What is the pediatric neurosurgery lifestyle like? What's a typical week? How is call usually handled?
What is the case load like? A lot of spine or what?
What's pros vs cons of adults vs peds?
lifestyle variable, but on average worse than adult with worse pay
for a pure peds practice you are usually employed/work out of a dedicated children's hospital. Average group is 2-3 people, so you are taking call q2-3. Usually at an academic center so you have residents and/or fellows covering. Our peds attendings don't get called in to operate in the middle of the night very often, but we are in a relatively low trauma setting. Often get woken up to staff a consult or accept a transfer etc.
very little spine in most peds practices, most peds scoliosis is done by orthopedics with some exceptions
Case load is a mix of hydrocephalus management (shunts/etvs-largest volume of cases, 15-60% of cases in peds practices), craniofacial, tethered cords (i guess you could call this spine), tumors, chiari, epilepsy, trauma, avms
peds vs adult is a pretty easy decision for most people once they have experienced it.
some important questions
do you like taking care of kids and their parents through a mix of stressful and extremely stressful situations for the families involved? do you view a shunt or shunt revision as an opportunity to perform a life-saving/preserving surgery or painful tedium?
less important but still important
do you want to do private practice and maximize your income? is it important to you to have flexibility in where you get a job post-residency?
Pros: taking care of kids and helping families through difficult situations (for people who enjoy that), wide variety of cases, very positive societal impact, higher percentage of low grade tumors with curative long term outcomes, work in multidisciplinary peds hospital environment, no back pain patients, few malingerers, drug addicts etc
cons: taking care of kids and parents (for people who don't like it), lower pay on average, very low lows (non accidental trauma, very poor prognosis tumors, some of the pediatric trainwreck pateints that rarely make it to adulthood), working in peds hospital environment, smaller job market, required extra year of fellowship
I was told by recruiter at the recent conference that there are basically "no" jobs in pediatrics. I was also told that we are producing more peds neurosurgeons than there are available positions.
Anybody know if there is any truth to this?
Very interesting discussion. Some very on-point responses. The truth is that pediatric neurosurgery tends to attract very dedicated individuals who value the rewards of helping children while being in a field with remarkable advancement in treatment and outcome. As a resident, nearly two decades ago, I was interested in neurosurgical oncology but found the dismal outcome of patients with primary brain tumors unbearable. I also enjoyed developing a physician-patient relationship that spanned over many years where I did not feel I was a technician rather than a physician. I watched my mentors and greatly appreciated how they knew there patients and patients families so well. I also enjoyed how they had to be creative and thoughtful about the care of patients with a developing central nervous system.
While it is true that there has been a dramatic increase in training programs which are not approved or sanctioned, organized pediatric neurosurgery is working on addressing this issue. Additionally, there are increasingly more pediatric subspecialists who operate on adults with pediatric diseases and congenital malformations.
Ultimately, would focus on what feels right during residency than some of the other factors discussed.
Good luck!