What is a Pediatrician?
Derived from the Greek words pais, meaning child, and iatros, which means doctor or healer, a pediatrician is a medical professional who specializes in providing medical care to children.
Although there are surviving manuscripts devoted to pediatrics from earlier times, it was not until the middle of the 19th century that it was recognized and developed as a new medical specialty.
Known for his many contributions to the field, Abraham Jacobi is considered as the father of pediatrics. He was born in Germany where he received his medical training, but later went to the United States to practice. It was there that he opened the first children's clinic in New York.
What does a Pediatrician do?
Providing physical, mental and emotional care for their patients, pediatricians are concerned with the health of infants, children, and teenagers.
Pediatricians perform diagnostic tests to obtain information of a patient's medical condition and administer treatments, therapies, medications, and vaccinations to treat illness, disorders, or injuries. They also treat children who are suffering from minor injuries, acute and chronic health problems, and physiological and psychological growth and developmental concerns.
Pediatricians counsel and guide children and their parents or guardians concerning diet, hygiene, and disease prevention. The field of pediatrics is a collaborative specialty — primary care pediatricians may refer patients to a medical specialist if they manifest symptoms of a serious medical condition, in order to efficiently address the issue.
Pediatrics is an exciting and challenging field to be in. It is also an incredibly broad field and can provide many options for doctors to choose from. After finishing a three-year pediatric residency program, about a third of pediatricians decide to train for an additional three years in a fellowship program. This enables a pediatrician to train for a career in a pediatric subspecialty, which can include:
Adolescent Health Specialist
Adolescents between the ages of 11 and 21 years can be taken care of by an adolescent health specialist. These pediatricians are specifically trained to help teens and young adults with emotional, behavioural, and physical care needs, including life-threatening illnesses. Certain health care issues related to reproductive and mental health can be treated confidentially.
Today's adolescents face many social and academic pressures, and can be treated for a variety of problems and conditions, such as: growth and development issues; school, learning, and attention problems; drug, alcohol, and tobacco use; nutrition, obesity, and eating disorders; acne and skin conditions; physical exams required for driver’s permits; orthopedic problems such as scoliosis; acute or chronic illnesses, from strep throat to asthma, diabetes, or cerebral palsy; headaches; chest pain; depression; stress; anxiety; self-esteem; sleep problems; and gynecologic and reproductive health/sexuality issues.
Pediatric Allergist/Immunologist
Children can often suffer from allergies or other health issues associated with their immune system. If a child has allergies, it means that their immune system is incorrectly reacting to things that are usually harmless (such as dust, pollen, pet dander, food, insect bites, and mold spores). This reaction can cause health issues such as hives, asthma, rashes, eczema, hay fever, diarrhea, anaphylaxis, sinusitis, pneumonia, thrush, or abscesses.
A pediatric allergist/immunologist's primary goal is to offer relief to the child. This is done by using specialized testing for diagnosing the condition and then deciding on the appropriate treatment. Treatment may involve pinpointing and avoiding things that cause the allergic symptom(s), administering allergy shots (immunotherapy), or prescribing medication.
Pediatric Cardiologist
A pediatric cardiologist is a specialist in diagnosing and treating children with heart conditions and heart diseases. They work closely with other specialists (such as heart surgeons, heart rhythm specialists (electrophysiologists), medical geneticists, anesthesiologists, nurses, dieticians, and therapists) in order to assess and arrive at an accurate diagnosis. Each child's specific condition needs a comprehensive and individualized treatment plan.
Pediatric cardiologists are able to work with patients before they are even born, throughout their childhood, and into adulthood. There are a variety of conditions that can be treated, such as: arrhythmia (irregular heartbeat); congenital heart disease; circulatory disturbances; chest pain or fainting; cardiac transplantation; supraventricular tachycardia; inherited long QT syndrome; heart murmurs; cardiovascular collapse; cardiac failure; cardiovascular abnormalities in neonatal intensive care; fetal cardiac abnormalities; transposition of the great arteries; and the management of critically ill children with cardiac problems.
Pediatric Emergency Physician
A pediatric emergency physician cares for infants, children and adolescents who require urgent and immediate medical attention and assistance due to being injured or acutely ill (these injuries or illnesses can often be serious or life-threatening).
