thinking about switching

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bluebirdie

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So right now I am a PGY-1 resident in a family medicine program. I applied to both family and peds during my 4th year but ultimately chose family because, #1 I enjoy it #2 the money is a little bit better #3, other than intern year in family, residency is much more mellow and #4 I didn't think I wanted to subspecialize. Although, overall, peds was a better fit, and something I was very passionate about. I have done two peds rotations this year and am currently doing a month of inpatient peds right now and I must say I am having an awesome month. It fits like a glove. It's been really busy, and have had some run-ins with some interesting people this month, but overall it has been my best experience of residency. I had thought about switching earlier in the year after my first pediatric month, but I thought some of those feelings stemmed from not feeling part of my family medicine program. Now, I feel invested in my program and I am still having feelings of wanting to do pediatrics. This month has been my best month of residency and I feel like everything fits like a glove. I am very passionate about pediatrics and I'm thinking of switching and now am thinking that I may want to subspecialize in something like ID or pulm or maybe do primary care. I think there would be an opening for me at the program I am currently rotating though. However, I still have reservations on switching because I would basically have to do my entire intern year over again, and I do have 200 G's in educational debt to pay back. I know fp isn't a cash cow by any means, but i have heard mixed things about salaries in the midwest for primary care pediatricians as well as id and pulm docs. Have any of you switched into pediatrics or know anyone that has can shed some light on the situation?
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good luck with your decision-making. seeing people like you want to follow your heart despite choosing another specialty based on more 'rational' thinking makes me think i'm making the right decision with peds.
 
Bluebirdie, at one point early in my 3rd year I was thinking about FP and talked to one of the PD's at my home program. He made a very insightful point to me. I told him that I really loved pediatrics and that I was a bit torn between the two. His reply was that if I had any real desire to do peds, I should do pediatric training. His main point being that as an FP I would not be the kind of pediatrician that I wanted to be. He said that for anything beyond the usual well-child checks and typical childhood illnesses, he was always consulting his Pedi wife because she was so much better educated in peds than he was. He felt that anyone coming into FP who wanted to be a really good doctor for children would ultimately be unhappy with FP training.

I was a bit put off at the time that he was discouraging me from his own profession which struggles to find good applicants in our program. After a few minutes of thinking about it, I realized he was doing me a great favor.

So if your real desire is to be an excellent doctor for children, you may be right to switch programs now. Once you're out in practice making money, it'll be that much harder to consider additional training.

btw, most of the info for physician salaries that I've seen have put FP and general peds in the same range of income. Check our FAQ's for some links if you don't have them already. :)
 
TexasRose said:
Bluebirdie, at one point early in my 3rd year I was thinking about FP and talked to one of the PD's at my home program. He made a very insightful point to me. I told him that I really loved pediatrics and that I was a bit torn between the two. His reply was that if I had any real desire to do peds, I should do pediatric training. His main point being that as an FP I would not be the kind of pediatrician that I wanted to be. He said that for anything beyond the usual well-child checks and typical childhood illnesses, he was always consulting his Pedi wife because she was so much better educated in peds than he was. He felt that anyone coming into FP who wanted to be a really good doctor for children would ultimately be unhappy with FP training.

I was a bit put off at the time that he was discouraging me from his own profession which struggles to find good applicants in our program. After a few minutes of thinking about it, I realized he was doing me a great favor.

So if your real desire is to be an excellent doctor for children, you may be right to switch programs now. Once you're out in practice making money, it'll be that much harder to consider additional training.

btw, most of the info for physician salaries that I've seen have put FP and general peds in the same range of income. Check our FAQ's for some links if you don't have them already. :)
Click to expand...

Thanks for all the input guys!
 
I'm kind of partial to #2 in the prior thread. It's kind-of wierd reading something I wrote 2 years ago. One thing you should find out is weather you can change rotations for the rest of the year and thus cut down on extra time you will spend in peds. This really depends on your current and future program and how flexible they will be. You should have some elective time in your 3-year peds schedule that you can use for things you've already done. We had a 'tern last year switch part way through the year and he'll graduate on time.

Ed
 
edmadison said:
I'm kind of partial to #2 in the prior thread. It's kind-of wierd reading something I wrote 2 years ago. One thing you should find out is weather you can change rotations for the rest of the year and thus cut down on extra time you will spend in peds. This really depends on your current and future program and how flexible they will be. You should have some elective time in your 3-year peds schedule that you can use for things you've already done. We had a 'tern last year switch part way through the year and he'll graduate on time.

Ed
Click to expand...


