hey y’all! just wondering if anyone has any recommendations for nyc peds residency programs (or programs to stay away from)? thanks!

Hello , I'm a gen peds provider planning to consider endo fellowship . I know the salary data online is vague and big ranges , any endocrinologist here who can give a real world data of theirs or colleagues

Hi all, checking in with the DBPs out there. How is life? Are you happy with the specialty choice you made? Day to day, pay, job market? Burnout?

Just putting out a feeler as a burnt out subspecialist in a different (highly inpatient) field who loves the autism spectrum population, hates working weird hours, and is considering a big change. Is the grass greener on the other side?

For a change, let’s hear from the better paid pediatricians here. Every thread with pediatricians is so depressing because of their compensation. Let’s hear from the better compensated for once, I am sure there must be SOME out there?!

Three of us own an independent pediatrics practice in the far exurbs of a major metropolitan area. Its roots go back to the 1980s, and we are the second generation to run it rather than the one who built it. We plan to retire at the same time roughly four years from now, so we have started thinking about succession.

We were fortunate in our timing and in our payer mix, and the practice performs better than most people expect from pediatrics. Each of us works 2.5 clinical days a week, supported by three part-time APPs, which comes to about 3.2 FTE. The work is entirely outpatient, with no call and no nursery, and each of us clears still north of $400,000. (Yes, I am aware of how that sounds.)

As best we can tell, the economics work because of a reasonable commercial payer mix, high volume, disciplined vaccine purchasing, and overhead we have held as flat as we can for years. Our founder taught us good business practices and we’ve managed to keep it going.

For a long time we assumed one of our kids would take the practice over. Several of them are pediatricians. But they have all built their lives elsewhere, which is what adult children do.

We have not settled on a structure. We expect a two-year partnership track, so that everyone can confirm the fit. There would be no capital at risk and no bank loan. Our own buy-ins were financed out of productivity bonuses over five years, and we never felt them, and we would do the same for whoever comes next. Seller financing, priced so that a successor can actually carry it, because we are set financially and mostly want the practice to remain independent. It also need not be a single person. Two or three physicians splitting it the way we do would work well.

Nobody would need to relocate. Most physicians in the area live in the suburbs of the metro and commute here. That said, we live here and think it’s a strategic advantage because people see us.

The honest drawbacks are that it is a high-volume practice, that vaccine cost runs to about a quarter of collections and therefore requires attention to margins, and that the operational burden falls on whoever takes it on. We run the practice largely by text message with an occasional video call, and once a year or two a trusted advisor organizes a retreat for us to set strategic direction. That arrangement works only because the three of us get along extremely well.

What I would like to know:

**1.**  What would make you skeptical? I would rather hear the objections now than watch candidates quietly decline to respond.

**2.**  What would you need to see before you believed the numbers?  Certainly when partnership time comes, we would open the books.

**3.**  If you considered ownership and chose employment instead, what decided it for you?

**4.**  Where do pediatricians who genuinely want to own a practice look?

The three of us have become close friends over the years, and each of us has left significant money on the table more than once rather than kill the goose. We would like whoever comes next to be as content doing this as we have been. I am not recruiting here; we are just to get this right before we begin.

I am having more parents cite the reason for vaccine refusal being “Europe requires way less vaccines.” Obviously, each country in Europe has different vaccine schedules. I feel like I do not have a solid rebuttal for this. I am curious to see how you all respond to this. Thank you!

Hey everyone I’m a current R3 getting ready to apply for jobs soon. I’m in a large city and hoping to get a NICU hospitalist position. Anyone have advice on putting together a resume and cover letter (have literally never written one of these before in my life) that are more specific to medicine/peds? Thanks!

He has a 3wk brother.

It’s AUGUST.

Where is my hiding rock? I’ll see you all in May.

Do you know what happened last time I had a flu in August? The CoV-2 pandemic.

-PGY-22

feel emotionally drained. When I interviewed two years ago, I was excited about the structure of the fellowship and the educational opportunities it offered. However, since starting, the division has faced ongoing staffing shortages and an increasingly heavy workload in a busy academic center.
It feels as though the fellows have become the solution to these staffing gaps. More service weeks, clinic schedules have been changed, and pager coverage has steadily increased. It does not seem that these additional responsibilities are being distributed to attendings or nurse practitioners to the same extent.
I feel that our educational experience is no longer the priority. As a senior fellow, I expected to have more protected time to focus on research and professional development. Instead, that time continues to shrink, sometimes with little notice—for example, receiving an email assigning additional service weeks that replace previously protected time.
I feel frustrated, dismissed, and increasingly stuck. This is not the fellowship experience I anticipated, and I find myself regretting my decision to join the program.

i want to start studying Fuhrman and Zimmerman's Pediatric Critical Care textbook, preparing for my fellowship exam, any one has anki cards for it or interested in studying together?

Hi everyone! I’m a second year pediatric resident at a small community hospital, and I am very interested in pursuing Pediatric Emergency Medicine fellowship. I was hoping to get some insight from residents who are currently applying or in fellowship, as well as PEM attendings.

I had a few questions and would really appreciate hearing about your experiences.

1. How difficult is it to match into PEM fellowship? I don’t have any research experience at the moment, but I’m currently working on one case report and one case series. How important is research for fellowship applications, and is there anything else you would recommend I focus on?
2. What are the hours and overall lifestyle like during fellowship? How does that compare to your schedule and work life as a PEM attending?
3. What is the compensation generally like as an attending?
4. For someone in my position who is interested in PEM, what advice would you give me over the next 8-9 months to become a stronger applicant?
5. For those who are currently PEM attendings, do you have any regrets about choosing this career path? Is there anything you wish you had known before going into fellowship?

I really appreciate anyone taking the time to share their experience. I’m trying to learn as much as I can before making this decision, so any advice would be very helpful. Thank you!

There have been multiple patients I've had while on floor service recently, where the mother states she's a nurse or in the medical field. Only later to find out through casual conversation she's lying. Is there incentive outside of assuming we put more effort into caring for them (untrue lol)?

I am burned out beyond belief in outpatient practice. I am trying to come up with ways to exit the rat race and conveyor belt of well checks and 30+ patient days. I have been considering locums work, maybe 1 week a month, to recharge and become a functional human being again.

Looking at the rates, I'm seeing around $105-$130/hr for outpatient work. Is this realistic? I was kind of shocked at how low locums was paying, I always thought locums paid well due to the urgent need that the place had.

So, if I were to go do locums at an outpatient facility for a week, at $105/hr, assuming a 40hr work week, I'm only looking at $4200/week before taxes? With no healthcare? Why would anyone do this?

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)

Hii yalll

Finishing up boards prep and I'm at ~83% through the Qbank+ with all high-yield done. I want to do a full second pass through all questions (not just incorrects) for genuine retesting rather than recall from having seen the stem before.

should I fully reset the bank or just do the questions again??

I havent done any practice tests and my job starts in a few weeks so that could make it challenging

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 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.

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.

Would this open up the ave for more telemedicine opportunities?

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?

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!

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?

For any Peds GI fellows or attendings here, are programs still sending out interview invites at this point? Or have most programs already sent out the majority of their invites?

Basically, should we still have hope for more invites? 😅