe to be there at times. I was wondering, however, is peds similar in nature just with a smaller patient to deal with (i.e. IM for small people)? I am hoping it isn't because it really is what I a hoping to go into. Any thoughts?

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[otter41]

I had that same question during my third year IM clerkship. Fortunately, when I got to peds I noted that there were some key differences. 1) The patient population is peds is so diverse. The difference between a newborn and 6 month old is astounding. One of the cool challenges in peds is learning how to relate to constantly changing patients. 2) The major problems that arise are very different in peds and IM. No COPD, hypertension, chronic DM, and CHF in the peds population but lots of otitis media, gastroenteritis, and upper respiratory infections. 3) The people who are attracted to peds have a very different personality (in general) than IM. You really have to enjoy kids and be able to deal with parents. You have to accept the fact that a good deal of the patients you see daily won't be able to tell you what is wrong with them and enjoy that challenge. You have to be flexible in your patient approach and laid back but at the same some exude confidence to the parents.

By the way, I also got very bored during my IM clerkship so was happy that when I got to peds that I actually enjoyed it. It has a really different feel then IM. Hope this helps.

 

[mhdousa]

Children are just little adults.

-M

 

[Popoy]

Originally posted by mhdousa
Children are just little adults.

-M

I beg to differ.... To quote our pediatric/neonatologist at DMU "Children are not just little adults." The reason being is that they may present with s/sx that is not typical of the pathophysiology of that disease....

Peds patient are a unique subset of the population of patient.... and as otter41 has stated, it takes a different personality to work with peds patients....

then again, I may be wrong....

 

[mhdousa]

Originally posted by Popoy
I beg to differ.... To quote our pediatric/neonatologist at DMU "Children are not just little adults." The reason being is that they may present with s/sx that is not typical of the pathophysiology of that disease....

Peds patient are a unique subset of the population of patient.... and as otter41 has stated, it takes a different personality to work with peds patients....

then again, I may be wrong....

Wait, I'm a little confused -- my adult/internist told me: "Children are just little adults." He told me that insurance companies pay you based on the height of your patient, so that's why pediatricians make so much less than big-people-doctors. He also said that pediatricians are glorified veterinarians, so I've been trying to do some reading (anyone on this forum know any good animal textbooks?? people weren't very nice to me on the Student-Veterinarian Network!!) in order to do well in my peds clerkship. It's going to be difficult though -- I've gotten pretty bad evaluations so far. My attendings all say that I spend too much time doing physical exams on the parents and I ignore the kids. But to quote our adult/internist: "Pediatricians treat the parents, not the kids" -- so I figure, what's the point of examining the kid?!?

Please help me, super moderator. Tell me what I'm doing wrong.

-M

 

[Popoy]

Originally posted by mhdousa
"Pediatricians treat the parents, not the kids"

Please help me, super moderator. Tell me what I'm doing wrong.

-M

We were told the same.... Please help US, super "M". Tell US what we're being taught wrong seeing you seem to be all knowing and condescending.... Aren't we all student simply sharing each others experience??? Then, I'm simply sharing mines....

 

[jdog]

IM is similar to Peds in the same way that black is similar to white, the Lakers are similar to the Cavaliers, Tom Delay is similar to Tom Dascle, and The New York Times is similar to a credible news source.

This is to say that they are not similar because mosty people who do IM hate and belittle Peds, and most people who do Peds like me can not stand the sight of an adult patient.

If you look at about any salary survey general IM and general Peds are about the same (modest as it is), but one whho chooses to do IM over Peds for the extra 5 or 10 thousand dollars that you might make, have a nice career

The difference in money comes in the specialties, where IM specialties can make really big money, and Peds specialists can make big money.

So IM specialists can be really really wealthy but Peds subspecialists can just be plain old wealthy.

You decide.

And one more thing. Is there any other profession on the planeet with more miserable unsatisfied people than general IM. I havn't seen one.

 

[HiFi]

Originally posted by mhdousa
Wait, I'm a little confused -- my adult/internist told me: "Children are just little adults."

He should stick to internal medicine. He doesn't have a clue. Just keep writing those scripts for antidepressants and proton pump inhibitors, and the occasional beta blocker

Originally posted by mhdousa
He told me that insurance companies pay you based on the height of your patient, so that's why pediatricians make so much less than big-people-doctors.

