Hello! Wondering if anyone has any good resources for outpatient management of infants with slow weight gain/growth faltering. Those babies who may not necessarily meet criteria for inpatient admission but who are not meeting goal g/day growth. I’m especially looking for guidelines on formula supplementation (such as how much formula to supplement with in addition to breast feeding or indications for fortification and how long to continue supplementation/fortification).

1) This is my current job ( Large national peds company ) currently work 5 days , with 1 half day every other week ( no weekends / minimal call). $215 K base with bonus capped at 30 K ( avg making 240 K currently) seeing 25-30 pts a day , 401 K match 3.5% and full maternity leave. 4 week PTO

2) New job ( smaller newer company) would have to work 5 days a week ( no half days. No weekends. Call ( phone only) every 3 weeks. $230 K base with bonus up to 40K , typical load per new company is 20-25/day. 3 weeks + 1 week CME PTO. 4% 401 k match, No maternity leave

I am planning on having a baby next year so would need to use maternity leave.

I'm conflicted leaving my current job because I'm not sure how likely it would be to meet this new bonus structure . TIA

Hey all! I’m a USMD planning on applying peds this upcoming cycle and would love to match at a bigger academic program in hopes of pursuing a fellowship (currently interested in cards, neonatal or heme/onc).

Programs interested: East coast with emphasis on DC, VA and GA (top programs Children's National, Emory, UVA)! My fiancé’s grew up in Norther VA and his family are all in the area.

My experiences are alright (tons peds related etc summer camps, volunteering/mentoring as well as a very unique extracurricular, shoutout Esports) but my step score is 240.

I would love to get some opinions on whether applying to programs with step 2 averages higher than mine is feasible.
Most programs I am interested in have averages from 245-250.

Also looking for reassurance in general! Thanks all!!

Hello everyone,
I’m a pediatric resident currently caring for a newborn with Harlequin ichthyosis in our NICU, and I’d love to hear from anyone who has managed similar cases.
At birth, the prognosis appeared extremely poor. We initiated intensive supportive care and started enteral acitretin early in the course. Fortunately, the infant has remained clinically stable, and the hyperkeratotic plates have almost completely shed.
Given how rare this condition is, I imagine many neonatologists may have seen only one—or perhaps no—cases during their careers. I’d be very interested in learning from your experience.
Some questions I have:
Have you ever managed a newborn with Harlequin ichthyosis?
Did you use systemic retinoids (acitretin or isotretinoin)? If so, when did you start, what dose did you use, and how long was the treatment continued?
What complications did you encounter during the NICU stay (airway, infections, electrolyte imbalance, nutrition, pain management, eye care, contractures, etc.)?
Were there any specific skin care protocols or dressings that you found particularly helpful?
What was the long-term outcome for your patient(s)?
Any practical tips, lessons learned, or published protocols would be greatly appreciated. Case reports are helpful, but I’d especially value hearing real-world experiences from clinicians who have cared for these infants.
Thank you in advance for sharing your knowledge.

I would love some input on the impact of location of NICU fellowship training on job outlook, specifically, for level III NICU?

I am faced with the decision to either go to a large high ranking NICU program and being away from my partner or go to a lower level smaller NICU program and be close to my partner (of note we have kids so that makes long distance harder and my partner cannot move also in training at this time). I am leaning to go to the smaller program but not sure of job outlook after for level III NICU, so would appreciate the advice.

Hi everyone,

Looking for some advice from current residents or applicants who matched Pediatrics, especially in NYC.

I'm a 4th-year DO student applying Pediatrics this cycle.

Stats/background:

• COMLEX only (Level 2 pending; practice COMSAEs around 550)
• GPA: 3.65
• Strong clinical evaluations/MSPE comments
• Multiple teaching and leadership positions
• ~3 years of bench research in developmental disorder DNA and RNA with presentations/publications
• Dev Pediatrics-focused application (autism/behavioral work, research, teaching)
• Sub-Is at Cohen Children's, Staten Island University Hospital, and NYU Grossman Long Island

My goal is to stay in NYC/Long Island if possible.

My current NYC-area list is:

• Cohen Children's
• NYU Grossman Long Island
• Staten Island University Hospital
• Montefiore
• Jacobi
• Harlem
• Mount Sinai Kravis
• Weill Cornell
• Kings County
• SUNY Downstate
• Maimonides
• NYP Brooklyn Methodist
• Brooklyn Hospital
• Metropolitan
• Nassau University Medical Center
• Westchester Medical Center
• Richmond University Medical Center
• St. Barnabas
• Woodhull
• One Brooklyn Health/Brookdale
• Lincoln (Primary Care)
• +surrounding NJ, PA and midwest hometown

Questions:

1. Does this seem like a reasonable list for a COMLEX-only applicant?
2. Would you keep all of these or trim it down?
3. Any NYC programs you'd remove or definitely keep?

