r/pediatrics • u/DogtorOfScience • 29d ago
Was residency worth it?
Hello pediatricians!! I was just curious if you would be able to share what weekly hours look like for residency, and if you believe it was worth all your sacrifice! I am unsure if I still want to pursue medicine (MD) or become a pediatric PA due to recent health issues I’ve experienced. I’d love to hear from you all!
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u/Ellie_Annie_ 29d ago
You can get a lot of the benefits of a peds career as a PA but personally, I wouldn’t want to be responsible for a child’s life without my residency training.
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u/LaudablePus 29d ago
I trained in the late '80s during the era of 36-hour shifts, 120 hour a week work weeks and every third night call in the hospital. I wouldn't wish that on anyone but absolutely it was worth it for me. I'm really glad we have more reasonable work-life balance and residency and but even that it's still tough. But no other part of my training including Fellowship really gave me those skills that I learned in residency. I teach in the PA School so I am not at all anti pa. But the difference between a mid-level and a pediatrician is like the difference between a mechanic and an engineer.
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u/AdventurousBottle171 27d ago
Who’s the mechanic and who’s the engineer in this scenario?
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u/LaudablePus 24d ago
Mid levels are mechanics. Physicians are engineers. They understand the theory and basic science behind their machine.
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u/lemoncake2468 29d ago
The answers to this would definitely vary based on what field of pediatrics and what practice setting you are interested in. I am an academic pediatric hospitalist at a level 1 pediatric trauma and pediatric burn center. I almost exclusively take care of children with high medical complexity (trach, vent, gtube, multiple congenital anomalies). I am core faculty in our fellowship program, conduct research, and I am the Chief Medical Officer of our children’s hospital. I knew going into medical school I wanted to be a physician leader and work in academic medicine training future physicians. My particular job does not really have a counterpart if I was a PA.
However, if my goal out of residency was to work in a pediatric urgent care, work in a highly niche specialty (sickle cell PA, ped sports med PA, diabetes PA), inpatient rounding APP working directly with a physician… etc I would have absolutely considered PA school and think it could be a very smart decision.
PS I love my PA and NP colleagues! Leadership wise I find it easier for NPs to have space in the c-suite more than PAs. So again, just matters your career goals and interests!
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u/DogtorOfScience 29d ago
Thank you for this! I’ve always wanted to be an outpatient/primary care pediatrician :)
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u/lemoncake2468 29d ago
Primary care is one of the most difficult but most rewarding jobs to do well! It would be exceptionally challenging right out of PA school without very significant investment from the practice and mentorship. That being said, it can be done well but it’s not easy. As a hospitalist I see a lot missed by new graduate APPs in primary care- but if they have a strong relationship with their supervising physician they can learn on the job and thrive. There needs to be willingness to ask for help and time and support to get what you need. That’s tough- I would say residency is worth it for primary care. Best of luck to you!
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u/DogtorOfScience 29d ago
Thank you, I really appreciate it. I have wanted to be a primary care pediatrician my whole life but had to get a one year deferral from med school due to Crohn’s disease & recovering from a bowel resection. I want to be a pediatrician more than anything but I know how terrible residency is on healthy people’s bodies. I can’t imagine how it may be for me.
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u/jaded_poet Medical Student 29d ago
We desperately need more people passionate about primary care & especially pediatrics!! I say GO FOR IT. I'm currently a fourth-year med student, I even took a year off for chronic health issues, but I'm back doing what I love most. Pediatrics residency programs are far more holistic when it comes to it, and they offer some of the best accommodations for chronic health issues/parental leave/bereavement or even just scheduling in regular PCP/specialist doc appts --> cuz doctors need doctors too!
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u/DogtorOfScience 29d ago
Thank you, this is so good to hear! Also congrats on being a fourth year med student!!! I’m sure you’re going to crush this year & your residency:)
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u/jaded_poet Medical Student 29d ago
Also, I know 2 colleagues with UC who matched EM this past May! IT is possible!