I think he's pulling your leg. Kind of a funny joke. tell him that my patients weigh less than their charts, and I earn a lot more than internists do. Of course, you don't measure height in an infant, so maybe his theory is valid

Originally posted by mhdousa
He also said that pediatricians are glorified veterinarians, -M

neonatologists maybe, but not pediatricians.
seriously, preterm infants are not little infants, infants are not little children, and children are not little adults.
the pathophysiology is completely different in each category.

 

[labangel]

umm...I think y'all need to take mhdousa a little less seriously...

 

[NMMed]

I've never seen someone go so far for a joke, and still have the majority of people miss it...

 

[dsherida]

To work in peds, I think you have to be able to really have a strong and compassionate attitude. Many of the patients are there not because they have been smoking all their lives like adults, but because they were just dealt a bad hand.
My question though, is that I don't know much about specialties. Does IM make more money because they see more sick adults? What would a cardiologist compared to a peds cardiologist make? I think they do the same amount of work, so that seems odd!

 

[HiFi]

Originally posted by dsherida
My question though, is that I don't know much about specialties. Does IM make more money because they see more sick adults? What would a cardiologist compared to a peds cardiologist make? I think they do the same amount of work, so that seems odd!

depends on the specailty.
most peds subspecialties are in academic centers, so the pay is significantly lower.
There are plenty of invasive adult cardiologists, doing cath's all day on the Marlboro and McDonalds crowd and making a fortune.
Not too many kids need a cath, so there are a lot fewer invasive peds cardiologists.
A big city will have about a half dozen peds cardiologists in private practice. The rest are at the medical school affiliated hospital. Some make more money than others.
In most areas of medicine, what makes money is a procedure.
You are not paid to think, because if brain power was reimbursed, Infectious Disease docs would all be rich.
A 40 minute consult where you go through a 10 lb chart, pays a fraction of what you make for a 5 minute procedure like wart removal.
So therefore peds subspecialties that pay the most are things like Emergency medicine, neonatology, allergy and immunology ( if you are doing a lot of allergy testing in your office ) GI ( if you do a lot of endoscopy ) cardiology ( echos )pulmonology ( of you do some bronchs and office PFT's ).
lower paying are things like endocrinology, ID

For the most part adult subspecalists earn more than peds subspecialists because there are far more procedures to be done. That's the main difference. It has nothing to do with who is more sick

 

[pathstudent]

Peds is just like IM for achondroplastics.

 

[mhdousa]

Originally posted by pathstudent
Peds is just like IM for achondroplastics.

Anyone else not surprised that this guy has "path" in his username?

 

[jaylily]

I haven't started any clerkships yet... hell, I haven't even started med school yet, but IM and Peds are two fields that I have the most interest in right now. (Oh how that can change) Are they seriously THAT different?

 

[sanfilippo]

I like this debate...it all depends to whom you talk.

Med-peds specialists want you to believe that there is no difference and that combining the training has more synergy than disparity and that the age cut-off's used to determine where one field ends and the other begins is totally arbitrary...there is some truth to that because adolescent medicine remains a black box...who's more qualified to treat them, internists or pediatricians or someone with dual training?

I found there was some similarity in the approach to inpatients on both IM and peds rotations, especially pediatric inpatients with severe illnesses. However, the outpatient experiences are quite different and neonatology and the first few years of life are radically distinct in diagnosis and treatment than the rest of peds or IM. I think after that IM becomes more similar to peds but diseases of each age range varies and one has to be cognizant of that and how "adult" disease may manifest itself differently in kids...I mean, very few kids complain of osteoarthritis or have raging DM Type 2 but with the obesity on the rise, that may change.

If you want primary care and want to be able to treat both kids and adults, consider med-peds or FP. If you want to subspecialize, it may be better to consider IM or peds separately the way things stand, but only a minority of med-peds graduates decide to subspecialize. These are the current trends and I don't think anything will radically change in the next 5 years unless the AAP and the ABIM merge (highly doubt that).

However, the personality of almost every pediatrician I have met is upbeat and they are extremely patient...very few with the "gloom and doom" demeanor that can be found in internists, especially those dissatisfied with their practices.

I'll refer back to th med-peds thread, which was very good.

-S.