Most doctors well into their tenure of medical already have a general idea about how other specialists spend their days (except for radiation oncologists, where no one else knows what they do). However, as a medical student, I had incredibly limited insight into the variety of means to practice medicine. Even as an attending physician, I am still discovering how creative some medical specialties allow one to be. For instance, how many of you guys knew that you could be a cash-only neuromuscular neurologist?
Fortunately, all medical school rotations will include some exposure to pediatrics, but this doesn’t mean that one or two months of rotation is adequate to inform students on the merits of pediatrics. This article will serve as an overview for those students considering a career in pediatrics or those medical students who are in their MS3 rotations considering what specialty to choose.
The medical aspects of pediatrics
Pediatricians take care of children, who are not small adults! This ranges from well-visits to intensive care hospitalizations. One can also opt to take of children as subspecialists who train in a separate fellowship, like pediatric cardiology. There are too many pathways to take care of kids than I can keep track of. A rough diagram can be summed up as such:
Pediatrics residency spans three years, with some programs adding a year of research if you choose. Fellowships can also span anywhere from one year to as long as one desires, although at some point you have to realize that the only way to truly master your profession is to get out and practice medicine. After training, there are a few common venues to practice pediatrics.
The daily grind
Outpatient pediatric medicine is the more common approach to practice, and it is exactly what you think it is. Patients are scheduled perhaps every twenty minutes throughout the day, along with space for add-on emergencies. Some are well visits. Others are sick visits. Kids also get sick during winter months, so pediatricians are typically busier during those months. A pediatrician’s clinic schedule may range from twenty to thirty patients a day. It’s also common for most doctors to spend at least an hour after clinic tidying up notes or calling patients/parents about lab or test results. With the mandate of electronic health systems, we can all expect to spend some time after clinic to finish charting.
Years ago, most outpatient doctors also took care of their own patients while hospitalized. It’s more common that there are some pediatricians who work strictly on the inpatient services to take care of hospitalized kids. What that means is that you could become a pediatric hospitalist. All newborns need to have physicians to be discharged from the hospital.
Unfortunately as important as our next generation is, society has decided to reimburse “pediatrics” anything at only insulting to mediocre levels. We all have to realize that none of us should ever consider going into medicine for the sake of money, but many medical students that have rotated with me have boldly commented on physician salaries. The bottom line is that you’re not going to starve if you become a doctor who takes care of kids. Don’t expect to own any McMansions.
There are also options to go against the grain. Concierge medicine is becoming more popular in affluent areas, where the patients pay a certain retainer to obtain better “access” to the doctor. It is more common for internists to become a concierge practice, although the same can theoretically be done in pediatrics.
Other possibilities simply include working outside of clinical practice: consulting, health insurance reviewer, or even medical officer within a corporate health system. The sky is the limit.
“Smart Money, MD” is an ophthalmologist who blogs at the self-titled site, Smart Money MD.
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