Thursday, April 19, 2012

Why I didn't do Pediatrics

I love kids.

In college, my advisor was a pediatrician, because I thought that's what I wanted to be. When I was in medical school, I was the co-President of the pediatric club. During third year, I scheduled pediatrics to be my third rotation because that's the order in which you're supposed to do the field that you're interested in. (You don't want to do it too early because then you'll look like an idiot, but not too late in case you hate it and change your mind.)

I'm not a pediatrician. So what happened?

Here's why I decided against pediatrics:

1) I spent my whole damn rotation sick with URIs and GI bugs.

2) Really sick kids make me desperately sad, to the point where even doing a practice question about a child with cancer ruined my whole day.

3) I am really, really bad at looking in screaming baby ears. And that's like half of what pediatricians do.

4) I found medicine involving non-sick kids to be really boring. Strep throat? Boring. Rashes? Boring. Otitis media? Boring.

5) Parents = mega aggravating. (Of course, now I deal with adult children, which are also mega aggravating.)

6) When I saw a cute baby, I mostly just wanted to play with the baby, kiss him all over his cute little pudgy face, and then go home and make lots of babies. And when I couldn't do those things, I got frustrated.

7) Whenever we'd have guests at peds club, they always complained about their salary. (I saved the most shallow reason for last.)

It was telling that my lowest shelf exam score the whole year was in pediatrics. Somehow it just didn't mesh for me. Although there are certainly times when I wish I was hanging out with cute little kids all day.

15 comments:

  1. This is why I'm afraid I won't be doing peds either. Love these posts!

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  2. Yes, my first day of peds clinic was enough to turn me off. Love kids, hate screaming kids.

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  3. I was recently reconsidering peds because someone suggested it might be a good fit for me since I really liked my rotation. But I have to agree:

    1) Inpatient academic center medicine you see 50% (or so it seemed to me) kids with terrible disabilities due to genetic syndrome / some awful disease like cancer or HIV whom you can't fix. I found this horribly depressing. I kept imagining what it must be like to be the parent of a kid like that, and that was even MORE depressing. For some reason this doesn't bother me so much with adults.

    2) Outpatient -- BORING!!! Just like you said. And when you had a kid with something interesting, the attending was usually annoyed because it took him/her off their 7 minute per patient schedule.

    3) I loved the cute kids too -- my favorites are the 3-5 year olds (who knows if I'll feel the same way with my own). I enjoyed talking with them. But yeah, there was no time to do this.

    4) It really pained me to watch parents F up their kids with unrealistic expectations or declarations that completely benign behavior was the worst thing the child could possibly do. Also when the parent was really upset about something else, transferring that to the kid instead of recognizing what the actual problem was.

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  4. Every single point you made is exactly why I also decided not to go into peds... even though I loved taking care of babies. And, I'll also add, outpatient peds = boring as heck. I'll stick with Ob :)

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  5. Numbers 2 and 6 will probably end up being the biggest reasons for me not going into paeds. Last year I got ridiculously attached to an orphaned baby with Stage 4 RVD.
    And The Boy gets very nervous when I start cooing over babies.
    Sigh.

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  6. I agree with pretty much all of those reasons, up to and including my having the lowest exam score of any clerkship rotation.

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  7. Actually, now that I *have* kids, I would probably add that spending all day with cute kids/babies would probably make me miss my own kids unbearably.

    Or alternately, it would make me so sick of kids that I'd never want to see them again.

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  8. all 7 of those things are true of me, and i'm a peds resident. also, i love my job. go figure. i don't love outpatient, but that's a small part of what i do.

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  9. I am right there with you on #6.

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  10. What if peds was your only path to ped onc?

    Thank you for posting these. I've wondered about many of them myself; namely crappy parents and how I would cope; how do you phrase, "You are an assssshat and terribad parent" in a professional way? Or how does one say, "Your assshat is going to jail, CPS has been called."

    But, I really would like to do ped onc. Sniffling noses, sore throats, ear aches and all.

    Thank you again!

