How long is Pediatrics Residency?

[Guest HSR07]

I have gotten conflicting information. I have heard it's 3 years, or 4 years, or it's 3 years now and is changing sometime and will soon be 4 years? Can someone clarify this for me? I'm just interested in a general pediatrics residency.

 

Thanks.

[Guest summervirus]

A general pediatrics residency is 4 years long.

[Guest marbledust]

As summervirus mentioned, peds is 4 years. The first 3 years are considered "core" years. The 4th year can be done as a general year of peds or it can be used to do/start a fellowship in a wide range of pediatric sub-speciality areas such as critical care, cardiology, emergency medicine, etc. - which differ in length.

[Guest Ian Wong]

The confusing thing is that everyone who starts a Pediatrics residency will do at least three years of it. After you complete these three years, you can either do a final fourth year, which qualifies you to be a general pediatrician. One the other hand, after those three years, you could also opt to start a fellowship (which will be anywhere from 2-3 years long, as far as I know), which would qualify you to be a subspecialist pediatrician (ie. a pediatric cardiologist, or a pediatric endocrinologist, or a pediatric rheumatologist, etc.)

 

In the US, it's slightly different as a general pediatrician down there only needs to do three years of residency before being allowed to start practice.

 

Ian

[Guest cracked30]

Don't forget Ian, in the US they do an internship year so the total is still four.

[Guest moo]

In the US pediatrics is considered to be a primary care specialty, whereas in Canada, pediatricians usually see the sickest of kids, if I'm not mistaken.

[Guest aneliz]

Some do...but there are still plenty of 'community' pediatricians in Canada...pretty much family doctors for little people...

 

Then there are the 'consultant pediatricians' - still general peds but they tend to see kids that are referred by their family doc...

 

And then there are all of the subspecialists:

 

Developmental Peds

Neonatology

Cardiology

GI

Heme/Onc

etc

[Guest HSR07]

Thanks for the info everyone. Now I have another question regarding "community pediatricians" vs "consultant pediatricians". A pediatrician I met was talking about the differences between how they are compensated, or that because of the way the system works one of them isn't as well compensated as the other...or something like that, I didn't completely understand. I realize that's a very vague description, but if anyone else understands what I'm getting at, could you explain this?

[Guest Kirsteen]

Hi there,

 

I'm no pro in this area, but to me the difference between the two may be that one (the consultant) is hospital-based, and the other, community-based, as more of a primary care physician, akin to a general practitioner.

 

Cheers,

Kirsteen

[Guest Ian Wong]

Don't forget Ian, in the US they do an internship year so the total is still four.

Nope. A peds residency in the US is three years, which includes the internship year. In the US, they do have other combinations of residencies; one fairly popular one is called Med/Peds and is a four year program after which time you are eligible to write the boards in both Internal Medicine and Pediatrics, and become double-boarded. That might be what you're thinking of, but a general pediatrics residency in the US is three years.

 

Ian

[Guest jmh2005]

Actually, a lot of "consulting pediatricians" work solely in the community however maintain hospital privileges to see their inpatients (but not 'run' the ward, just see their 2 or 3 kids in for x, y or z)...but these doc's typically are in the smaller-medium sized communties, ie. Burlington, Oakville, Barrie.

 

I just finished my peds clerkship and I was actually shocked to learn that most are consultants and shy away from primary care peds.

 

There are also those docs that do consulting peds in the academic cities that rotate and cover ward service. For example when I did my 3 week rotation on the pediatrics ward at McMaster and St. Joe's, the attending doc for these weeks was a community peds doc who did soley consulting, but also does ward service and covers call.

 

All the peds residents I met at Mac, seem to do all 4 years to be a generalist, then have to do the extra year or two if they wish to subspecialize, not just 3 years.

 

Hope that helps

[Guest UWOMED2005]

Don't forget, there are also family physicians who tailor their practices (by choosing what clients to accept) such that their only patients are peds patients. While technically not "pediatricians," these family docs tend to develop a greater expertise in pediatrics through on the job experience.

 

I know of one family doc who teaches at UWO who started medical school wanting to do pediatrics, but when they hit clerkship they realized what they envisioned as pediatrics (ie community peds taking care of both sick AND well kids) was actually family practice.

[Guest therealcrackers]

I am on my pediatrics rotation right now, and had an interesting post-call discussion with the PGY1 who'd been on for a trying night (lots of floor stuff, 3 kids parked in emerg because there are NO beds on the floors or in the ICU).

 

She said that there are three types of pediatricians.

 

1. Community pediatrics. These are folks who will do general paeds residencies (so 4 years), and will end up treating children in the community, usually for things like vaccinations, ADHD, well-baby checks (and the stuff like hip dysplasia that comes out of it). A lot of this is overlap with family medicine; not all of these docs will have admitting privileges at local hospitals in tertiary care centres, but most of them do in smaller cities (qv. Stratford vs. London). The highest overhead.

 

2. Emergency or critical care or neonatology pediatrics. These are subspecialty residencies (so 2 or 3 years after the first three years of general pediatrics), and these docs are EXCLUSIVELY at tertiary care facilities; there are I think 5 pediatric emergency rooms in Ontario (several more across the country, no doubt, but I'm going with what I know), 5 level III neonatology ICUs and several level IIs, and 5 critical care units. These docs do not have clinic patients usually, but will treat and deal with the patient population that comes into their domain on an emergent basis --- so low overhead.