Pediatric emergency physicians usually treat the following types of emergencies: high or persistent fever; severe infections; difficulty breathing; severe pain; dehydration; seizures; severe allergic reactions; fractures; head injuries; burns, poisoning; overdoses; asthma; diabetes; sickle cell disease; and animal bites.
These types of medical emergencies often require special procedures, equipment, and techniques that pediatric emergency physicians are educated in using. Pediatric emergency physicians work in emergency departments of children’s hospitals, teaching hospitals, community hospitals, and pediatric urgent care centres.
Pediatric Endocrinologist
Endocrinology is the science that studies hormones (chemicals that affect how other parts of the body work) and glands (organs that release hormones into the bloodstream). A pediatric endocrinologist deals with problems or disorders related to children's hormones and the glands that produce them.
Hormones determine how a child will grow and mature, therefore problems seen by pediatric endocrinologists are quite different from those seen by endocrinologists who care for adults. Issues related to growth and development can cause issues for a child's sexual development, which can then have significant effects on their physical and emotional well-being.
Examples of hormonal disorders that pediatric endocrinologists can treat: low blood sugar (hypoglycemia); enlarged thyroid gland (goiter); ovarian and testicular dysfunction; obesity; diabetes; early or delayed puberty; underactive or overactive thyroid gland; rickets; hypocalcemia; pituitary gland hypo/hyper function; growth problems; and adrenal gland hypo/hyper function.
Neonatologist
Neonatologists are trained to handle the most complicated and high-risk situations relating to newborns. They work mainly in the newborn intensive care units or special care nurseries of hospitals. If there is a problem identified before the birth of the baby, a neonatologist can team up with an obstetrician and assist in the baby's care during pregnancy. For babies that are born premature, or have serious illnesses, injuries, or birth defects, a neonatologist can be there at the time of delivery and in the ensuing care of the newborn.
Premature babies are babies that are born before their bodies are ready to leave the mother's womb. Critical organs such as the lungs, heart, stomach, and skin may not be mature enough to function without help. Neonatologists have specialized training and are able to evaluate and treat a newborn's medical problems, using equipment that is designed specifically for the tiniest of patients.
Neonatologists can handle conditions such as birth defects, breathing disorders, and infections, and help to coordinate care and management of premature newborns, newborns with critical illnesses, or newborns in need of surgery. They consult with pediatricians, obstetricians, and family physicians regarding conditions affecting newborns, and in some cases, may even provide short-term follow-up care on an outpatient basis.
Other sub-specialties:
- Pediatric Nephrologist - Treats children with kidney or urinary tract disease, bladder problems, kidney stones
- Pediatric Pulmonologist - Treats children with breathing and lung diseases
- Pediatric Rheumatologist - Treats children with joint, muscle, and bone disorders, arthritis, etc.
- Pediatric Gastroenterologist - Treats children with digestive system, liver, or nutritional problems
- Pediatric Hematologist/Oncologist - Treats children with blood diseases and cancer
- Developmental-Behavioral Pediatrician - Treats children with dyslexia, writing difficulties, and other school-related issues
- Pediatric Infectious Diseases Specialist - Treats children with a recurring or persistent disease caused by bacteria, a fungus, a parasite, or other rare infection
What is the workplace of a Pediatrician like?
Pediatricians can work in a number of environments, such as hospitals, private practice offices, health maintenance organizations, community health centers, public health clinics, schools, or the military and government. They are less likely to enter solo practice and more likely to work as salaried employees of group medical practices.
In a typical setting, pediatricians enjoy a pleasant working environment as they are generally assigned to offices and examination rooms most amenable to children. Offices and rooms are equipped with children's books, toys and activities to occupy children during waiting periods and distract them when undergoing painful procedures.
Working with children has its drawbacks, however. They can be unruly patients, often restless and sometimes hysterical and frightened by doctors and medical procedures. The utmost patience must be exercised when dealing with children, which is where pediatrics training is invaluable.
Frequently Asked Questions
What is the difference between adult and pediatric medicine?
A common adage in the medical field is that ‘children are not simply little adults.’ In other words, there are significant differences between treating adults and children. The smaller body size and less mature internal organs of an infant or child are physiologically substantially different. These variances can present congenital deficiencies or defects and developmental issues very specific to young patients. A pediatrician’s interpretation of symptoms, diagnosis, and prescribing of medications and other treatments are all influenced by the age of the patient.
