r/pediatrics

I’m a relatively new attending with a new job in the nursery. My medical director wants me going to resuscitations and helping at deliveries for babies who should go to the nursery (above 35w, >2kg) which I’m fine with (renewed NRP and everything). But when I tried to apply for neonatal stabilization privileges, the medical staff office said I’m not allowed because I’m not neonatology trained. Is that right? Is it hospital dependent? Should I just let my medical director deal with it? How can the APPs attend deliveries but I, a pediatrician, can’t? (Not a knock on them because I’m re-learning a ton from them. Just questioning the system)

And what are they doing with our dues money? Do they distribute patient information handouts free of charge? Because I’ve been buying the ones I distribute. I’d love to see some advocacy for better pay and job security for us, the lowest-paid specialty year over year. Or more free education/resources for members.

I’m a rising M4 and have been between psych and peds basically all of medical school. But I’ve told everyone I’m applying peds since M1, if that makes any sense lol. I’m just not sure if I’ll actually love all aspects of peds. I’m pretty set on not doing fellowship, I’m old-ish and honestly just want to start attending life ASAP.I don’t know if I love interacting with parents as much as I thought I did, and I’m also not sure how much I enjoy well-child checks or newborn medicine. I definitely don’t want to do something high-acuity like hospital medicine for my entire career either. On the other hand, I really like psych for the work-life balance and honestly find it the most interesting/“fun.” Weirdly enough, my psych patients from my psych rotation are some of the ones I still remember the most, whereas I don’t remember many patients from my other rotations. So now I’m like… should I actually be paying attention to that? 😂 The problem is I haven’t done any psych Sub-Is, and my board scores are pretty low, so I’m not sure how realistic switching gears this late in the game would be. Idk, I guess I’m just wondering if anyone has any insight or has gone through something similar. Also do not want to do child psych 100% bc that has been suggested to me in the past.

The question amongst my group is regarding DTaP/Tdap and whether an unvaccinated adult gets adequate diphtheria and pertussis protection from Tdap if they’ve received no previous vaccines? It has not come up for me before here, but when I worked in Eritrea years ago, we gave DTaP to unvaccinated adults to provide diphtheria protection. We only had DTaP and Td available. And we also had quite a few diphtheria cases. We’re having trouble finding recommendations that don’t seem to assume previously-received DTaP. Thoughts?

I’m new to Reddit and to the group👵 I’m looking forward to the discussions!

I'm peds rheum. Whenever a patient no shows for an outpatient consult or cancels without rescheduling, I send the consulting group a letter notifying them of the missed apt.

Is this actually useful for primary care?

I’m applying Peds because I genuinely enjoy working with kids and loved my experience working in a pediatric clinic. I also like the lifestyle, especially since I want a family in the future. I have no student loans and don’t need to be rich, but I want to live comfortably, travel, save/invest, and afford a nice home. People keep telling me to choose IM instead because Peds pays poorly, and it’s making me second-guess my choice. Pediatricians: Do you feel financially comfortable? Is the pay really as bad as people say, and would you choose Peds again?

Keeping location and health system anonymous. Midwest region:

Full time outpatient gen peds APP position listed on ziprecruiter with salary range $166k-215k. Meanwhile, same health system < 5 miles away (also on ziprecruiter) offering full time outpatient gen peds physician with a salary range of $160-205k.

How did we get here?

Hello, I am a board certified Primary Care Pediatrician currently working in the East Coast.

I have graduated from my residency in 2025.

I absolutely love my practice, but unfortunately, I am on a visa. And these days things have become so difficult, especially to travel to my home country because of lack of appointments for visa stamping. It’s been two years I’ve seen my family. Hence making this painful decision to move.

Any insight as to how the practice in Canada is? How different is it compared to USA? I know that the pay is some lower than what it is here and I heard the specialist referrals may take a lot of time.

Any guidance would be helpful!

Am I just unlucky or is the current job market worse than 1-2 years ago. I remember my seniors applying to the exact same region getting offers starting around 250-270 and I’ve been getting offers but in the 190s.

Hi everyone!
I'm looking for some advice - how is the job market for peds GI? IMG here, completed 2 years of pediatrics in my home country, completed a PhD, and I'm currently working as a postdoc. Clinically, I loved GI (esp. IBD management, love to listen to the Bowel Sounds podcast :) ), I am not into general peds, though.

My husband wants to do IM and a hem-onc fellowship, so we'll be going through couples match and residencies at the same time, and probably stay in a bigger city after our training. We also want to start a family at some point, and with research years adding to our YOG, I'm worried about my options (I'm 31 and the clock is ticking).

I love treating kids - I'm just worried about whether it's worth pursuing in my case.
Thanks for any advice!

4th year DO med student applying IM, but now considering a late decision to dual apply peds. The obvious answer would be to apply med/peds but I'm not competitive enough (Step 2: 23x Level 2: 54x).

