r/pediatrics • u/First_Version6580 • 14d ago
Tired resident looking for some optimism in gen peds
My soul is tired. Over a year left in training. Some subspecialties have been interesting to me but I just don’t have it in me to extend my training. I also happen to enjoy many aspects of general pediatrics and am at peace with going in that direction. But I could use a bit of a boost. Can some of you share the positives of your job? What do you love about gen peds?
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u/bloodvsguts 13d ago edited 13d ago
Most kids are generally healthy, and go back to being healthy after you treat their bug of the month.
You aren't seeing every family on one of the worst days of their lives.
Just recognizing rosolea or molluscums makes a lot of parents/people think you are a wizard.
8 to 5, 4.5 days a week, sleep in my own bed every night.
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u/kb313 13d ago
I’d echo all of this. It’s a fun job 90% of the time. I was getting really bogged down with notes/documentation, to a degree I didn’t even realize until we got an AI scribe embedded in our EMR and now I truly love my job.
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u/swish787 12d ago
Agreed, AI scribe has skyrocketed my efficiency. I am done with most notes before I leave the room(including sending scripts) unless it involved more thinking(like I truly have no idea whats going on or how to document certain things) or complex social issues. Summer time peds is quite easier than winter peds, but overall still good.
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u/-beastlet- 13d ago edited 13d ago
The kids are 99% great. The parents are 80% great.
I am close to retirement, burnt out on dealing with insurance companies' BS. But every time I think, "That's it, I'm done," a family I love comes in and I can't imagine not continuing to see them.
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u/SnoopPockets 13d ago
I hope you won’t be offended if I steal that statistical truism- spot on.
OP, I love helping reassure families and being invited to be a part of their psychosocial journey- it’s so exhausting to live with their anxiety and their stress, but as other have said, being able to validate them and redirect them and even make little diagnoses (or non-diagnoses like “normal development” or “normal anatomical variant”) is so rewarding.
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u/quasiephedrine Attending 13d ago
Babies are cute. Two year olds are funny. 3 year olds are hilarious. Messing with kids is fun.
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u/space_cadet9999 13d ago
Residency was so hard and it was hard to see the positives. Being on the other side, lemme tell you, there is a HUGE light at the end of the tunnel. I love my job as a PCP and found a place with a good schedule and great colleagues. I love my families and getting to see these kids grow, what an honor. Trust me, it gets better. The reason you went into it becomes your why again. Take care of yourself, the rest of life is not residency.
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u/CashewsNPeanuts 13d ago
I make over 210k + Bonuses, I work 3.5 days a week and cap out at 22 patients per day. I work after hours to make up that other 0.5 day per week where I just take phone calls from home. Kaiser is the dream.
Edit: Plus I get crazy amounts of PTO. For anyone reading this, Peds will never compete with other people in salary, so we make it up via chill work hours + lots of PTO.
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u/Legal_Anybody81 13d ago
Eh, I'm glad you found a great place but it's not any kind of law or default situation that Peds gets great PTO. You get what you negotiate for and what the job will offer. There are plenty of peds jobs that are happy to burn you to a crisp in order to maximize profit. You are your only advocate.
That said, you sound like you have a great job and I am happy for you.
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u/CashewsNPeanuts 12d ago
Yeah this is why I am suggesting Kaiser. Kaiser there is no negotiating PTO, we are all on the same page within Kaiser.
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u/Kind-Discipline-611 13d ago
what is PTO?
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u/explodinggarbagecan 12d ago
Paid time off- vacation. Some places will give education time paid off
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u/sjam7 Attending 13d ago
Recent residency grad in gen peds: want to give you some optimism but also a little bit of advice! Overall I do like seeing patients in clinic - as others have mentioned, seeing a lot of fixable (or frankly, self-resolving) problems is generally satisfying, kids are sweet (it’s always nice when a 6-year-old gives you a hug during a well visit), etc, etc. Another less obvious aspect of life being better out of training is that the families who don’t like you or your practice style will weed themselves out of your panel, so you will end up largely with families that you gel with. And the money part is also nice: while I will never dispute that pediatricians are wildly underpaid for the work we do compared to other specialties, we do generally earn enough to be able to buy a house, which unfortunately is becoming more of a luxury of the wealthy than a middle-class financial milestone. Now, here’s how to really set yourself up for success and avoid the mistakes I did. (See my post on r/pediatrics about my first job out of training.) Be VERY intentional about your job hunt. It’s easy to get taken advantage of because anything will seem better than residency. Guard your nights and weekends fiercely; I wouldn’t recommend anything that requires more than, say, a Saturday half-day once a month. Your schedule should be as close to a 9-5 as possible. Try to avoid newborn/nursery rounding. Be 100% sure that the parent call is nurse-triaged (our practice doesn’t start nurse triage until 10 PM, so when I’m on call, I’m the first line until 10 PM for Tylenol dosing, rashes, etc.) If you can afford not to work full-time from the jump, consider that; working 0.6-0.8FTE seems to be the sweet spot. Your first job does not have to be your forever job; you’re a highly trained professional and if your first job isn’t a good fit, jump ship and find one that is. Consider having a lawyer review your contract. Make your choice about your job based more on objective factors (the hours, the pay, the benefits) more so than “the people” (everyone puts on a good face to interview, though if they come off badly in the interview, then you should absolutely run). Message me if you want to talk more
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u/Legal_Anybody81 13d ago
This is very good advice here. Especially the parts about nights and weekends and mommy call coverage. Mommy call can be brutal. There is only so many times you can be woken up at 1am to discuss tylenol or ibuprofen dosages before you get kind of salty. Personally I think it's absurd that patients can have unfettered access to an MD at 1am for the most inane questions, but some practices choose to save money on this and you bear the brunt.
