TAKING CARE OF THE PHYSICAL AND EMOTIONAL WELL-BEING OF KIDS
Pediatrics is the specialty of medicine that focuses on the comprehensive care of children—beginning from birth and continuing through the adolescent years. Yes, kids are cute, innocent, and fun and most will get better. But children also rarely explain their symptoms, know several ways to soil your clothing, have parents who can be frustrated and angry, and sometimes, sadly, do not get better. It is important to note that caring for kids is not just about treating their physical and medical problems. Every good pediatrician also addresses the mental and emotional health of their patients, which is equally as important as organic disease.
Most pediatricians practice general pediatrics, which particularly involves a lot of health maintenance and preventive medicine. It is your crucial job to make sure the child is developing appropriately, is reaching each milestone, and is otherwise healthy. Without you catching if there is anything wrong, the child could have serious health problems as an adult. In the outpatient setting, the emphasis is on growth, development, diagnosis of acute and chronic illness, parent education, and child advocacy. The inpatient setting also covers a wide range of medical and social issues, from respiratory distress in preemies to head trauma in adolescents.
General pediatricians enjoy the challenge of being proficient in a wide range of topics. Many diseases of adulthood first present in infancy and childhood with just a few vague symptoms, and the general pediatrician must know the initial workup and then when to consult subspecialists. For example, a patient who is not gaining weight has a wide differential diagnosis including gastroesophageal reflux, celiac disease, Hirschsprung disease, inflammatory bowel disease, congenital heart disease, hypothyroidism, cerebral palsy, neglect, cystic fibrosis, tuberculosis, HIV, urinary tract infection, renal disease, metabolic disease, eating disorders, collagen vascular disease, and malignancy. The pediatrician keeps the wide differential diagnosis in mind when taking the first steps, obtaining consults when necessary, and making sure that every last test and lab result is being followed up. During sick visits, your skills in diagnosis are critical as you decide which kids will improve on their own and which kids are truly sick and need further attention.
WHAT QUALITIES MAKE A GOOD PEDIATRICIAN?
Has a particular interest in children.
Enjoys extensive patient contact.
Is a laid-back, sensitive, and good-natured person.
Likes working with his or her mind.
Prefers taking care of a healthier patient population.
LIFESTYLE AND PRACTICE OPTIONS
In general, pediatricians lead busy but manageable lives. However, the hours worked and amount of call taken varies greatly among practice settings and pediatric subspecialists. General paediatricians in ambulatory settings work 4 or 5 days a week and are on call for parents’ phone calls on a regular basis. Some of the middle-of-the-night phone calls can become tiring over time, but paediatricians who spend more time educating their anxious
parents during office visits will end up sleeping much better.
Private practice is a great setting for those who like to make the big decisions about where, when, and how a practice will run. Going into solo practice is still possible, but many pediatricians choose to join a group practice. The group can hire you as a general employee, or you can be hired for a partnership track. This track usually consists of working for them for a year, then, if it goes well, buying into the practice. Being a partner adds another layer of challenges, but allows more freedom. You will have equal say in every issue, from leasing office space and hiring support staff, to deciding which insurance plans you will accept and which lab tests should be run in your office.
In a group practice, all physician members take alternate turns going to the hospital to round on the group’s inpatients. The morning starts in the nursery, meeting new babies and their families, and then moves to the general floor. Rounds usually finish before noon, in time for you to go back to the office and see afternoon appointments.
Hospital-based clinics and health maintenance organizations (HMOs) are good positions for pediatricians who do not want to deal with every last detail of the business side of a practice. These offices are just as fast-paced as private offices—and sometimes even busier. Many contracts with hospital-based clinics require the pediatrician to spend 1 month per year as the attending on the hospital’s general floor. This month serves as a nice break from the day-to-day work of the office and offers an opportunity to work with a wider circle of colleagues and learn more about how to handle certain disease processes.
PEDIATRICS IN THE EMERGENCY DEPARTMENT
The majority of childhood illnesses can be handled during office hours set aside for sick visits. If the child needs more attention, however, your role in the emergency department (ED) remains very important. Many EDs today are staffed by pediatricians, allowing you to take part in the patient’s progress on the phone and arrange for prompt follow up. In some suburban and rural hospitals, however, the ED is staffed by adult physicians who do not feel comfortable performing procedures like lumbar punctures on newborns. Pediatricians sometimes have to come in during the middle of the night to perform these procedures. In addition, you also may be called in to attend cesarean section deliveries. Although most hospitals have nurse practitioners or residents to cover all deliveries, some rely on private paediatricians to take regular call.
As the entire field of medicine has specialized, more hospitals have begun hiring pediatricians to be the full-time attending of service on the general pediatric floor. They are known as hospitalists. This position is especially good for those who enjoy a more acute setting where kids are sicker and need more immediate workups to diagnose their illness. Many cases can be handled by you, the general pediatrician. In a tertiary care center, where patients have many more chronic and complex conditions, the general pediatricians then assumes the role of team leader, working with specialists on a daily basis and learning from their input the important information that will help make a diagnosis and treat the sick child.
Pediatrics offers the chance to subspecialise in a number of fields, including the following, which I will talk about individually in a separate post:
Allergy and Immunology
Hematology and Oncology
WHY MIGHT PEDIATRICS BE RIGHT FOR YOU?
Pediatrics offers many different avenues in which a physician can find his or her personal niche: long-term health issues, acute critical care, and specialties that emphasize anything from physiology to psychosocial skills. A career in paediatrics also provides balance, because you continually educate both children and their parents. By building long-term relationships, pediatricians get to see kids when they are doing well, not just when they are sick. In the same day that you meet an infant who may not be growing properly, you will also give words of encouragement to a teenager, inspiring him to set goals for his future, and talking to him about sex, drugs, and rock ‘n roll.
At the most fundamental level, of course, all pediatricians simply love working with kids. Forming special connections, they can understand and communicate with children when other doctors may not. While building a great deal of trust, pediatricians help kids reach their potential and be the best they can be. Medical students considering this specialty should make the most out of their clerkship and determine whether spending time with infants, children, and young adults is something that they enjoy. If you come away even a little more energized, with a feeling of gratification from having helped a child, then perhaps paediatrics is the career for you.
WANT TO BECOME A PEDIATRICIAN?
If your dream is to become a pediatrician, or any type of physician, then the University of Health Sciences Antigua School of Medicine is the way to make those dreams a reality!
For those of you have graduated from university and have the premedical requirements, our direct-entry MD program is for you.
If you are still missing some premedical courses, are a recent high school graduate with your eyes set on the prize of becoming a doctor as quickly as possible, then our accelerated premedical program is right for you.
We also offer an innovative joint MD/MPH program that will allow you to graduate with both your medical degree and the much-respected masters of public health. This will enhance your career prospects, as well as prepare you for careers in areas like preventative medicine and international health.
Let us help turn your dream into reality. Contact our Admissions Team today to learn how you can join the UHSA family!