LHCF
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Join Date: May 2006
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Has anyone been torn between neonatology and obgyn? How did you make the decision?
For old bear professor and doc hollywood:
1. What is a typical day like for you?
2. How would you describe the lifestyle/malpractice issues for
neonatologists?
3. Is neonatology a competitve fellowship? (Meaning someone who wants to become a neonatologist may not match?)
To answer your questions specifically
1.I'm writing this
at work at 5 in the morning.
There's your first clue as to a typical day
There are no typical days. It depends on the typs of practive you join
You have I would say more options in neonatology than just about any other career , in terms of lifestyle, practice type and hours and even income
I have friends that are in academic neonatology with a primary research focus and they do 3/4 of their time ( or more ) in their lab, and only set foot into the NICU a few months a year. I have others that are on a primary clinical track and do very little resarch but have a very big teaching job.
I can really comment more about the private practice worls since that's what I do.
There are solo practitioners ( pretty rare ) .....and small private groups, and large private groups.
A couple of my friends work for Pediatrix, which I think of as the Wal Mart of Neonatology. They cover lots of hospitals besides their own. I am not bashing pediatrix. I actually interviewed in a few of their programs, but I decided not to join "the Firm". The whole corporate mentality wasn't for me
I work in a hospital based group of 5 docs. We provide 24 hour in-house coverage for a pretty busy 30-40 bed unit. When I am working I am very busy. When I am off I am OFF. No beeper. No office. Off. I like to travel so that works out great. I can go pretty much anywhere I want since I am not on the schedule and this doesn't count as vacation. I get pretty good chunks of time off and then do one week where I am in the hospital about 90 hours. I do that on average one in 5 weeks. the rest of the weeks are closer to 40-50 hours, providing night and weekend call. We make our own schedules so all of us pretty much work when we want and are off on the times we want off. ( for the most part ) Holidays and weekends still need to be covered so you always end up missing something
One thing is for sure, if you choose this field you will work your share of nights. Some places offer call from home, but rest assured : you will be spending a fair amount of time in a hospital at night. That's actually the part I like. I like to be up at 3 AM taking care of really sick patients. Guess if I didn't I'd be working in an office writing Ritalin scripts and doing sports physicals and getting gum out of ears.
All 5 fellows from my class went into private practice.
4 of the 5 in the class behind me went academic.
People choose for various reasons. I guess my class was materialistic since at the time the salaries were about double to do private. I just waw one of my friends at SPR and I am happy to report that things are greatly improving on the salary front on academic part ( at least where he works ) Great news!
A "typical day" would be as follows:
Some type of sign-out rounds in the morning usually about 8 AM with the previous evening physician. ( residents of course probably getting there to preround at 6 or 7AM... )Then actual rounds on your census of babies ( fellows making rounds with the residents before the attendings show up to make sure nothing is screwed up to make the fellow look bad ) Attending rounds with the entire team usually begin at about 1000 and continue until finished ( stopping sometimes for lunch or a noon conference ) usually wrapping up by 2 PM, when the scut is carried out feverishly. Sign out rounds usually occur for the night call doc at about 5 or 6 PM.
And the whole process repeats.
Torn between neonatology and OBGYN
? Not in a millions years
I Loved neonatology.
I
Hated OBGYN. The two ( though working close together ) are MILES apart. If you had said torn between neonatology and peds critical care, or anesthesiology I think those are more similar. I almost did anesthesiology as a career. In a crash c-section I am still always watching the anesthesiologist instead of the OB
2. Lifestyle?
Well I think lifestyle is pretty good. The salaries are also variable , based on location and type of practice. You can work every other night on call ( or be on call every night I guess if you are in a small town area and provide coverage for deliveries or emergeicnes ( YUCK ). Obviously if you are doing bench research with a very light clinical duty, you are not on call a whole lot.
I can only comment on my salary and I am very happy with it. Four years out in practice now ( after 4 yrs college, 4 yrs med school and 6 yrs residency and fellowship )and I think I am earning almost the minimum salary for a major league baseball player. I'm pretty stoked about that. Malpractice is one area of concern I suppose. I work in a high risk field. You will be sued sooner or later. My partners have all been sued for various things, and it seems like never for any actual malpractice, only bad outcomes which do happen with the sickest patients. I've testified in a few depositions already for OB's that were getting sued, in which I took care of the baby afterwards. (The external fetal monitor doesn't do much as far as I can tell other than increase your c-section rate and make money for the lawsuit industry. Trial lawyers, defense lawyers. They all get paid in the end.
I honestly don't worry about getting sued, but the more I get into the field the more I find myself doing things defensively....to cover my ass. I don't like it but I think we all do it. I still consider myself to be somebody that tries to practice medicine without thinking of things like that, but It's pretty hard these days. All physicials practice defensive medicine from time to time either intentionally or on a subconscious level. We use words like " being extra cautions" when what we are really saying is "I am ordering this test to rule out you suing me should something bad happen later"
3. Last I checked it still wasn't too competative. I think like most careers there is ebb and flow in the job market. There are still plenty of jobs at teh present time and I don't see that changing in the next decade. Maybe there will be even more available as pediatric residency training gets more and more watered down in the care of the newborn. When I was a resident in 96-99 people told me I was nuts for doing the fellowship and said I'd never find a job because I guess the market wasn't so hot at the time. I didn't care, it's what I loved. Now as more and more hospitals are delivering more and more complex cases away from referral centers and as more and more spraql occurs with nice 800 bed hospitals in the burbs with 30 somethings having their IVF and their 24 week twins, there seem to be a plethora of jobs. Also last time I checked you can virtually get a job in just about any academic department. So many medical schools, so few fellowship graduates.
Getting a fellowship isn't probably too difficult. Try to get a fellowship at a really good program with a very busy unit. Try to go to at least an ECMO center so at least you can manage an ECMO patient and you won't be limited by where you can go and work.
Even though we don't do ECMO, I was glad I trained and am comfortable with managing those patients, in case I ever decide t oleave my current practice and work in a place where the do ECMO
**Match?? Is there a match now?
When I applied you just applied and thei either offered you a spot then and there ( or within a week or so )
I would suggest doing some electives in the NICU. Seeing is believing. Maybe you will get hooked. It's really addictive.
Hey what great timing. My 27 weeker with the perf is done getting his ex-lap. Time to see him and get a waffle and a big cup of coffee
post specific questions, though I only browse this forum rarely. I usually check in a few days aftere I post something so I'll try to answer
also try
www.neonatology.net and specifically
here for more information. I think that's a pretty good synopsis