MD & DO Should I go into peds? (MSI4)

[g4m3r2]

Hi everybody,

I'm currently split between psych, derm, and peds, but realize that it's probably not a good idea to pursue three specialties at once.

I was hoping to get some insight on whether I should pursue peds, given my background info as well as my pros and cons list for and against peds.

The points I make below are based on limited amount of exposure and are generalizations based on this experience.

Thanks so much in advance!

Background info:
- I came into med school wanting psych, liked derm lectures (and rotation) so decided to consider derm, and loved peds rotation.
- I like the concept of IM (lots of thinking through problems) but didn't like the execution -- working up dozens of complex comorbidities from years ago which patients sometimes don't recover from, and are sometimes perpetuated by the patients' lack of willingness to change their lifestyles (eg. smoking, alcohol etc)
- I have great respect for family doctors and enjoy the variety of conditions treated by GPs. One thing I personally didn't enjoy is the amount of not-as-clinical work the profession can involve (signing forms/papers/health check-ups requested by employers/to some extent prescription renewal on stable illnesses)

Points for peds:
- Loved the staff and the residents! Everyone was so happy and helpful
- Children are usually healthy. They usually recover well from illnesses, and don't have too many comorbidities. In other words, I am using my cognitive problem solving skills, but aren't working up dozens of chronic diseases where outcomes may not change.
- The variety in presentation is quite nice. It also helps that GP's have deemed the patient warranted further workup for medical reasons and have referred the patients to pediatricians. So unlike other specialties, I would get the undifferentiated presentations that I liked about family medicine, but some of the not-as-medical or not-as-clinical visits have already been weeded out.


Points against peds:
- Honestly, I sometimes facepalmed (internally) more than once when well-intentioned, but hyperanxious parents bring in their kids for reasons which need reassurance/education rather than medical interventions (eg. short stature in short parents, coming in for the flu etc). Although I do think reassurance is part of any medical field, I did see a greater proportion of the "worried-well" in pediatrics compared to any other discipline I've been exposed to. I know anxiety/reassurance will be a huge part of psych (one of my alternative careers), but maybe subconsciouly, I am more understanding of their presentation because I know it is part of their pathology.
- Although children are growing on me now post-rotation, I've never historically been a "children-person". I have no problems interacting with them but haven't been one of those people whose eyes just widen and hearts just melt when they see children. When they're behaving well, I find them cute but find that I don't know what to do when they're misbehaving/crying. Of course, being a "children-person" isn't a dealbreaker for becoming a good pediatrician, but I think it certainly helps.

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[IMGASMD]

What’s MSI?

 

[OnePunchBiopsy]

I’m not a pediatrics resident, but I’ve rotated in pediatric surgery. There are some things that you may not pick up on when you rotate as a medical student. Here are some perspectives worth considering when you compare pediatrics to specialties like derm and psych.

1. Pediatrics is a primary care specialty and is usually the primary team when sick patients are admitted to a children’s hospital. It doesn’t matter if dermatology, surgery, Ortho, (insert specialty service) wants to admit the patient. If the patient has some/multiple comorbidities, they usually prefer you being the primary admitting team. Sure, this would be fine for a typical child with little-to-no comorbidities, but even kids can be medical disasters. You have to be willing to be the captain of the boat and steer the ship of care for those patients. This also means you are stuck doing all the orders, admission notes, and discharge summaries. Derm and psych are rarely the primary admission teams (short of a psych ward), and are usually consulting services that make recommendations and get to “sign off” when their work is done.

2. In pediatrics, you are treating the parents just as much as the kids. You’re going to have to deal with nervous parents calling you, messaging you your whole career.

3. Derm and psych have very few emergencies requiring urgent evaluation. This means you are rarely going to get called in the middle of the night. In Peds, if anyone is uncomfortable treating a child, you’re going to get a call.

 

[DO2015CA]

If you are going to do inpatient peds at a children’s hospital you are going to have chronic kids that have multiple comorbidities that need to be managed similar to IM. Not all peds inpatient is easy management. If you are doing outpatient then you will be functioning as primary care and have the same annoyances such as paperwork that any PCP deals with.


Lastly, there are two types of pediatricians, “kids people” and those that hate adults. I like kids and genuinely enjoy interacting with them but I’m in peds because I absolutely loathe treating adults. I love my job and have good relationships with the kids/parents. I wouldn’t trade my career choice ever. Just know that not all pediatricians are heart melting Disney people

 

[PrideOrPanthers]

Why not Derm with a peds fellowship?