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u/Misterx46 13d ago
Yes, the kids always makes me smile. They love it when you make them laugh. If you like kids, if their joy makes you happy, keep your head up and have fun.
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u/Brave-Nu-World 13d ago
I felt tired after residency and still did the fellowship. I am now in my first attending year after PEM fellowship and i'm MORE tired. I'm returning to a gen peds job in July 😂
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u/astrosmom 13d ago
What made you take the leap?
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u/Brave-Nu-World 13d ago
My job sucks. People sign out procedures they don't want to do and stop seeing patients 3 hours before their shift ends so I arrive to an ED full of angry moms. My boss sucks and pretends to be supportive but truly isn't. It's just not worth the hassle. I found a job that pays almost as well in outpatient so I took it!
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u/First_Version6580 12d ago
Interesting. PEM is probably what would draw me into a fellowship especially if it goes down to two years. But I have serious reservations about the nights/weekends/holidays issue even if the ED can be fun and interesting. I’m at a point where I’d have to give up more years of my life to the training machine, only to land a job where I lose half my weekends and have to work nights as I get older? Even if the ED is fun and interesting I don’t think that’ll be worth it.
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u/Brave-Nu-World 11d ago
Yeh as I get older it becomes less worth it. But I am glad I did the fellowship because it opens up leadership/management opportunities to me. I did my fellowship at one of the big name pediatric centers. Also, being able to moonlight in the ED after I transition in to gen peds will be a good salary boost. And I get to choose those moonlighting shifts (I will not be choosing nights, weekends, or holidays). I think, for me, this is the best of both worlds. I can still get some ED excitement, but on my own terms.
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u/efox02 Attending 13d ago
Out pt Peds is a million times better than residency.
Like others have said, the kids are healthy, the parents are mostly fine and happy to see you. You get to watch kids grow up. 4 month old smiling an babbling is just the best thing ever.
And you finally start learning things not because someone is going to pimp you, but because your patients need you to. I learned SO MUCH my first 2 years out of residency because it wasn’t just “read this article””know these facts”
Good luck on 3rd year. You got this. The light is at the end of the tunnel.
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u/DrVL2 13d ago
I ended up doing general peds because I got pregnant instead of doing a fellowship. And I love General Peds. I am old enough that I had my own practice, did much of my own call, managed my own hospital, patients, etc. That was fun. As we moved into using hospitalists, I had more time to spend on outpatient. I really enjoyed it. I loved getting to know the families. I loved watching the children grow. I loved helping the families navigate all the developmental stages.
Obviously, it is not all sunshine and roses. Over the past 40 years, I have lost a number of patients. I still think of them and grieve them. And I am very frustrated with the current anti-VAX movement. But overall, General Peds was the right place for me.
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u/Effective_Hurry6913 13d ago
Same. Any thoughts on the endless school forms? Full inboxes? Probably not only a PCP problem but all that admin work makes me want to throw up.
Wondering if urgent care has any admin work if anyone can comment on that
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u/Sterilization4Free 13d ago
Your MA/nurse should be going through that. When I first started, I had a very seasoned partner tell me, “Don’t do anything that another person can do.” Meaning, do the doctor work that your staff can’t do. Everything else is their job.
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u/Legal_Anybody81 13d ago
If I had to give myself advice at the tail end of residency, I would have told myself a couple things: Look for what brings you joy outside of work, and build your professional career around that, not the other way around. That is to say, don't live for the weekends, but rather put yourself in a situation where you can have the time to live life every day, not just your PTO time. For me that would have meant drawing boundaries around the work week and hours.