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  11. Part peds, part psych: Being still altruistic and way into denial after my child psych clinicals in school, I went on to work in the field for six months. Sometimes the kids were fun; often, it was hell just stepping inside the unit's locked doors. (Well, it's psych, after all.)

    We rarely saw parents, whether bio, adoptive, or foster; but when we did, it was usually a sickening experience. Talk about parental a*holery: One sweet kid who actually got lots better while in the unit (rare) was sent back home (by court order -- "that sucks" barely touches the surface of staff's reaction) to the abusive mother who'd ruined the kid's life in the first place. She quickly moved with him to a state with a "less intrusive" social-services system. Effitall.

    And, yeah, we still had otitis media, strep, FUO's and all the rest to deal with, besides more theoretically interesting but clinically yucky problems like enuresis and encopresis. But what was good about minor illness was that the sick kids would usually turn passive and compliant and uber-huggable. And deep down, they all needed lots of hugs; just too often they wouldn't accept them.

    It was a relief of sorts to transfer to adult psych, even though the games changed from "Who can ditch class today?" etc., to "Who can smuggle a weapon through the security search today?" (I know PM&R docs deal with their share of very angry patients, so figure you know pretty well how to "talk down" someone who looks like he/she really wants to go nuclear. Like, say, the chief resident.)

    Will add "thanks to PM&R docs" from someone who's seen a lot of good things happen for patients, courtesy a caring doc and staff.

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  12. I enjoyed my pediatrics rotation but there a few reasons I chose not to go into the field.

    1. Baby talk: I can't do it.

    2. Although it is commonly thought of as a field for laid back people, I've found that many academic pediatricians have a sanctimonious attitude that is truly off putting. Not all children are precious darlings, some are bad, some are jerks. Accidents happen to kids and we can't prevent many of them (sometimes I wonder if we should even try). I guess you could say that I could become a pediatrician without adopting that attitude, but I've found that the best ones did have that attitude and I have no wish to be a mediocre doctor.

    3. The field is being over-run by women. I realize this is not PC. I am a married man, I can't afford to have female friends-- I already have one. I want to be buddies with my co-residents-- hang out and have beers. I have no problems with female colleagues and female authority figures. I just don't want to be the third dude in a class with 20 other female residents.

    4. The salary is too low for the amount of work they do. I would hate to make less than my IM friends for the same amount of work.

    5. None of the subspecialties really appealed to me. I like the idea of being a generalist. But if I need to support my family and pay my loans, I'd need a very good paying job. Doing a fellowship in pediatrics is the best way to do so, but there were none that appealed to me.

    The sad truth is I really enjoy pediatrics. I think it is the most noble medical field. My favorite text during the 3rd year was Baby Nelson's. I even like general peds clinic. I also think adolescence is the best period of life.

    (maybe I will regret this decision)

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    Replies
    1. No sympathy for this:

      "3. The field is being over-run by women. I realize this is not PC. I am a married man, I can't afford to have female friends-- I already have one. I want to be buddies with my co-residents-- hang out and have beers. I have no problems with female colleagues and female authority figures. I just don't want to be the third dude in a class with 20 other female residents."

      How do you think women felt when they were the the third woman in their entire medical school class of 160? And what prevents you from hanging out and having a beer with female residents just as you would with men? That's how I met my wife actually. And if you can't afford to have female friends because you have a wife... well, sounds like the wife is... uptight...that is your problem, good luck with that.

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    2. You are right. That is my issue to resolve. My wife and I do not have a great marriage; med school has not been good for us. I get along very well with all my female coworkers. The danger for me would be in entering into an emotional affair with someone with whom I did not exchange vows. And before you dismiss this idea, it is something that nearly occurred earlier in our relationship.

      Ah, the joy of anonymity

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    3. I, for one, applaud your attempt to guard your heart and marriage. I very much hope, for you and your wife, that this difficult season in your marriage soon passes. My husband and I have been married for literally decades, and those who have been married for long periods of time will tell you that the difficult times are real, but can be overcome with perseverance, and that holding on through the difficult times is well worth it.

      Again. I applaud that you are honest with yourself and make your marriage such a high priority. Hold on...there are better days ahead.

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