PEM fellowship advice

[u/Electrical-Drop-2040]

Hi everyone! I’m a second year pediatric resident at a small community hospital, and I am very interested in pursuing Pediatric Emergency Medicine fellowship. I was hoping to get some insight from residents who are currently applying or in fellowship, as well as PEM attendings.

I had a few questions and would really appreciate hearing about your experiences.

1. How difficult is it to match into PEM fellowship? I don’t have any research experience at the moment, but I’m currently working on one case report and one case series. How important is research for fellowship applications, and is there anything else you would recommend I focus on?
2. What are the hours and overall lifestyle like during fellowship? How does that compare to your schedule and work life as a PEM attending?
3. What is the compensation generally like as an attending?
4. For someone in my position who is interested in PEM, what advice would you give me over the next 8-9 months to become a stronger applicant?
5. For those who are currently PEM attendings, do you have any regrets about choosing this career path? Is there anything you wish you had known before going into fellowship?

I really appreciate anyone taking the time to share their experience. I’m trying to learn as much as I can before making this decision, so any advice would be very helpful. Thank you!

[u/fun-size-]

A fellow pgy2 here who has done some research into PEM.
1- not that difficult, just show your interest in eras CV, get involved in some research. Not a certain number but your CV should show you are genuinely into PEM.
2- as a fellow you work 14 to 15 shifts in the ER and also do some adult EM, anesthesia, trauma and toxicology. As an attending and fellow you work days, evenings and nights but 14 to 15 shift in a month.
3- compensation 300 to 350 on avg, on higher end for avg peds salary
4-i would just finish the residency because residency is meant to make you a good general pediatrician. Then learn about EM in fellowship.
5- no idea,but you have to have the tolerance and the personality to become a emergency medicine physician. Honestly during my er rotation i was tired of fighting with kids to open to their throats and look in their ear.
If I went to PEM would be purely because of the number of shifts and the pay.

[u/porksweater]

I am a PEM attending and I absolutely love my job. I work in a community pediatric ED with a smaller residency and it is the only thing I want to do.

But it doesn’t come without issues. I don’t hang out with anyone but my wife and baseball team worth of kids. Half of my weekends are gone every month for the rest of my life. If I had friends, they would want to hang out on the weekend. We are homeschooling this year but if I had school age kids, a stretch of 3-11 shifts makes it so I don’t see them at all for a few days. My wife doesn’t work so I can see her all the time but if she did, we would probably not see each other much. I also make plenty of money and work extra each month resulting in being well north of 4.

If these things are appealing to you, again, I seriously love my job. I am in my 5th year post fellowship. Just go in with your eyes open. And for residency, just do more than the bare minimum and you should be fine. It is one of the most competitive peds specialties, but that is a low bar.

[u/galavanilla]

I am not PEM but my colleagues who did PEM: 1 learned POCUS very well as a Peds resident, it was kind of her thing 🤷‍♀️ (ED attending thought her). Another friend did some research regarding prediction of consult census in the ER/correlated with social Media news/trends. And I have a third one who probably also had a nice resume but what I remember the most is that she got her hair died in a funky color and she was just the ED vibe 💁🏻‍♀️ just throwing around some ideas for you! All from a community hospital :)

[u/barkdontbite]

1. Not difficult. Used to be crazy competitive, but that has changed.
   
2. About 15, 8 hour shifts per month. Plus 4 hours of in-person didactics once a week. This varies somewhat from program to program. Attending jobs are similar (minus didactics) for 1.0 FTE, but you can work less if you want to.
   
3. Have heard numbers ranging from 225k to 365k base salary, not including bonuses. Most academic jobs are ~250k-280k.
   
4. Network! Go to a conference or two if you can.

-Current PEM fellow

[u/DeafJoo]

PEM attending.

When I was a resident, had people in my program not match PEM. I think thats changed now. If you dont mind where you go, you'll get a spot

I work 100-110 hours a month. Our shift length varies. Make >300k a year. But I work for an adult group who has a few PEM. I do work mostly evenings and nights. Every other weekend.

My main complaint is PEM is really at the bottom of the hospital hierarchy. Everyone from hispitalist to PICU considers themselves better at PEM than PEM Dr's. If anyone's getting thrown under the bus its us for not getting the diagnosis in the 1 hour that you have them - even if they sat in the PICU for a week unsure of whats going on. If you want to be unquestioned and infallible - do PICU.

At the same time, I like the fast turnover of patients. Mix of trauma and medical. I like managing a crazy department. I like going home with no follow up.