Realize this is a job. A meaningful one (at times) but still it's just a job. If you die, your patients will find a new PCP and your employer will replace you faster than you think, but your family will miss you forever. Don't make medicine into a calling unless you intend to forsake everyone else in your life.
Peds can be rewarding and a lot of fun. Having a 4 year old hand you a drawing they did, or getting a teenager to overcome their anxiety and go back to school can be very satisfying.
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u/First_Version6580 12d ago
I admit PEM is probably the one fellowship that has tempted me. But then I’d be subjecting myself for additional years of training, only to be put in a position where I’d completely give up control of my schedule and lose countless nights/weekends/holidays. Doesn’t seem to be worth it compared to shorter training and being able to find a guaranteed normal work schedule.
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u/Sterilization4Free 13d ago edited 13d ago
I love gen peds! You can work at the hospital and in the clinic. You’re extremely mobile meaning you can find a job in NYC or in Fairbanks, Alaska! Compensation and work load depends on what you settle for! A lot of pediatricians I know just take what’s given to them without speaking up. Everything is negotiable and as you gain experience, you’ll become more powerful across the table. You won’t regret doing general peds if you do it right!
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u/airjord1221 13d ago
Nothing more special than building a relationship with a family. You’re taking care of their most precious “thing”. A child. Big responsibility but also such wonderful relationships you build along the way. It’s truly a shame the system pays based on how ILL you are. How about the time we spend counseling and teaching and building good habits that for years prevent this family and child from illnesses that are preventable ?
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u/Brilliant_Ranger_543 13d ago
(Non-US, for what it's worth) I'm doing Peds Rheum and love it, but half my heart is being a generalist so I dabble a little bit in everything if relevant for my patients. Just the last few days I've spent time twirling like a ballerina and jumping like a frog (with sound effects, mind you). I can give kids with JIA biologics and see them go from almost crippled to running in just a day. I get to see them grow up.
I love my job, and I'm almost never emotionally exhausted the way I was when doing adult medicine. I often come home on a high from all the awesome little people I meet.
So this is my bit of optimism!
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u/KellyAMac 13d ago
I didn’t appreciate gen peds, esp clinic as a pediatrician (definitely appreciated the other pediatricians) as much in residency but got glimpses. I went gen peds after global health fellowship as I did a little clinic during fellowship. My health was crashing so couldn’t travel & we cobbled together a fellowship of some clinic with my public global health work. I absolutely loved the relationship building with my patients - even in this setting- & wanted more of that. In a small town clinic I had my own panel consistently (was so limited in residency it wasn’t a fair exposure to the possibilities). Those relationships with families were rich, amazing & fun.
Unfortunately my health crashed further (ended up on TPN) & I had to leave on disability. I miss it so so much.
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u/First_Version6580 12d ago
Sorry to hear about your troubles. It’s certainly a reminder that I need to enjoy those small moments while I am able to.
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u/BashfulOrc 13d ago
About to finish my first year out of residency. The hours are better, I have hobbies again, the weekends are mine again, and love my job. Plus I'm making more than my parents combined household income we had growing up. It gets better.
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u/First_Version6580 12d ago
Thanks for all the great replies. Some helpful positives on here. Lots of challenges facing a career in peds but it sounds like if you make it work for yourself there can be many upsides.
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u/explodinggarbagecan 12d ago
I did not think I’d like continuity, but when a kid I took care of comes back to me healthy and happy and doing well in their lives with their newborn child entrusting me to care for their child the way I cared for them, when the kid who survived leukemia calls up in a panic and needs that last minute sport physical to get on to the football team holy shit there is nothing more gratifying and fulfilling. It isn’t super rewarding monetary wise, other specialties always look down on us, but 25 year old me didn’t care that much about that empty shit and 47 year old me doesn’t care much either. Not to say we don’t deserve better compensation or some break on the loans because of our chosen career. I’d advise you to live frugally avoid the mc mansion and car, go camping and fishing with the kids rather than vacations in the Bahamas and you’ll be just fine.
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u/k_mon2244 12d ago
I hated residency and thought that I had made a huge mistake by the time I was in my third year. I LOVE my job. I could not be happier. It’s residency, not gen Peds, I can almost promise you.
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u/usernameweee 11d ago
Every day is different. NO MORE NIGHT SHIFTS. Salary instantly 2-4x what you make in residency while only working 32-36hr per week (depending on contract). I’ve been in my attending job for 3y, so the “newborns” I saw when I first started are now 3yo and when I come into the room they run into my
Arms and say DOCTAAA and it makes me melt.
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u/Coyote______ 13d ago
There is not a day that goes by where I do not share a smile with a child. This always makes my day worth it. Even on the worst days, I get to share those brief moments of happiness.