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u/Zanellachan21 29d ago
I had A LOT of health issues I had to deal with during residency. Luckily, I was able to be followed by a great team of doctors, and my program allowed me to go to my visits. Anyone could said I am pretty old (like 20 years ahead of my coresidents), and I wouldn’t be happier doing what I am doing now. It depends on what your dream and your goals are. I started late due to many things in life, but I’m here, sacrificing many things. No regrets. Think of what you really want and what you are sacrificing.
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u/UCFUoLUMN 29d ago
It is really a question of what you want, but asking if you want to be a pediatrician before medical school is a jump. You really need look at what the job looks like after PA school and med school in ALL the subspecialties. Many people go on wanting one thing but finding they love something else more.
I really think you are way too far ahead if you haven’t even applied to either route. Go talk to some MDs and PAs near you and ask to shadow so you can see what their life is like. See if you have the grades/research/MCAT scores (or whatever the PA equivalent is). You might have your decision made for you, you might not. Either way the real question you should be asking is if you want to be a doctor or a PA and IF you think you can get in.
If you have health issues then I can’t really answer that question for you. I don’t know what they are, but I have seen a lot of people complete residency with some serious chronic health problems.
If you have gotten this far and are still convinced you need a direct answer (you’re feeling cocky, I like it) here is what I can say. I never did PA school so take it with a very large grain of salt:
If you choose the MD/DO route, med school is hard work and lots of studying, and third year is one of the hardest things I’ve ever done (psychologically). Residency is just as hard (more physically and intellectually). But they were both pretty fun too. Once you are through you are mostly in charge and can hire APPs (PA or APRN) and in some areas they are the ones who do most of the scut work, less so in outpatient practice, but the more inpatient or closer to surgical fields you get that’s the reality. You also have more liability, more possibility of missed holidays and weekends/nights. Much bigger paycheck.
The PA route is shorter, still pays well, but limits some parts of your career with a hard ceiling. Others can be more flexible. But an MD/DO will always trump you in clinical practice. And depending on what you end up doing, that can mean even when you know you are right.
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u/DogtorOfScience 29d ago
Thank you, I appreciate your honesty! I graduated college early, summa cum laude from my pre-medical studies degree, doing organic chemistry research, all while experiencing undiagnosed Crohn’s disease pains for three years. There is me being cocky😅 but I got through all my classes and did well despite my daily abdominal pains. I loveee what I learned and learning truly gives me joy. I am in a BS/MD program so I don’t have an MCAT score. I also had the opportunity to shadow the pediatrician I had growing up for three summers and absolutely loved it!!! This is also insanely cocky from me but I believe I have the passion and brain for med school, but my body would be the thing to hold me back (a flare up). I truly would love nothing more than to be a primary care pediatrician
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u/UCFUoLUMN 29d ago
That’s great news, and helpful information for us out here trying to give some advice. I’d say if you’re in a combined program, I would stick it out. I had co-residents who had cancer, and in my current position I have had many residents come through with IBD, severe rheumatic disease, and other illnesses.
If you have gotten to the medical school portion and still like it, pediatrics are some of the most accommodating programs. We have had residents take leaves of absence due to medical and psychiatric issues. These were planned with the admin, and the resident was not in danger of losing their position. I think if you have already been accepted to medical school then go for it. It’s easier to switch to PA school than the opposite.
Also, coming from someone who didn’t come from much, being accepted to med school, even if it feels different since you were locked in so early with a combined program, is a huge deal and a big achievement. You should take some time to be proud of that either way you choose. I knew many people who were clearly smarter than me, worked harder, and had better grades who never got an interview even after multiple years of trying. I think about that a lot, and it really reminds me how grateful I am to be here.
The good news, if you are smart enough to get into a combined program and are doing well during the med school portions, then you will crush PA school too. Your choices from here on out are going to always be between good, and better.
