TLDR: what’s fair pay for a new grad pediatric clinic attending in Oklahoma over the holiday season and what are you guys charging extra for the nights you’re on call?

Hi guys! So I need some help figuring out some things and making sure I’m not going to be taken advantage of. I am a new grad peds attending taking a gap year before applying for fellowship, and decided to travel, and do some outpatient Locums in the meantime. A place in my hometown (clinic in non-rural Oklahoma) offered me a gig, literally a few weeks out of residency (the gig was only a week) and it was kind of unexpected but since I already had my state license and I was available so I went through with it. I was notified of it through the Locums company Weatherby and that’s who I used. I haven’t really done any more work since then since I’ve been traveling, but I’m back in my hometown for the holidays and let my Recruiter know. I guess he reached out to that same Clinic to tell them I’m in town and to see if they need coverage and they do. However, the clinic manager called me directly to ask if I was available in certain dates before he let his rep know just to make things easier. So basically it’s for the last two weeks of December, but this time they want me to be on phone call for the entire last week (I wasn’t on any type of call last time) and he made a comment asking if I have an extra fee for that (as if physicians usually don’t?? I’m assuming they do?). I said yes, but I would discuss that with the recruiter. He also made a comment about how last time the rep on his end told him the very last minute that I would need mileage covered for my long drive and if I still needed it. And I said, yes, only to realize after hanging up that I don’t live here anymore so I’ll actually need a whole rental car lol.

Now, here is where I need some help. For my last gig, knowing that I was straight out of residency, I was offered $100 an hour. Looking back, I think that’s kind of low even for a new grad? Though this is a Outpatient Pediatrics, so I don’t know. I’ve heard of mid levels being paid that much for Locums. I also was not paid for the day I did my EMR training/orientation which looking back I should have asked for myself, but since it was my first real job and they didn’t offer it and it happened so quick, it never even occurred to me.

My question is, what’s a fair hourly rate and what are you guys getting paying? And how do you charge for the days that you’re on phone call? Also, with this being during the holiday season, I feel like maybe demand is high and my charge should be higher than on average days? If I negotiate the price, would that be a negotiation for the Clinic to pay me more or for the Locums company to pay me more? I really don’t know much about this, but I do know Locums companies charge a lot more from the office than what they give you and tend to try to not pay you as much as possible so I would appreciate any insight!

I’m working inpatient psych and need a good set of PRN orders for common med side effects I could encounter (constipation, nausea, headaches, etc)

What do y’all prescribe as PRNs? Some relatively benign stuff you’d feel comfortable prescribing to most kids.

If you could specify dose (we can’t do dose based dosing unfortunately), formulation, frequency, and specific indication that’d be great. Also if you could specify if it is different per age group.

Thanks!

Does anyone have any good resources for peds CCRN exam? Has anyone ever taken it and used any good resources ? Help!!

I'm currently a first semester freshman trying to figure out what to pursue, and I was originally interested in OT because I was a gymnastics coach for several years and really enjoyed it. However, doing more research into it has brought me to the conclusion that I'd be spending about the same amount of time and money academically (minus residency) to make a lot more in psychiatry. Although I really like the physical learning side of OT, I also really enjoy learning about mental health disorders in children. So, I'm really wondering, what does each job look like on the daily? What should I expect to be doing in my every day life? What does the schedule of each look like? How much paper work? How much of actually working with the children? What do these look like in a hospital vs. outpatient setting? Any help would be appreciated!

Insight just received my score. US-IMG

thank you

What are your thoughts? Will vaccine approvals or requirements change? Will our field be disrespected even more?

Need help thinking of ideas for hospitalist medicine related topics that are new/somewhat controversial and would make a good topic for a grand rounds presentation. Thank you!

Hi, I am a resident in paediatrics from India. I am considering looking for job opportunities abroad or fellowships in subspecialty in the UK or US. I have a doubt whether to live in India in the future or move out. I know the payout is good and work life balance is better. But considering the birth rates dropping drastically every year more so in the west, I am thinking whether paediatricians will have as much job opportunities and salary growth in the near future. Birth rates are dropping in India too but considering the high population, demand will slow down maybe after 2-3 decades. Just look at South Korea, the country with lowest birth rates, young people are not choosing paediatric as a career and many paediatricians are switching careers due to low income. Research opportunities are far less in India though, hope that changes.

This is the thread where all questions about residency applications and Match should be placed for the current month. We will continue these threads monthly through the application season.

I am a second year resident who will become a general pediatrician, and most training is geared towards inpatient / medical management.

Looking for suggestions for resources (books, podcasts…) with practical advice pcp give to their patients/parents about general Peds topics-

Remedies for things like teething, weaning out paci, exercises to encourage rolling over, etc…

Stuff that’s not necessarily in the textbook that you’re typically told you ‘learn with experience’

I'm currently a PGY-1 in psychiatry, but considering a switch to pediatrics for multiple reasons. There are limited opportunities to work with children and adolescents at my program, and I feel the medical training that a peds residency provides is better aligned with my goals. I didn’t consider pediatrics bc of limited exposure in med school, but I wonder if a peds residency followed by a post-peds portal program may be a better path to child/adolescent mental health than the psych-to-child psych route. I’m passionate about working with kids, specifically school-aged to adolescents.