 

3. Consultant pediatrics. These are MOSTLY but not always subspecialty pediatricians (so anywhere from 4 to 6 years total), such as respirology, infectious disease, nephrology, cardiology, neurology, GI, etc. Also the surgical types appear here, with extra training tacked on to an ENT/Ortho/Plastics/Neurosurg/General/Cardiac Surgery Royal College training program (so 6-9 years total). These docs will usually be based in the hospitals at secondary and tertiary care centres, and some will be based in the community (a couple of the respirology types in London have their base at nice offices on Oxford St.); virtually all of them will have admitting privileges to hospitals, and many of them will on occasion take shifts in the ER. Their overhead is in the middle, depending on the scope of their practice.

 

While it didn't win me over to pediatrics, it was a great discussion about how things work in the wonderful world of kids' medicine. I'll save the discussion for the differences between a clerk and a resident for later...

[Guest physiology]

If I eventually wanted to get into pediatric cardiology, I could go into internal medicine OR go into pediatrics?

 

The former would involve matching into IM, then doing a fellowship in cardiology, and then a further year in pediatrics?

 

And the latter would involve pediatrics for 3 years, and then a final year in cardiology?

 

Is it easier one way or the other? There are more IM residents than pediatrics right?

[Guest physiology]

Can you also let's say, do pediatrics, and then do a fellowship in ophthamology or emergency medicine (FRCPC one, not the family medicine one?)

[Guest Ian Wong]

If you want to do pediatric cardiology, you need to do a pediatrics residency followed by a peds cardiology fellowship. If you did an Internal Medicine residency and suddenly developed the urge to treat kids instead, as far as I know you'd have to go back and do a complete pediatrics residency followed by a peds cardiology fellowship.

 

If you want to be a pediatric ophthalmologist, you have to do an ophthalmology residency (5 years) followed by a peds ophtho fellowship (which I assume is an additional 1-2 years). You can do a peds Emerg (2 years?) fellowship after a pediatrics residency, but as far as I know, you'd only be qualified to staff peds patients (ie. you'd most likely be working at a children's hospital).

 

If you wanted the full-on Emerg experience of taking care of anything that presents through the doors (whether that be a 5 year old with the flu or a 55 year old with an MI), you'd need to do either the 3 year CCFP Emerg program, or the 5 year FRCPC.

 

Navigating the spectrum of possible specialties is tough. Some peds subspecialties originate from pediatrics, followed by a fellowship (ie. peds cardiology, peds endocrinology, neonatology, etc). However, many others require you to do a residency followed by a pediatrics fellowship, and often this is a surgical residency. ie. Ortho residency + peds fellowship = pediatric orthopedic surgeon. or Ophthalmology residency + peds fellowship = pediatric ophthalmologist.

 

There's a few links in this forum regarding the different specialties and subspecialties, and which residencies and fellowships are necessary to attain those goals.

 

Ian

[Guest PedsHemeOnc]

in bc things are very different than ontario

 

here no one does primary care pediatrics. That is done exclusively by family docs.

We only see kids that are referred to us by their GPs - so we see only those who need extra care.

 

so we have 2 types of pediatricians here:

 

1) general pediatricians

these have offices outside a hospital, admit kids to hospitals, and attend high risk deliveries in hospitals. They get kids referred to them by GPs. They are paid fee-for -service (ie see a kid, bill a code depending on what you did)

They have 4 yrs of pediatric training.

 

2) subspecialists

they work exclusively in the hospital and only do what they have extra training in (ie cardiology, nephrology, ER, ICU, or oncology). They have offices and clinic space in hospital and most get paid a yearly salary. They do not do any general peds.

They have done 3 or 4 yrs of general peds followed by 2 or 3 yrs of subspeciality training.

[Guest PedsHemeOnc]

i should also add that the royal college (the governing body of specialties in canada) were really pushing for a change in pediatric training (led by a pediatrician from toronto).

They were pushing for training to be changed to:

3 yrs of core general peds after which you wrote your exam

Followed by either:

2 yrs of further general peds (ie 5 yrs of training instead of 4)

OR

2-3 yrs of subspeciality (eg oncology, cardiology etc)

 

the peds residents across the country unanimously opposed this new set-up and it was squashed at the big yearly Pediatric conference

It should be noted that quebec did switch to this new method - so if you train in quebec you now must do 5 yrs minimum (what was unfair was that people who were in the middle of their training now had an extra yr tacked on!)

[Guest physiology]

Hey PedsHemeOnc,

 

I love the name. I plan to pursue heme/onc in peds as well.

 

Yes, I was speaking to the peds heme/onc resident at 3B in Childrens and he was saying that you can do the heme/onc fellowship after 3 years, but most people do it after 4. They then get the "general pediatrician" title. This gives more flexibility I suppose. For instance, if someone got tired of all that extra training, they could fall back on their general pediatrics certification.

 

He was also intimating that pursuing fellowship training after 3 years was too rushed. Too bad the pediatrics residency handbook from Childrens hospital doesn't reveal the length of each and every fellowship.

 

Just from browsing the resident profiles, most sub-specialists finish their training in 7 years (GI, cardio,). Yeop - that makes them a R7 (shudder). Some specialties like allergy are shorter though.

[r_eswara]

Is it hard to get a Pediatrics Residency in ontario if you finished your medical school in the Caribbeans? whats the process? thanks

[nosuperman]

Is it hard to get a Pediatrics Residency in ontario if you finished your medical school in the Caribbeans? whats the process? thanks

 

Yes, its difficult. You apply through CaRMS (http://www.carms.ca/). That site will have all the info you need. For some general numbers, as per the 2010 reports there are 16 paeds spots in Canada (11 in Ontario) reserved for IMGs. This year 67 IMG's picked paeds as their first choice, 12 matched, 3 matched to an alternate choice, 52 went unmatched. [source]

 

Also just as a heads up - thanks for using the search function - though this thread is 5 years old so most of these guys won't be around to answer questions.