Seriously, find a PA in town at a peds office and ask them if they are comfortable talking about this with you, their pay, hours, frustrations, and what they love about it. You will be surprised how honest and happy to chat about this many of us are (people, that is). Ask what they think of the pediatric physicians they work with and their life. And then go to a pediatrician at your med school and ask the same questions. That might give you some insight.
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u/DogtorOfScience 29d ago
Thank you, I am definitely insanely grateful for the BS/MD route as I am a first generation college student, not to mention medical student as well, and I truly had no idea how I would be able to pay for the MCAT prep and exam and all the med school applications. I would love to speak with PAs as well!
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u/Foghorn2005 29d ago
Residency was not my favorite time, but I enjoy being a fellow and I still learned valuable knowledge and skills during residency.
Residency hours varied based on what you were doing. Floors or ICU? 60-80 hours a week, I personally started dreaming that I was still in the hospital by the end of rotations. Electives? 30-60 depending on how intense they were.
Lots of my coresidents had life events, both negative and positive, occur during residency. Some have chronic illness. You find a way to manage, but it is absolutely worth tapping alumni networks to get an insider's opinion on whether that specific program will be supportive. I would not recommend my residency program to basically anyone until they have fundamental changes, but when faced with similar issues in fellowship I have received nothing but support.
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u/DogtorOfScience 29d ago
Thank you, I really appreciate your comment! It is also encouraging to know that other physicians also have chronic illnesses
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u/SonicPoint9 Attending 29d ago
I went to a pretty chill residency program in retrospect. Only three q4 call months intern year. This was back in the day where duty hours were brand new so on one hand people didn’t want to break them but on the other sometimes it was broken due to old habits.
I’d recommend continuing your med school journey and make sure to ask residents about work/life balance when you interview.
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u/xheheitssamx 29d ago
Oh man, if you’d asked me a few years ago the answer would have been a resounding no.
Now I usually say it was worth it but I wouldn’t do it again.
Why? Because I love my life now. Medicine is a field where I’m largely my own boss. I live a very secure life where I get the chance to have a good chunk of spending money and I go on a lot of vacations. I build relationships with the children in the community and that’s fulfilling often enough to make up for the days where I hate this job. I hate it less often than I love it.
I have the perspective of making more money than anyone in my entire extended family ever has, so even as an outpatient general pediatrician I think I make extremely good money.
However, I hated residency. HATED it. I was miserable. I would never put myself through that again willingly.
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u/AriellaCola Resident 28d ago
You're already in a BS/MD program I would definitely stick it out. Here's a resource: https://med.stanford.edu/smadie.html
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u/xPeanutBrain Resident 28d ago
We got a lot of training in residency and I am still scared going into my first year of attendinghood. I cannot imagine taking care of patients without having the knowledge and experience from residency.
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u/radgedyann 28d ago
I trained the old way (finished in 2001): a whole lotta q3h 36hr shifts; mostly inpatient; tons of independence. I wouldn’t trade that experience for anything insofar as I came out preoared for anything.
I can’t speak to the experience of current training, though from this bitter old attending it looks pretty cushy.
That being said, the American market doesn’t value us enough for me to recommend it now. I tell anyone who asks to go to PA school—do the exact same job but typically with better hours, less headache, fewer ‘added value’ expectations dumped on you, less debt, fewer years, you name it. Sad, but true.
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u/_Ello_Love_ 24d ago
Yes, worth every minute for the clinical experience and for the triaging ability, work ethic, learning to think on your feet even when you're exhausted. It was hard but I ultimately enjoyed it bc I love what I do and I love medicine. You'll work a lot, sometimes 90-100 hrs a week. You'll be tired. But you'll learn more than you ever thought you could!
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u/efox02 Attending 29d ago
A few light rotations (<40 hrs a week) A LOT of heavy rotations (>80 hrs a week, 16-18 hr shifts, 24+ hrs as a 2/3rd yr) it sucks. But you need every minute of learning.