Has anyone here made a similar switch? I'd love to hear about your experience and any tips on navigating the process. Thanks!

TLDR; PGY-1 in psychiatry considering switching to pediatrics

Best fellowship programs

i have been thinking of going into medicine revolving around something pediatric. been thinking of being a pediatrician but i've had people tell me if i get my stna first and work in that field some places would pay most if not all tuition to help you work towards the career you want. i am trying to minimize debt and get into the profession i want but research is giving me a dead end. does anyone have any kind of advice or suggestions for this kinda thing? i didn't even know this was a thing until today and i am very intrigued with the idea of it and wanted to get further information on it so i can prepare and make the decisions i need to make to set myself up for success.

Hey ✨ PGY1 Pediatrics here. Did you guys have to do a block of Adult ED rotation in your residency? I m trying to see if that’s ACGME mandatory or depends on the hospital.

Hey guys, first post looking for advice. Mental health treatment wasn't my initial goal when I started as a pediatrician. Now, I'm 2 years out of residency and I'm finding that my practice is becoming more and more mental health, and it has become a passion project for me. No pediatricians in my area really treat mental health, and I have started getting referrals from around the area in addition to those already in the practice. I have been considering getting a certificate as a board certified behavioral analyst to augment my treatment modalities and do some behavioral therapy possibly, but I'm not sure how that would integrate into my current practice, or if that would be embarking on an entire new career path, which I'm not sure I want. Does anyone have experience with this very niche idea? If so, any advice or information about the path forward would be appreciated.

Hey, so I ended up with a decent number of interviews, some at children’s hospitals, some not. I even asked a resident in my last zoom social what she thinks are the pros and cons of being at a program that’s just a few peds floors within a hospital. And she said she saw it as a positive and tried to sell me on it.

But I wanted to hear your thoughts cause there’s probably a ton I haven’t considered. But am I right to think every program with a children’s hospital should probably go higher on my rank list?

Or just any other general advice with making my list? 😅

TY

I have my first job interview next week for a general pediatrics job out of residency. Would love to know how you have prepared for your first interview! I’ve been reviewing some potential questions and learning more about the organization, but listing questions you’d think I should be prepared for and other useful tips would be much appreciated!

I have a grade school aged child with complex needs / history. Has oxygen concentrator at night, recurrent pneumonia and asthma.

Parent would like a pulse oximeter that would wake them up at night to help parent sleep.

Any recommendations for child pulse oximeter with parent alarm? Could be DME or consumer product if reliable. Thanks

We have had a rollercoaster of the last few weeks due to our little one being ill. All the doctors who have seen him have suspected some rare and hard to find thing.

This last doctor on his case is a dog with a bone. She's is not letting go until she has all the answers because she's afraid our lil one will fall through the cracks of the system.

I have never felt so cared for and advocated for in my my life, and we are so grateful for her follow ups and her insistance on getting the tests he needs.

We would like to offer her a gift that would be sent to her clinic, but we don't know what's appropriate or appreciated.

Does anyone have an idea? Should we send something just for her, or all the staff too?

I'm told home baked goods are no-bueno since people are insane and you never know what's inside (fair enough). Bakery delivery? Flowers? Coffee and donuts? Bottle of wine? Any and all suggestions welcomed ❤️

*** Edit***

I don't have time to reply to everyone, but I wanted to thank you all for your comments. We'll be going down the route of a card, picture of kiddo and a hand written letter to her boss.

Hi everyone, I’m working in clinic on Halloween and just wondering what everyone will be dressing up as for halloween. Trying to brainstorm some ideas.

I was just curious to get the opinions of those who are in private practice as to how much they are being compensated by insurance companies. Please remove if this is an inappropriate post, but I figured it could be a beneficial discussion.

The reason I am asking is because any of the private insurance companies are underpaying us as a private practice and it is impossible to get a hold of anyone from an administrative side as they just keep kicking the can down the road and telling us we're working on it, which has been going on for greater than a year. some contract companies are not proper for every visit. We may receive the proper rate three out of five visits and those other two we let slide because there is simply no one who is helping us out despite how many times we reach out to administration in the insurance company.

What are people in private practice doing about such matters? I've had friends who hired billing companies and spent a lot of money yet we're not able to resolve this matter. I don't want to be in a position to sue the insurance companies as we are dependent on them, but at some point, we cannot go seeing more and more patients at a quicker rate simply to make up for the lack of proper payments.

Hi everybody

I have a 6+ year old patient whose parents are concerned about some behavioural issues, some of it sounds like it could be ADHD (possible anxiety too). Usually I like to use the Vanderbilt as a screening tool, but since the child is still in preschool I'm wondering how good it is. Does anybody have experience with it? I could let the preschool teacher fill it out as well.