So I kinda made the decision to switch. I feel kinda nervous about the whole thing. I like family medicine and feel very comfortable with my program and my clinic and my patients. I've made arrangements to switch. I'm freaking out a bit, but I do feel that I would do best in pediatrics. Is this normal to be feeling this way?
 
bluebirdie said:
So I kinda made the decision to switch. I feel kinda nervous about the whole thing. I like family medicine and feel very comfortable with my program and my clinic and my patients. I've made arrangements to switch. I'm freaking out a bit, but I do feel that I would do best in pediatrics. Is this normal to be feeling this way?
Click to expand...

There are folks who are certain about everything they do - in their career, in their personal life, in their faith,in their financial dealings, etc. Then there are the folks who always have doubts. There is nothing intrinsically better about the folks who are certain about things than those who have doubts. Both are just part of the way different folks approach decisions.

Good luck and congratulations on making a choice that you've wanted to make for a long time.:thumbup:
 
bluebirdie said:
So I kinda made the decision to switch. I feel kinda nervous about the whole thing. I like family medicine and feel very comfortable with my program and my clinic and my patients. I've made arrangements to switch. I'm freaking out a bit, but I do feel that I would do best in pediatrics. Is this normal to be feeling this way?
Click to expand...

Good luck :luck: ...I'm sure it will turn out fine. :thumbup:
 
bluebirdie said:
So I kinda made the decision to switch. I feel kinda nervous about the whole thing. I like family medicine and feel very comfortable with my program and my clinic and my patients. I've made arrangements to switch. I'm freaking out a bit, but I do feel that I would do best in pediatrics. Is this normal to be feeling this way?
Click to expand...
I think it's totally normally to feel that way about a big decision.

Congrats and good luck! :)
 
TexasRose said:
Bluebirdie, at one point early in my 3rd year I was thinking about FP and talked to one of the PD's at my home program. He made a very insightful point to me. I told him that I really loved pediatrics and that I was a bit torn between the two. His reply was that if I had any real desire to do peds, I should do pediatric training. His main point being that as an FP I would not be the kind of pediatrician that I wanted to be. He said that for anything beyond the usual well-child checks and typical childhood illnesses, he was always consulting his Pedi wife because she was so much better educated in peds than he was. He felt that anyone coming into FP who wanted to be a really good doctor for children would ultimately be unhappy with FP training.

I was a bit put off at the time that he was discouraging me from his own profession which struggles to find good applicants in our program. After a few minutes of thinking about it, I realized he was doing me a great favor.

So if your real desire is to be an excellent doctor for children, you may be right to switch programs now. Once you're out in practice making money, it'll be that much harder to consider additional training.

btw, most of the info for physician salaries that I've seen have put FP and general peds in the same range of income. Check our FAQ's for some links if you don't have them already. :)
Click to expand...

I couldn't agree with this more. I'm a third year peds resident and we work with FP residents at our children's hospital. While they may be very good docs, their exposure to peds is rather limited, and the mistake I see from practicing FPs is treating them like small adults. They are quite capable of doing well child check and ear infections, but really need to know when to get more help. That's difficult, especially since kids can be 'sick' yet not look it.

You won't get rich in either field, so I think you're even there. But if children really make you happy, and you don't mind giving up adult medicine and any procedures that come with it, then you need to do peds.
 
Stitch said:
I couldn't agree with this more. I'm a third year peds resident and we work with FP residents at our children's hospital. While they may be very good docs, their exposure to peds is rather limited, and the mistake I see from practicing FPs is treating them like small adults. They are quite capable of doing well child check and ear infections, but really need to know when to get more help. That's difficult, especially since kids can be 'sick' yet not look it.

You won't get rich in either field, so I think you're even there. But if children really make you happy, and you don't mind giving up adult medicine and any procedures that come with it, then you need to do peds.
Click to expand...

So here is how things stand. The funding for a spot at this other program has been approved. I am really starting to have cold feet. I am back at my home program. I do enjoy family medicine, but I feel that I do my best work in pediatrics. I worry about getting burnt out in pediatrics. I also feel like I know what to expect in family because I have been a resident at my current program and feel comfortable there. I am trying to look 10-15 years in the future and picture my life. That is extremely difficult right now. I am so frustrated right now!!!! ARGHH.
 
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bluebirdie said:
I worry about getting burnt out in pediatrics.
Click to expand...

I'm interested in what your worry is here? Is it that well-child care is too repetitive? Too stressful? That specialty care is either of these?

