Rate these subspecialty from the most competitive to the least competitive?

[one11]

In terms of getting a fellowship position, in the current time:

1- Pediatric Cardiology
2- Pediatric Pulmo
3- Pediatric Critical Care
4- Pediatric GI
5- Pediatric ID
6- Pediatric Allergy and Immunology
7- Pediatric Hem/Onco
8- Pediatric Genetics
9- Pediatric Nephro
10- NICU
11- Adolescent Medicine
12- Rheumatology
13- Emergency Medicine
14- Endo

?

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[FrkyBgStok]

i have heard that
1) cardiology
2) PICU/NICU
3) EM
4) everything else. there are a ton of fellowship spots every year that go open in peds subspecialties so the "everything else" means not even a little competitive.

Some spots at certain places are very competitive, but than cardiology, I have heard that if you want to do a fellowship in peds, you will in your specialty choice.

 

[oracle2]

I thoght allergy was the hardest to break into.

 

[FrkyBgStok]

http://www.nrmp.org/wp-content/uplo...gram-NRMP-Results-and-Data-SMS-2014-Final.pdf

Looks like it is
1) Sports Medicine
2) EM
3) Heme/Onc
4) Neonatology
5) Cardiology
6) Gastroenterology
7) Critical Care
8) Everything else

Looks like peds sports medicine was the only thing last year that completely filled, which isn't surprising with 20 total spots.

 

[chairman]

Among the major pediatrics sub-specialties, these are the most competitive to get into :

1) Cardiology
2) EM
3) Gastro

The rest are relatively easy if you are not picky about particular program. Overall, you should be able to get into any pediatrics sub-specialty of choice, if you focus, have a good applications, good letters of recommendation and are flexible about location and program.

 

[JMMH]

I think Cardiology and EM are the hardest ones to get a spot.

NICU and PICU seem relatively easy to get a spot in general, it's getting into a good program that's the tough part.

 

[13132]

Ill throw this question out there since it is a subspecialty themed thread. How common is it for someone to enter pediatrics with no interest in primary care peds? Basically, how many people have their eyes set on a fellowship from the outset?

I enjoy the pediatric population, but Im more interested in the unique medical problems that kids face/are suceptible to and the fact that lots of interesting stuff is discovered when the patient is a child and it would be awesome to do that in something like peds GI or Cards. I am not interested in well child visits and the things that are often done by primary care peds. Is this motivation for peds looked down upon? Sometimes I struggle with my interest in peds because Im not all Patch Adams like many of the people in my schools pediatric interest group.

 

[FlowLimited]

Ill throw this question out there since it is a subspecialty themed thread. How common is it for someone to enter pediatrics with no interest in primary care peds? Basically, how many people have their eyes set on a fellowship from the outset?

I enjoy the pediatric population, but Im more interested in the unique medical problems that kids face/are suceptible to and the fact that lots of interesting stuff is discovered when the patient is a child and it would be awesome to do that in something like peds GI or Cards. I am not interested in well child visits and the things that are often done by primary care peds. Is this motivation for peds looked down upon? Sometimes I struggle with my interest in peds because Im not all Patch Adams like many of the people in my schools pediatric interest group.

It is not uncommon for pediatric residents to be focused on fellowship from the beginning of training, especially in larger academic programs. What you want to avoid is portraying an attitude of disinterest towards general pediatrics while in residency. There is a lot about general pediatrics that is relevant to a budding specialist, so learn as much as you can.

Relatively speaking, pediatric subspecialties are not terribly difficult to match into, although fields like GI and cardiology are on the more competitive end of the spectrum. As a result, you have a pretty good chance of matching into the field you desire although there are never any guarantees. Keep that in mind if you feel like you could never, ever be happy as a generalist.

Lastly, being warm and fuzzy is certainly not an absolute requirement for pediatrics. Don't let the fact that you aren't dissuade you.

 

[oldbearprofessor]

This one comes up fairly often. It is fine to choose pediatrics based on planning on doing a fellowship. This is common and you'll likely not be at risk of being "forced" into general pediatrics by failing to match if you attend a US medical school. However, I advise people that you will not be happy in pediatrics if you really hate even doing a little bit of clinic type pediatrics. That is a part of residency and part of some, but not all specialty care (diabetics with colds may call their endo doc, etc). You should, as mentioned above look to learn from your general pediatrics in residency as it is a part of your career with most fields. It is also true that warm and fuzzy isn't absolutely needed, but I wouldn't go into peds if you don't enjoy interacting with children.