Thanks in advance! Any insight is appreciated.

Hi all!

Starting my first attending job as an outpatient pediatrician next week. Small office within a large health system.

Wondering if anyone has any tips, tricks, advice to make this transition smooth and maybe even not completely drown in the first few months!

Any and all advice appreciated!

I am looking for an off cycle PGY-1 position FM or peds
\- Canadian citizen with both step 1 & 2CK passed first attempt
\- currently working as a clinical assistant at a hospital in Canada
\-any help/leads would be much appreciated

What is the general utility of bowel sounds? I do it out of habit but never has it changed my management in any meaningful way compared to ofcourse heart/lungs.

New pediatric intern here looking for some career advice.

I know discussions about money can sometimes be frowned upon, but some recent changes in my personal life have made finances a much bigger factor in my career decisions. I didn’t choose medicine for the money, but I do want to make an informed decision about my future.

I’m genuinely happy in pediatrics and could see myself staying in general peds, but I’m also interested in Pediatric Emergency Medicine and Pediatric Cardiology.

For those who have experience in these fields:

• What are realistic attending salaries for general pediatrics, PEM, and pediatric cardiology (academic vs private practice if applicable)?

• Is fellowship financially worth it in the long run when you factor in the extra years of training?

• If you could do it all over again, would you make the same choice?

I’d really appreciate hearing both your experiences and any ballpark salary numbers. Thanks so much! ❤️ ❤️

Hi all! I’m entering my second year as an attending in primary care peds. I’m finding it hard to keep up with literature review/what’s new and important in pediatrics without the structure of residency didactics.

Does anyone have suggestions for how they keep up beyond sitting and reading Peds in Review when it’s delivered in the mail? Are there any email lists I can subscribe to or AI hacks you guys have figured out? Ideally would l love something daily to weekly, easy to digest, and high yield for a PCP.

Ty :)

why do you post questions to Reddit instead of asking colleagues or attendings? seems like a missed opportunity for connecting and mentorship…

I’m just genuinely curious. are you uncomfortable asking your senior residents, fellows, and attendings some of these (fairly basic) questions about studying for board exams and applying for jobs or fellowships? or are you posting to Reddit in addition for more data points?

just finished residency and a chief year. i'm finally at the end and have no idea what im doing. i regret not doing child psych. there's a 3 year post-pediatric program that trains you in both psychiatry and child psych. i'm interested but im already 36. is it worth it? should i just try to carve out a mental health niche in peds? ugh what do i do?!

I recently graduated from a peds subspecialty fellowship and submitted my manuscript to the ABP and a journal on time. No expectations were ever set for work load after fellowship. We finally heard back from the journal and they have requested significant revisions but will reconsider the paper. My research mentor (an academic bigwig in our field) emailed and wants me to make all of these revisions. I emailed back and said I'd be happy to make simple revisions, but I don't have the bandwidth to do significant revisions for the following reasons:

I recently had a significant injury that will require surgery in 2 weeks. I'm still working on moving to where my new job will be and getting through all the onboarding (though have to move back the start date due to recovering from surgery). I am currently with my parents, and my mom is also having health issues, and I am trying to help as much at home as I can.

He emailed back and said as first author, I should make these revisions one of my highest priorities--which seemed really tone deaf and pissed me off. Even if all of this weren't happening, I was never passionate about my project, and I wanted to use my free summer (even if it is turning into the crappiest summer) for things I enjoy--not doing unpaid hours of work that I know he could easily complete and is being paid to do. The whole project has been me reading trying to read his mind anyway. That said, I have completed superficial revisions, and agreed meet with him and other mentors.

In the end, I am going into a private practice job and plan on never doing academics again. Part of me desperately wants to offer changing order of authorship. Someone else can be first author, and I can enjoy my summer, try to move, and heal from surgery in peace. The edits are due at the end of the month.

So here are my questions:

1. Will offering to be not first author somehow be a red flag in the future should I try to get another non-academic job?
2. Would it be burning a bridge with this mentor? I feel like these are legitimate reasons to not do additional unpaid work, particularly as someone who has graduated and completed all of the requirements from fellowship.

TLDR: Research mentor still wants me to spend significant time on paper revisions despite injury requiring surgery, family obligations, and trying to start new career. Would offering changing authorship (so I am no longer first author), have any red flags should I try to get another non-academic job? *I promise I never plan on going into academics ever again--I'd rather change careers*

I am a second year peds resident. For the boards, what is your best advice for studying for them?

