Final Thoughts: Pediatrics

Pediatrics, my second clerkship, has come to an end...

• 5 weeks, 24 days, 225 hours of work in areas ranging from inpatient pediatrics in the hospital to  outpatient pediatrics in an ambulatory clinic.
• Working on Inpatient Pediatrics, I averaged over 56 hours/week.
• Working at Outpatient Pediatrics, I averaged 45 hours/week. 
• I enjoyed 10 days off in the last 35 (that's 2 days/week).
• I completed 0 nights on call (happy with that!!!)
• I studied pediatrics outside of work a total of 103 hours.
• My total work in pediatrics over the past 5 weeks is: 328 hours in 5 weeks (65.6 hrs/week...9.4hrs/day).

What I LOVED about Pediatrics:

• Kids don't have long med lists or a significant past medical history...most of the time. 
• Kids get sick and get over it. I like that.
• Kids are eager to learn from you, and often ask questions about what you're doing during each portion of the physical exam.
• You see a lot of the same stuff day after day.
• You get to educate the parents on how to keep their child/children safe and healthy. The only downside is that it's doubtful whether or not they will follow through on your suggestions.
• When a child is really sick, the parents generally will trust doctors...HOWEVER, they will be stubborn and demand unnecessary things that they think will "help make them better" even when they are completely not necessary or even potentially harmful (like demanding a CT of a kid's abdomen because his mom thinks that his constipation is something worse...so she would rather shoot her child with radiation than give him a load of stool softener and wait to see what happens?)
• You can almost always make a kid smile, no matter how sick he is.

What I DIDN'T love about Pediatrics:

• The whole inpatient experience was just lacking. I can't hold it against peds so much, because I think my dislike for that time stemmed from the residents and attendings being too caught up in their own lives to bother to do any form of teaching.
• When sick kids sneeze on you, or insist upon playing with my stethoscope, or touch everything of mine with their sick, germ-y hands. And the parents think this is completely acceptable. Gross. No thanks. 
• Babies with stranger anxiety is always a challenge to performing a good physical exam.
• Trying to look into an infants mouth without making them scream and cry. 
• Parents often act like they know what's best for their children, when sometimes they don't. Like choosing to not immunize their children, or hosting "chicken pox parties", or not giving the child his/her asthma medication as it is prescribed, and on and on and on...
• For me, the challenges are in all of the wrong areas. The biggest challenge is to be the child's advocate, and to try our best to help the parents to give the child the best care possible. We do a lot of anticipatory guidance, where we give some advice on how the parents can cope with problems or changes which will arise in the future. It is just a lot of work to speak for a child when his own parents seem to be ignorant of what is truly in the child's best interests. And this is the core reason why I don't like peds.  The kids are great (well, most of them), but the parents just ruin it for me. I know, I know...I'll be just like those parents one day - but at least I won't have to be the pediatrician that has to deal with me! ;)

I ended up enjoying peds about as much as I expected I would. It is definitely not for me. I'm okay with the idea that I might never have any form of pediatrics in my life again. I guess that's ONE specialty I can safely rule-out!

This cartoon totally sums up Pediatrics. Check out this doctor's blog here.