 

[dbeast]

Ill throw this question out there since it is a subspecialty themed thread. How common is it for someone to enter pediatrics with no interest in primary care peds? Basically, how many people have their eyes set on a fellowship from the outset?

I enjoy the pediatric population, but Im more interested in the unique medical problems that kids face/are suceptible to and the fact that lots of interesting stuff is discovered when the patient is a child and it would be awesome to do that in something like peds GI or Cards. I am not interested in well child visits and the things that are often done by primary care peds. Is this motivation for peds looked down upon? Sometimes I struggle with my interest in peds because Im not all Patch Adams like many of the people in my schools pediatric interest group.

I love answering this question because it happens more often than you'd think- especially for NICU/PICU/EM types, since general peds is sooo completely different and has a huge emphasis on preventative medicine rather than critical care. The down side is that you're in for a long 3 years... but when it comes time to match into a fellowship, you won't face the same degree of competition as your IM counterparts. On top of that, if you get good recommendations from being an outstanding general peds resident at a strong program, then you should have your choice of fellowship matches. If you can't tolerate gen peds enough to be at least moderately enthusiastic, you run the risk of looking like a resident who's difficult to work with.

A similar-minded friend straight up told our program director that he thinks learning about developmental milestones is boring, but he was making it his personal mission to somehow become interested in it at all costs. Not sure what the moral of that story is, except that honesty is okay if you're willing to meet in the middle. And go to a program with a cool PD. Or one with a lot of elective time to spend in your subspecialty. Or both.

As for being touchy-feely, you're going to find a few people like that in every program. It's pediatrics. But, your interview day will give you some ideas about which programs attract more or less of that personality type and there are plenty of people in the field who are like you. In fact, I kind of like some of our "mean" attendings. It's a nice change of pace.

EDIT: Fair warning, you will have to use phrases like "cooing" and "tummy time" simply because there's no other way to explain it. However, I've made it a goal to complete all of residency without saying "kiddo" or using fever as a verb.

 

[MEN2C]

http://www.nrmp.org/wp-content/uplo...gram-NRMP-Results-and-Data-SMS-2014-Final.pdf

Looks like it is
1) Sports Medicine
2) EM
3) Heme/Onc
4) Neonatology
5) Cardiologye
6) Gastroenterology
7) Critical Care
8) Everything else

Looks like peds sports medicine was the only thing last year that completely filled, which isn't surprising with 20 total spots.

That's from 2014, looks like there were some differences in 2015:

By # of applicants per spot available:

1. Sports medicine (3.3)
2. GI (1.4)
3. Cardiology (1.3)
4. EM (1.2)
5. Neonatology (1.2)
6. Critical Care (1.2)
7. Heme/Onc (1.1)
8. Endocrine (0.9)
9. Rheumatology (0.7)
10. Infectious Disease (0.5)
11. Pulmonology (0.5)
12. Nephrology (0.4)

http://www.nrmp.org/wp-content/uploads/2015/02/Results-and-Data-SMS-2015.pdf

 

[13132]

I love answering this question because it happens more often than you'd think- especially for NICU/PICU/EM types, since general peds is sooo completely different and has a huge emphasis on preventative medicine rather than critical care. The down side is that you're in for a long 3 years... but when it comes time to match into a fellowship, you won't face the same degree of competition as your IM counterparts. On top of that, if you get good recommendations from being an outstanding general peds resident at a strong program, then you should have your choice of fellowship matches. If you can't tolerate gen peds enough to be at least moderately enthusiastic, you run the risk of looking like a resident who's difficult to work with.

A similar-minded friend straight up told our program director that he thinks learning about developmental milestones is boring, but he was making it his personal mission to somehow become interested in it at all costs. Not sure what the moral of that story is, except that honesty is okay if you're willing to meet in the middle. And go to a program with a cool PD. Or one with a lot of elective time to spend in your subspecialty. Or both.

As for being touchy-feely, you're going to find a few people like that in every program. It's pediatrics. But, your interview day will give you some ideas about which programs attract more or less of that personality type and there are plenty of people in the field who are like you. In fact, I kind of like some of our "mean" attendings. It's a nice change of pace.

EDIT: Fair warning, you will have to use phrases like "cooing" and "tummy time" simply because there's no other way to explain it. However, I've made it a goal to complete all of residency without saying "kiddo" or using fever as a verb.