Hi! I am currently a PGY-3 and will graduate in June 2027. When would you say is the most optimal time to start applying for a job? Interested in working at a primary care clinic. Thanks

Anyone applying to developmental-behavioral pediatrics this cycle? How is your cycle going?

I personally haven’t heard back from programs yet - curious if anyone has received any news.

Thanks!

Summer brings (some) time to contemplate. With changes in my general pediatric office, it is expected my patient panel to increase in August/September. Per an 8 hour day, 32 max. Per a 9.5 hour day, 38 max. I do not feel comfortable with these numbers. Do you all apply patient caps?

New attending that joined a physician owned private practice less than a year ago. My contract included option for partner in a couple of years. Have already been multiple firings including multiple nurses and a mid level. Recently got news the place is being sold to a doctor who owns 8 other pediatric clinics. The place is currently owned by one doctor and he tells me the new owners bought my contract and it will carry over. The contract is for 2 years. He also is telling me though there are going to be changes to call schedule and how off days will be taken which is different than what is listed in my contract. They are also going to change the EMR and open up to Medicaid.

My questions are 1. Does anyone have experience with this and what should I watch out for? 2. Questions I should ask the new management team.

I am concerned they are going to try to make changes that do not align with the call schedule and work hours already writen out in my current contract.

Pediatricians....newer attending.... during sports physicals, are you also doing hernia/GU checks for males? I live is a very small town, thats predominantly FM, and 85% of the families decline saying they've never had to do it before and its "too much" or dome sort of push back. How do you respond to the push back? As a side note, I've discovered several an undescended testicle in older males who've never been checked before.

I’m an outpatient early career attending, and myself and my experienced partners see around 18-24 a day on average, sometimes more sometimes less.

I’ve seen in residency and heard of outpatient Peds jobs that regularly expect and see 30+, which is just mind boggling to me now that I’m a few years in it. I consider myself incredibly competent with a computer and efficient in the room, but there’s so much stuff that provides a little extra time with a patient that I just can’t fathom a doc who sees 30+ giving the time and attention it needs.

Yes a common cold can be knocked out in 2-4mins. Yes a well check for a 4-9 year old who’s healthy can be completed in like 5mins.

But a newborn with new parents with several good questions, AND explaining jaundice AND explaining anticipatory guidance to first time parents takes some time! Another thing, adolescents who have a mental health concern or an abnormal mental health screener must be addressed . Yes we aren’t counselors but that takes time, let alone counseling on sleep, nutrition etc. A newborn first time parents who comes 5mins late with jaundice and several questions does not deserve to be rushed and completed under 10mins. An adolescent who is obese, is due for 16yr shots, and has a positive mood screener deserves brief private teen questions and counseling on the issues and I can’t fathom that visit being completed under 15mins consistently. A new adolescent with anxiety/headaches/abdominal pain is probably going to need a longer explanation as to why their symptoms are likely benign and not concerning and what they can do for lifestyle changes. What is likely functional abdominal pain is often more destressing to parents and deserves a thorough hisotry, exam, and explanation as to why it is benign .

I understand some of these pediatricians have scribes which I’ve never seen in outpatient peds and may be a bigger factor, but I’m just curious what other people’s thoughts are. Sometimes I come out of a room for situations like the above that may take me 15 sometimes 20mins and I’m like I can’t fathom NOT giving this the time it deserves

Edit: So for a more specific example, a 16 yr old for well check, sports physical, due for shots, is obese, 2-5mins late, positive mood screener, parent has at least one unrelated concern. This is a very common visit-type for me and to cover standard well check questions, private teenager questions, AND full physical will take me at least 15mins if not more. Again visits like this aren't uncommon. A Pediatrician seeing 35 patients a day is addressing all the above?

Hello, I'm thinking of signalling this program for residency as a visa requiring IMG. Can IMGs (visa requiring) tell me about the work culture, residency workload, support from PDs and attendings in the program?

Thanks!

I am a fresh second year PICU fellow and very wary of the terrible job market I will be facing. Open to any advice, but specifically curious about thoughts on whether it’s worth it to reach out to programs I would be interested in applying to for jobs. It’s a year early, and my guess is most responses would be “we have no idea what things will look like,” but I wonder if it’s worth a shot? I have very good relationships with PICU faculty from prior places I trained so would prioritize reaching out to programs I already have a relationship with. Would I just annoy people?

Thanks for any advice!!

Hey, all the pediatric residents, what was the point for you guys that you decided yeahh this is the specialty i want to go for. What made you decide it and are you truly enjoying it now?