The fact that the pediatrician’s patients often cannot independently advocate or make decisions adds another aspect to pediatric practice: that of communicating with parents and family; and considering the concerns of potentially many people, not only the patient. This part of the pediatrician’s work can be particularly demanding in the face of a painful procedure or poor prognosis.
Can a Pediatrician treat adults?
Pediatric training is composed of four years of medical school and a minimum of three years of residency in pediatrics. The discipline is a very specialized one and its practitioners are specially qualified to treat babies, toddlers, children, and adolescents up to the age of eighteen, perhaps as old as twenty-one. Unless they are trained in both pediatrics and adult medicine, it is rare for pediatricians to step outside of their specialty to treat adults.
Does a Pediatrician require a specially trained Pediatric Nurse?
While a pediatrician is a licensed physician who is specifically trained in pediatrics or children’s medicine, nurses receive a bachelor’s degree to become a Registered Nurse or RN. Only by doing most of their work and gaining extensive practical experience in the pediatric field do they become labeled as ‘pediatric’ nurses. This experience includes administering immunizations, keeping developmental records, and often being patients’ first point of contact before they see a pediatrician. As they gain experience in the field, pediatric nurses may choose to specialize in a particular sub-discipline, such as anesthetics, oncology, or neurology.
What are some common pediatric health care issues?
Among the most common issues facing pediatricians today are:
- Fetal origins of adult disease
- Smoking among youth
- Neonatal Encephalopathy – a syndrome in newborns which disturbs neurological function, causing respiratory problems, depressed reflexes, sub-normal consciousness, and potential seizures
- Early-life origins of cardiovascular disease
- Type 1 diabetes
- Brain tumors in children
- Autism spectrum disorders
- Environmental Chemical Exposure
- Common childhood bacterial infections
- Nutrition and celiac disease
Where and in which specialties are Pediatricians most needed?
In both the United States and Canada and in fact worldwide, there is a shortage of pediatricians serving rural and less populated areas. Also in the U.S., while the total number of primary care doctors for children across urban areas is appropriate, there is an uneven distribution of these doctors throughout the fifty states.
As for the kinds of specialists in demand, the lists are varied. A recent study revealed that in Canada medical schools are training too many doctors in some pediatric specialties, and insufficient numbers in other areas of child health care. For example, the study showed that twice as many neurologists as needed and only half the number of required neonatologists – doctors who treat premature or ill newborns – are being trained. The Canadian Pediatric (‘Paediatric’) Society cps.ca and the American Academy of Pediatrics aap.org are the most reliable sources from which to obtain updated statistics regarding job opportunities in the field.
How long does it take to become a Pediatrician?
The training for a pediatrician takes approximately 11 years after completing high school, depending on the university and jurisdiction and the degree of specialization required, as they vary considerably across the world.
Typically, after high school, students will need four years of undergraduate courses in a college or university, majoring in biology or another science-related major. The course major need not necessarily be science-related, so long as the pre-med course requirements such as calculus, organic chemistry, biochemistry, biology, chemistry and physics are completed.
There is also a medical college admission test to pass along with a certain level of school grades to be attained in order to qualify and get accepted by a medical school.
Four more years will be required working towards a Doctor of Medicine (M.D.) or Doctor of Osteopathy (D.O.) degree. However, a few schools offer combined undergraduate and medical school programs that last six rather than the customary eight years.
The first two years of medical school mainly consist of classroom and laboratory learning, while the last two years involve first-hand clinical experience under the supervision and guidance of licensed professionals. After medical school, the next step would be to complete a one-year pediatric internship, which includes hands-on training and experience in baby care.
After a successful internship, students are required to take a two-year residency program to obtain further knowledge and experience in the field. Once this phase is completed, they are now ready to take the general pediatrics certification program which is necessary for obtaining a license. After getting board certified, they can commence their work as a licensed pediatrician.
Most pediatricians at this stage choose to continue their education in pediatric sub-specialties such as adolescent medicine, developmental disorders, gastroenterology, infectious disease, nephrology, oncology, cardiology, endocrinology, etc.