This is exactly how I feel (definitely been thinking about NICU and PICU). This post and knowing that people with my personality are fairly common in peds is comforting. While talking about development milestones is borderline painful to me I can still appreciate how important it is to catch kids falling behind. I feel like I would be able to do those types of things with a good attitude by framing things that way... realizing that its all important and always done for a reason.

Im going to save this post and remind myself of it each time I have doubts. Thanks!

 

[jl lin]

This one comes up fairly often. It is fine to choose pediatrics based on planning on doing a fellowship. This is common and you'll likely not be at risk of being "forced" into general pediatrics by failing to match if you attend a US medical school. However, I advise people that you will not be happy in pediatrics if you really hate even doing a little bit of clinic type pediatrics. That is a part of residency and part of some, but not all specialty care (diabetics with colds may call their endo doc, etc). You should, as mentioned above look to learn from your general pediatrics in residency as it is a part of your career with most fields. It is also true that warm and fuzzy isn't absolutely needed, but I wouldn't go into peds if you don't enjoy interacting with children.

 

[dbeast]

This is exactly how I feel (definitely been thinking about NICU and PICU). This post and knowing that people with my personality are fairly common in peds is comforting. While talking about development milestones is borderline painful to me I can still appreciate how important it is to catch kids falling behind. I feel like I would be able to do those types of things with a good attitude by framing things that way... realizing that its all important and always done for a reason.

Im going to save this post and remind myself of it each time I have doubts. Thanks!

Happy to help- message me if you have questions about programs or interviews. Remember that low acuity kids for 3 years is still significantly better than anything in adult medicine.

 

[drkristy85]

i have heard that
1) cardiology
2) PICU/NICU
3) EM
4) everything else. there are a ton of fellowship spots every year that go open in peds subspecialties so the "everything else" means not even a little competitive.

Some spots at certain places are very competitive, but than cardiology, I have heard that if you want to do a fellowship in peds, you will in your specialty choice.

So income-wise, PICU and NICU earn a lot. But EM and Cardiology are much more competitive, probably because of lifestyle....Peds EM is considered to have the BEST lifestyle of all the specialities

 

[drkristy85]

I thoght allergy was the hardest to break into.

\
yes it is quite competitive, even though crappy job market

 

[chemta2006]

Ill throw this question out there since it is a subspecialty themed thread. How common is it for someone to enter pediatrics with no interest in primary care peds? Basically, how many people have their eyes set on a fellowship from the outset?

Not uncommon. I remember from my interviews a while back that many programs showed the breakdown of gen peds vs sub specialties and for most of them it was about 50-50. I myself have been 95% hem/onc and 85% peds from the get-go (left the IM train after my last rotation of MS3, pediatrics).

Echoing what others have said in this thread, residency is about becoming a good general pediatrician so that you have a solid foundation if you do decide to subspecialize. So I'd recommend focusing on programs with excellent gen peds training along with access to experiences in the fellowship(s) you are interested in.

 

[settingqt31]

I had said Peds Hem/Onc from the time I was 13 years old and I have matched into a fellowship for it. Going into residency I was honest about my goals but also very focused on becoming well rounded both to pass boards but also because I know I want to do medical missions and you can't really go abroad and treat cancer as it is a long-term problem and so I wanted to leave residency confident enough to handle many issues abroad that would be more general peds based.

 

[michigangirl]

For what it's worth, I entered pediatric residency knowing I would absolutely not be a general pediatrician. Came out a pediatric intensivist and anesthesiologist. Clinic was not my favorite But I gained as many pearls as I could, particularly speaking with families.

 

[67552931811]

For what it's worth, I entered pediatric residency knowing I would absolutely not be a general pediatrician. Came out a pediatric intensivist and anesthesiologist. Clinic was not my favorite But I gained as many pearls as I could, particularly speaking with families.

Did you do peds first then gas then cc? Pardon if said question is terrible but I've always been quite intrigued by the above combo.

Thanks, doc!

 

[michigangirl]

Did you do peds first then gas then cc? Pardon if said question is terrible but I've always been quite intrigued by the above combo.

Thanks, doc!

Yes. Feel free to search my posts for more details. Most common and plausible route now Is to do combined peds-anesthesia residency followed by fellowships. 9-10 years.

 

[67552931811]

Yes. Feel free to search my posts for more details. Most common and plausible route now Is to do combined peds-anesthesia residency followed by fellowships. 9-10 years.

That's dedication right there! Haha, but I will search it up. Thanks for the reply, doc!