Or any other screening tools you use for ADHD and it's possible co-morbidities.

I want to see how many people are using AI in their clinics and what ways are y’all using them. I just started with Dax through epic and like it but want to see what other colleagues were doing? Is AI the way to help alleviate burnout by eliminating menial tasks? Interested to hear thoughts around AI

Okay so I was a peds onc patient when I was a kid. The care I received from medical professionals (mostly good but the bad too) is what made me want to go into medicine. I missed two years of K-12 because I was hospitalized for essentially those whole school years and couldn’t keep up in a substantial way. Cancer treatment did a number on my overall health and worsened pre-existing conditions, which still affects me today. I currently have a cvc (double lumen broviac), weekly PT, frequent infusions, injections, appointments, am an ambulatory wheelchair user etc. I usually have about 8-12 doctors appointments in any given month. Despite this, I managed to graduate hs 2 years early and am in my second year of pre med at 17. My team are hoping that we can improve things significantly with surgeries, new treatments, and the right medications and at least get me to the point where we can take the catheter out. But my health will need constant management for the rest of my life even if we do.

Here’s my actual question: is going into medicine with my circumstances worth it? Is it even possible? I really want this and I’m good at the subjects I need to succeed and get into med school. But when I look at the experiences that I’ll be subjected to along the way… I just can’t physically overwork myself in the same way most people can. Hell, with the current saline shortage my main goal is staying outpatient over anything academic. I see residents working under conditions that probably violate the Geneva convention and being violently union busted when attempting to do something about it, then sometimes turning to suicide. I see overworked and underpaid doctors in every speciality but ESPECIALLY peds, which is where I want to be. I would not go into medicine if it meant working with the adults (no shade y’all, not personal). And sometimes it makes me think I’m insane for wanting to do this. Am I insane? Am I wasting a potentially short life? And if not, how do I get through a medical education without hurting myself in the culture of the grind?

I just did a sub-I in peds heme/onc and absolutely loved it! I’ve been considering PICU because of the complex physiology. But I found the deep relationship you develop with the patients and their families so enriching. Plus, oncology patients have an entirely different physiology and set of risk factors compared to the regular population. For the heme/onc docs out there, what do you love and don’t love about the specialty?

I’m in my final year of pediatric residency at a small community hospital. As is with community hospitals, inpatient pediatric flow is limited. Autonomy for pediatrics is less even as a third year. I don’t feel prepared to be an attending. I keep getting thoughts that maybe I should’ve gone to adult medicine. The compensation as an attending is abysmal creating more doubts. I’m considering fellowship vs another residency. Am I insane or are there other people in the same situation I am?

This is my first post as part of this group. I am a second-year resident in general pediatrics. While rotating in the intensive care unit, I admitted and managed many critically ill patients. I have not seen any of them actively die, although I've learned of their deaths later.

I am grieving today because, in a couple of hours, a patient I admitted to the PICU about a month ago will be declared dead. The first patient I have received, admitted, cared for, and worried for weeks will die today. I know she is and has been brain-dead for a few days now, however, today her parents will withdraw all life-supporting care and death will be certified; it will be official and it hurts. I agree 100% with the parents' decision; she failed two brain death exams by taking one or two spontaneous breaths.

I did her neurological exam yesterday to write my final note on her file and despite her hands being warm, her chest rising and falling with every mechanical ventilation, and a pumping heart, she was dead. Knowing what the result of every test would be, I still did it, and I think all doctors should experience this. Pupils that once reacted to light are now dilated and fixed, eyes remain in place while the head is turned side to side, and so forth. The image of death shifts when the body is intact from the outside and the only thing wrong is the control center which we can't see with our naked eyes.

I am grieving. I have cried and am crying right now. Every time I look at the clock and the minutes come closer to 4 pm I know I will get the message that she has been "disconnected" from life support or that she took her last breath. I decided not to be there when it happened because I think this is a time for her family to share. I said goodbye to her yesterday and that will have to do.

I hope this post helps others process their grief. It is complex because we mostly don't know our patients. We care for them for only a sliver of time in their lives but still, some can impact our spirit when there is nothing else we can do for them. I hope writing this helps someone else as much as it has helped me. It is 4:01 pm...

I was just wondering what standard practice is on thank you emails after an interview in peds. I know some programs specifically say they prefer not to receive them. However, if nothing is mentioned about "thank you" notes, is it considered best practice to send thank you notes? Who do you send them to? The PD, PC, the interviewers?? Will thank you note affect ranking?

I still don’t know what I want to do currently see CHOP hiring for gen peds for subspecialty services (oncology, EM, NICU, PICU). Is anyone aware of other children’s hospitals that are hiring positions such as this? Or any thoughts of whether these opportunities could lead to mentorship to eventually apply to these fellowships?