Monday, August 24, 2015

MiM Mail: Paediatrics training vs. family medicine

To the mothers in medicine team!

I'm a doctor working as a second year paediatrics registrar with a new baby and was hoping you might be able to give me some advice- I have struggled with choosing a career path for the last six years since I graduated from medical school- I generally don't like very stressful jobs but on the other hand, have always really enjoyed complex, interesting patients I've seen whilst working in hospitals.

At the moment, I'm a second year paediatrics trainee (and have yet to sit the exams for the college of physicians). I have a twelve week old baby and am contemplating going back to work where I will need to do three more years of training after my exams, of largely shift work (nights, evenings, weekends). If I do the training part-time, I would need to spend six years (and thats without having more children, which my husband and I would both like).

For these reasons, I'm considering changing careers to general practice (family medicine where I will be able to finish training in 18 months (or 3 years part-time and can say goodbye to shift work forever!). I think I will miss hospital-based medicine (and just getting to see children) but I think it might be more family friendly? Any advice from people with similiar dilemmas in the past, and how they decided what was best, would be really appreciated!



  1. This is a pretty heavily American forum. I'm not at all familiar with the British system so I don't think I can give good advice, but I'll give you abstract versions of the same questions I would ask an American in the same situation:
    If you switch jobs, is it forever, or could you go back to training in the future if you wanted?
    What about pediatrics do you find fulfilling and could you do it as family medicine?
    How important is time at home to you know v. when you finish and how will that balance work when you're done?

    (in the U.S. family medicine and pediatrics are the same amount of training -- 3 years from graduating medical school.)

    1. Thanks for the response. Lots of good questions to think about. In our system, junior doctors all undertake two years in general hospital terms followed by choosing their specialty. Family medicine is a further two to three years full time in a private outpatient setting and paediatrics is a further six years training in a largely hospital based setting with most terms having 24 hour rosters so a little different to the American system. Paediatricians generally don't provide primary care and have patients referred to them by family doctors if there are complex issues or the child is very unwell.

  2. In the words of a famous LL Cool J song "who do you love? Are you for sure?" (famous to 1990s hip hop American kids like me anyway). I agree with Larval Doctor - what do you love?

    You mention the varying training times and that you don't like stressful jobs but you enjoy complex patients - but can you see yourself doing the daily jobs of the family med doc or the pediatrician (sorry I can't put the extra A in there, it's muscle memory)? Yes, while extra training would not be the most fun, if you cannot see yourself doing the daily work of the Family Med doc once you're done you'll just have to find a way to manage the extra time in training.

    Similar to many of my responses to folks in your position, work backward. What is the most expeditious course to get to what you want to do - or maybe I can phrase it this way - the most expeditious course to get to what you heart needs to do. You'll find a way whether it's the shorter or longer course. You made it this far!

    Best wishes and please keep us posted.


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