I've known a large number of pediatricians in both general and specialty areas. Although anything is possible, I've seen very little burn out among pediatricians and my friends are all "really old".:p

I'm in a fairly intense specialty and yet many of those who were amongst the first neonatologists are going strong in their mid-60's and beyond. I've seen many folks enjoy themselves more in pediatrics as they get older. Until I get so old that I can move in with my children and be a burden to them :laugh:, I expect to keep practicing! Of course, I might slow down on the in-house night call a bit...

Make the choice that reflects what will make you happiest with your career and what will make you look forward the most to going to work each day.:)
 
bluebirdie said:
I applied to both family and peds during my 4th year but ultimately chose family because, #1 I enjoy it #2 the money is a little bit better #3, other than intern year in family, residency is much more mellow and #4 I didn't think I wanted to subspecialize. Although, overall, peds was a better fit, and something I was very passionate about. I have done two peds rotations this year and am currently doing a month of inpatient peds right now and I must say I am having an awesome month. It fits like a glove. It's been really busy, and have had some run-ins with some interesting people this month, but overall it has been my best experience of residency. I had thought about switching earlier in the year after my first pediatric month, but I thought some of those feelings stemmed from not feeling part of my family medicine program. Now, I feel invested in my program and I am still having feelings of wanting to do pediatrics. This month has been my best month of residency and I feel like everything fits like a glove. I am very passionate about pediatrics and I'm thinking of switching and now am thinking that I may want to subspecialize in something like ID or pulm or maybe do primary care. I think there would be an opening for me at the program I am currently rotating though. However, I still have reservations on switching because I would basically have to do my entire intern year over again, and I do have 200 G's in educational debt to pay back. I know fp isn't a cash cow by any means, but i have heard mixed things about salaries in the midwest for primary care pediatricians as well as id and pulm docs. Have any of you switched into pediatrics or know anyone that has can shed some light on the situation?
Click to expand...

I don't think it was a good idea to choose family practice over pediatrics because the pay is better in family practice. I would ask yourself why you choose family practice in the first place, i.e. was it something more than an extra $5,000 dollars a year? I.e. there must have been something you liked about family practice? The salaries are so similar between pediatrics and family practice I can't see anyone choosing one just based on salary, it is like choose the Number 1 Big Mac value meal over the Number 4 Chicken value meal because it is 10 cents cheaper but deep down you wanted the chicken?? Do you want to know if you can make more money as a peds specialist versus family practice?? I think peds specialties are pretty low-paid and not in financial terms worth the missed 2-3 years of salary as a general pediatrician, i.e. only those who want to do this specific type of work do it. . .
 
I am a PGY-1 in ped. I like to switch to adult medicine like IM or FP. Anyone recommedations?
 
KentW said:
Not that there's anything wrong with that, of course. ;)
Click to expand...

No doubt.


But I'm always curious to people's motivation for switching fields...especially with in a greater discipline (primary care). Presumably, they had to have motivation to go into the field they originally chose...what changed? And why similar fields, why not jump ship all together and do surgery, gas, rads, or something not similar.
 
iatrosB said:
No doubt.


But I'm always curious to people's motivation for switching fields...especially with in a greater discipline (primary care). Presumably, they had to have motivation to go into the field they originally chose...what changed? And why similar fields, why not jump ship all together and do surgery, gas, rads, or something not similar.
Click to expand...

I can't imagine wanting to work with adults, but I've given serious thought about doing peds anesthesia when I'm done (coming soon). The kids are fantastic, but I'm tired of dealing with terrible parents and convincing them to take care of their kids, and gas would allow me to work with them but deal with less of the chronic follow up stuff. I nearly ended up in PICU, which was my initial aim with peds, but then thought the lifestyle was better in anesthesia.

Still undecided though and may end up in child abuse. :oops:
 
Stitch said:
I can't imagine wanting to work with adults, but I've given serious thought about doing peds anesthesia when I'm done (coming soon). The kids are fantastic, but I'm tired of dealing with terrible parents and convincing them to take care of their kids, and gas would allow me to work with them but deal with less of the chronic follow up stuff. I nearly ended up in PICU, which was my initial aim with peds, but then thought the lifestyle was better in anesthesia.

Still undecided though and may end up in child abuse. :oops:
Click to expand...

Correct me if I'm wrong, but that's another 4 years of training? :eek:

3 gas, 1 peds fellow gas
 
So I've decided to go ahead and switch to peds. All I have to do is sign my contract. I'm a little nervous about switching still because I hate change, but in the end I think it will be for the best.
 
bluebirdie said:
So I've decided to go ahead and switch to peds. All I have to do is sign my contract. I'm a little nervous about switching still because I hate change, but in the end I think it will be for the best.
Click to expand...
Welcome to peds! :D I hope you'll be very happy with your decision.
 
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