Are Pediatricians happy?
Working with children can be rewarding, challenging, exciting, and mentally stimulating. The clinical aspect is fascinating and one needs to be competent at dealing with severe life threatening emergencies as well as chronic lifelong conditions. It is a speciality that demands excellent interpersonal and communication skills.
Pediatricians are teachers first and foremost. They teach kids how to live healthy lives and help parents learn the latest ways to get their kids to succeed and live well. Pediatricians get to be professional and serious when discussing things with parents, but can also flip into child-friendly play mode when examining and getting to know a child.
It is important to have work-life balance as this career can be mentally and physically draining. Like any speciality in medicine, pediatrics has it's ups and downs, however for most pediatricians the ups definitely outweigh the downs.
Should I become a Pediatrician?
If you're interested in practicing medicine and you love being around kids, a pediatrician career may be the perfect choice for you. Ultimately, the best way to decide if a pediatrician career is right for you is to find a pediatrician who'll allow you to follow him or her around at their practice or as they do their hospital rounds to get a true idea of what a typical day is like.
Here are some pros and cons to consider while you're mulling over the idea of becoming a pediatrician:
PROS
Helping Children
Becoming a pediatrician gives one the opportunity to prevent and treat illnesses in children in particular. If you love children, you can play a major role in helping them live long, healthy lives. Pediatricians, particularly in office settings, get a chance to build bonds with kids and their parents through routine visits during the first few years of their life. Seeing a child recover from an illness based on your care is very rewarding.
Making a Comfortable Salary
Pediatrics is the lowest-paying medical specialty, however, pediatricians have relatively low malpractice costs.
Flexibility
Pediatricians can start up their own practice and be their own boss or they can join a group of doctors and share responsibilities. If running a business is something you don't want anything to do with, you can work for a practice that has office staff who will take care of all the business details.
Choices in the Field
Pediatricians can choose to focus on certain pediatric specialties, such as adolescent medicine, child abuse pediatrics, developmental- behavioral pediatrics, diagnostic laboratory immunology, medical toxicology, neonatal-perinatal medicine, neurodevelopmental disabilities, or pediatric cardiology. Pediatric specialists have taken more extensive training in their area of practice.
Job Prospects
The job prospects for anyone wanting to become a pediatrician are quite good, as the population is growing and as such there are children who need to be seen by doctors that are specialized. The demand for pediatric care is very high, and for pediatricians entering into the workforce over the next decade, they can expect available work and many opportunities in this field.
Advancement Opportunities
There are many job opportunities that are related to the health and well-being of children. Advancement opportunities are available in areas such as pediatric surgery, pediatric allergy, and pediatric endocrinology. Some of the highest paying would include entering into pediatric cardiology, oncology or neurology.
CONS
Length of Education & Costs
Becoming a pediatrician requires four years of university, four years of medical school, and at least three years of an internship and residency. You can expect to pay anywhere from $40,000 to $160,000 for four years of university (smaller schools are generally less expensive than major state universities such as Harvard and Yale). You can expect to pay anywhere from $100,000 to $160,000 total for four years of medical school. Residency does provide some income, between $40,000 and $55,000 per year. Should you decide to participate in a fellowship following your residency, you can also expect to earn a moderate salary during that time.
Work Schedule
The average pediatrician works approximately 50 hours per week. This includes time spent in the office, visiting patients in the hospital, doing paperwork and being on call. Most pediatricians make themselves available to their patients after regular office hours, which often means nights and weekends. A doctor by himself (often small-town pediatricians) are usually on call everyday, however doctors in a group office setting would be on call much less often. In larger clinics and hospitals, pediatricians work in rotations, which include night, evening, weekend and holiday shifts. These types of schedules make it sometimes difficult to balance work and family life effectively.
Pressure of the Job
The rising costs of lawsuits and medical malpractice insurance has increased the pressure on medical professionals to perform accurately. There is also added pressure as a result of appeasing parents; parents are often insistent on the types of treatment they want, putting pediatricians in possible conflict with what they believe is proper care.
Pediatricians are also known as:
Paediatrician
General Pediatrician
Infant Care Pediatrician
Infant Care Physician
Child Physician
Adolescent Physician
Primary Care Pediatrician