All my fourth year subIs are IM as my peds rotation wasn't until March/April. I really liked the pathology in inpatient peds/nicu, but outpatient peds was boring to me and the attending I was with scared me about 1) low pay 2) declining respect for this specialty 3) overall NP/PA creep into the space esp in gen peds. As I do more IM subIs, I'm kind of numb about the littany of problems with adults where I'm just sort of delay death (sorry to be morbid) vs peds where there was always forward momentum.

So what changed? I have a mentor who is in a peds subspecialty. He's known me for many years, before I went to med school. He's believes that 1) peds is a happier workplace 2) more fulfilling work (which I did experience during my rotations) 3) higher chances of better residency program and subsequent subspecialty match (e.g. cards/GI/hem onc). Edit: I forgot to mention I want to start a family in the next couple years, so probably during residency.

I have a month to make this decision at the last minute. I could get 1, maybe 2 peds LOR (the second one would be a bit of a stretch) and I could possibly switch out one of my IM sub I in sept for peds. I just don't know if I could actually get into an academic peds program without an app that "screams peds" (per my school's career counsel) to later sub-specialize or I'm being idealistic.

Any perspectives or advice would be greatly appreciated.

Hi everyone! M3 here, so still early in my training, but curious to hear some perspectives as I start to make headway towards a decision for specialty choice (which I assume will come up sooner than I expect).

I am a non-trad, mom to a toddler, hoping for another child before residency - very interested in ID for multiple reasons and hoping to follow that through residency. I have loved my peds rotation and am curious - for those who decided on peds ID - about what went into your decision, your work-life balance, finances, and general day-to-day, especially if you can share any contrast to adult ID. Potentially interested in academic medicine, especially given that I assume many peds ID jobs fall in that category.

Thanks!!

Hi all,

I'm a US transplant in BC.

Any pediatricians here that do outpatient only in BC? Seems like we have a lot of complex psych burden to manage so have had to make my teenage visits for psych 1 hr. With this kind of trend, I am not making much. Currently 4.5 days patient facing hours, but spending loads of unpaid hours on notes, inbox etc.

Any other outpatient peds struggling with finances? Also paying back 6 figure loans, overhead is 25%. The EMR in canada (OSCAR pro) are revolting with click fatigue, don't have in-built growth charts that calculate exact percentiles (like Cerner did). Lots of windows that pop out instead of staying in the EMR window. Dot phrases cannot automatically add values from chart into your note. etc etc.

Please reach out, would love to hear strategies on how you've been able to make workflow efficient and maximize earnings. Thanks!

What are your opinions on the SWYC? I feel like it tends to flag patients as having a delay when they actually don’t? I had a patient recently that was flagged on the SWYC, but when I ask our built in milestones in Epic and look at Bright Futures, the kid is perfectly fine. Is anyone else seeing this?

if you practice peds in the US, hope you’re hanging in there ok. get news out of the White House, we don’t have to inject kids with soda bottles worth of vaccines anymore, we can separate them into 3 vaccines that don’t exist.

also I had my first vit K Refusal in a long time along with the uptick in ppl refusing vaccines and it’s just fantastic.

Exactly what the title says.

Do you feel like the training you received was adequate to transition into a full CAP comfortably? Do you second guess your dosages or clinical acumen?

Please let me know.

Good morning dear pediatricians,
I am a family physician practicing in an FQHC. I have a situation that I would be so grateful for anyone’s thoughts (or direction to resources) for.

I have a developmentally disabled patient for whom the guardians disagree on what constitutes “the best care” and also “harm”. Does anyone have resources on how to navigate medical decisions here legally and ethically?
They rarely come to the clinic in person, and when they do they have voiced any disagreements with the plan after the fact and not during the visit.

My typical go-to’s (try to have discussions in person, only do what both guardians agree to) just aren’t quite adequate here.

Im being intentionally vague because l’m mainly seeking information to help me handle situations like this better in the future rather than guidance for this particular case per se.

Thank you for your time and for all you do!

I struggle with time management but have gotten so much better in clinic. However, when it comes to our Spanish speaking population, I find those appointments take forever.

I am all for supporting our Latinx community! I wish I spoke Spanish myself! No hate. Just want to be the most efficient in clinic!

Does anyone know of good tips to make translated appointments go faster? I would love to give them all the time in the world and they deserve it! I just can’t with the schedule and time allotment and want to make sure they are getting the best care.

I’m feeling incredibly burnt out. I am in my ninth year of clinical practice and have worked in multiple practice settings. I just don’t want to do it anymore and I’m exhausted. I am ready to leave clinical practice and finically it is not a problem for me (high earning spouse who works a ton). I have young kids and want to give them more of my energy. Has anyone else done this? How did it go?

Hello,

I'm a medical student img looking to join peds residency. Just wanted to know the job market for the following peds subspecialties:

1. Peds cardio

2. Allergy immuno

I got interested in peds psych towards the end of my usce. Is there any way I can incorporate peds psych in my practice?

Please let me know!