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Paediatric Medicine Residency Overview

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Paediatric Medicine is the area of Medicine concerned with the health of children, from birth through to adolescence. It therefore incorporates all areas of their health, including physical, emotional and social wellbeing. A paediatrician must therefore learn core skills in diagnosis and management, as well as broader abilities and understanding in preventive health and wellbeing. Salaries for paediatricians are relatively lower than some specialties, with the median salary after a Residency is complete being $232,000. Note that this can be dramatically increased through further training in some of the more in-demand subspecialties.

Residency Core Requirements

A paediatric residency requires three years worth of training in an accredited program. Upon completion of the residency, there are a number of different fellowships that may be undertaken. These include the following: adolescent medicine, neonatal/perinatal medicine, pediatric cardiology, pediatric critical care medicine, pediatric endocrinology, pediatric gastroenterology, pediatric hematology/oncology, pediatric infectious diseases, pediatric nephrology, pediatric pulmonology and pediatric rheumatology.

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Application Statistics & Competition

In the most recent available data, there were a total of 3,153 applicants for 3,016 spots. This makes a ratio of 1.05 applicants to each position, making paediatrics one of the least competitive specialties. There were 1655 US MD Seniors who applied to Paediatrics, of whom only 27 did not match. In terms of DO Seniors, there were 585 who applied and only 20 failed to match – meaning 96.6% matched successfully. This is therefore one of the best fields for US DO Seniors to apply to, in terms of competitiveness. Equally, paediatrics is an excellent choice for IMGs, with only 0.59 US MD applicants per each program spot. In terms of mean scores, the mean USMLE Step 1 score was 230, and Step 2 mean score was 245. A step 1 score of 200 would still give a 95% chance of matching, and a Step 1 Score of more than 240 would make a 100% chance of matching.

Sample Interview questions

Is there any scientific data that supports vaccines causing autism?

Andrew Wakefield’s initial hypothesis on the MMR vaccine was, in brief, that the measles virus triggered inflammatory lesions in the colon, disrupting its permeability and allowing the passage of neurotoxic proteins, which in turn reached the bloodstream and brain, causing autism. Then followed mainstream coverage, and a widespread push from parents, politicians, and public figures. However, Wakefield’s study was seriously flawed, with conflicting interests, research misconduct, and likely outright lies. The Lancet retracted its publication of the article, and Wakefield was the subject of disciplinary action by the BMA. Since Wakefield, dozens of studies have found that decreasing exposure to MMR did not lead to a correlatory decrease in autism incidence. In fact, despite more parents choosing not to have their children vaccinated, rates of autism continued to rise. As such, the only ‘scientific’ data supporting vaccines causing autism is deeply unscientific.

What are the most common presentations of non-accidental trauma?

Bruising should be studied – an accidental bruise will likely be found over a bony prominence, whereas bruises on the cheeks, neck, or buttocks (for example) are less likely to be accidental. The shape of the bruises should also be studied – for example, there may be an imprint from an object used to hit the child, or the negative imprint of a hand. Many childhood burns are also due to abuse – scald burns and thermal burns are most common. In abuse, burns would most commonly occur on the hands, feet, legs and buttocks. Fractures of the ribs are also common in children who have been abused; a spiral fracture of the humeral shaft or femoral fracture in a child that is yet to walk are also particularly concerning. Abusive head trauma is the most common cause of death in children who are victims of non-accidental trauma, so one must look for the non-specific signs that could indicate a diagnosis of AHT: vomiting, poor feeding, lethargy, etc. Lastly, one should be alert to damage to the eyes, or bruising or bleeding in or around the eyes.

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Important considerations

It’s worth bearing in mind the range of fellowships available, and their importance in terms of securing a higher salary. It’s also worth considering the applicant ratios, especially as a DO or IMG – this is a great field to move into. 

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