Pediatricians are physicians who provide health care to infants, children, and adolescents. Typically, a pediatrician meets a new patient soon after birth and takes care of that patient through his or her teenage years. There are nearly 27,000 pediatricians employed in the United States.
Pediatrician Career History
Children became the focus of separate medical care during the 18th century in Europe. Children’s health care became a recognized medical specialty during the early 19th century, and by the middle of the 19th century, pediatrics was taught separately in medical schools. The first pediatric clinic in the United States opened in New York City in 1862. About that same time, several children’s hospitals opened in Europe.
Studies focused on developing treatments for infectious diseases of childhood such as measles and scarlet fever. By the beginning of the 20th century, pediatricians began promoting the normal growth and development of children. Well-child clinics began to open around the United States.
Some of the most significant breakthroughs in children’s health care have been in disease prevention. By the middle of the 20th century, the development of vaccines and antibiotics greatly decreased the threat of infectious diseases.
Pediatrician Job Description
A significant part of a pediatrician’s job is preventive medicine—what is sometimes called “well care.” This involves periodically seeing a patient for routine health checkups. During these checkups, the doctor physically examines the child to make sure he or she is growing at a normal rate and to look for symptoms of illness. The physical examination includes testing reflexes, listening to the heart and lungs, checking eyes and ears, and measuring height and weight.
During the checkup, the pediatrician also assesses the child’s mental and behavioral development. This is done both by observing the patient’s behavior and by asking the parents questions about their child’s abilities.
Immunizing children against certain childhood diseases is another important part of preventive medicine. Pediatricians administer routine immunizations for such diseases as rubella, polio, and smallpox as children reach certain ages. Yet another part of preventive medicine is family education. Pediatricians counsel and advise parents on the care and treatment of their children. They provide information on such parental concerns as safety, diet, and hygiene.
In addition to practicing preventive medicine, pediatricians also treat sick infants and children. When a sick or injured patient is brought into the office, the doctor examines him or her, makes a diagnosis, and orders treatment. Common ailments include ear infections, allergies, feeding difficulties, viral illnesses, respiratory illnesses, and gastrointestinal upsets. For these and other illnesses, pediatricians prescribe and administer treatments and medications.
If a patient is seriously ill or hurt, a pediatrician arranges for hospital admission and follows up on the patient’s progress during the hospitalization. In some cases, a child may have a serious condition, such as cancer, cystic fibrosis, or hemophilia, that requires the attention of a specialist. In these cases, the pediatrician, as the primary care physician, will refer the child to the appropriate specialist.
Some pediatric patients may be suffering from emotional or behavioral disorders or from substance abuse. Other patients may be affected by problems within their families, such as unemployment, alcoholism, or physical abuse. In these cases, pediatricians may make referrals to such health professionals as psychiatrists, psychologists, and social workers.
Some pediatricians choose to pursue pediatric subspecialties, such as the treatment of children who have heart disorders, kidney disorders, or cancer. Subspecialization requires a longer residency training than does general practice.
A pediatrician practicing a subspecialty typically spends a much greater proportion of his or her time in a hospital or medical center than does a general practice pediatrician. Subspecialization permits pediatricians to be involved in research activities.
Pediatrician Career Requirements
While in high school, take college prep classes, with a heavy emphasis on science and math. Biology, chemistry, physics, and physiology are important science classes. Any advanced math courses are also excellent choices.
Classes in English, foreign languages, and speech will enhance communication skills, which are vital to being a successful physician. Such social sciences as psychology and sociology, which increase your understanding of others, are also beneficial.
After earning an M.D. degree and becoming licensed to practice medicine (see Physicians), pediatricians must complete a three-year residency program in a hospital. The pediatric residency provides extensive experience in ambulatory pediatrics, the care of infants and children who are not bedridden. Residents also spend time working in various specialized pediatric units, including neonatology, adolescent medicine, child development, psychology, special care, intensive care, and outpatient.
Some of the other subspecialties a pediatrician might acquire training for include adolescent medicine, pediatric cardiology (care of children with heart disease), pediatric critical care (care of children requiring advanced life support), pediatric endocrinology (care of children with diabetes and other glandular disorders), pediatric neurology (care of children with nervous system disorders), and pediatric hematology/oncology (care of children with blood disorders and cancer).
Certification or Licensing
Certification by the American Board of Pediatrics is recommended. A certificate in General Pediatrics is awarded after three years of residency training and the successful completion of a two-day comprehensive written examination. A pediatrician who specializes in cardiology, infectious diseases, or other areas must complete an additional three-year residency in the subspecialty before taking the certification examination.
To be a successful pediatrician, you should like children and adolescents; have patience, compassion, and a good sense of humor; be willing to continually learn; have a desire to help others; and be able to withstand stress and make sound decisions.
Exploring Pediatrician Career
There are many ways you can prepare for medical school and a career in pediatrics. Participation in science clubs, for example, will allow for in-depth explorations of some areas of science. Volunteer work at hospitals or other health care institutions will allow you to see many aspects of medical care. Such volunteer work can also provide a taste of what a physician’s career entails, and help you decide if you is suited for it. You can also ask your science teacher or counselor to arrange an information interview with a pediatrician to see if this career is a good fit for you.
The majority of the nearly 27,000 pediatricians in the United States are involved in direct patient care. Of these, about one-third have private practices. The others work in group practices, community clinics, hospitals, university-affiliated medical centers, and health maintenance organizations. Only about 10 percent of pediatricians work in administration, teaching, or research.
There are no shortcuts to entering the medical profession. Requirements are an M.D. degree, a licensing examination, a one- or two-year internship, and a three-year residency. Upon completing this program, which may take up to 15 years, pediatricians are then ready to enter practice.
For the pediatrician who plans to set up a private practice, it is wise to consult with his or her medical school placement office to find a suitable geographic location in which to do so. Certain locations, such as rural areas and small towns, offer less competition for patients and, therefore, better chances of success.
Many newly licensed pediatricians take salaried jobs until they can pay off some of their medical school debt, which is likely to total more than $50,000. Medical school placement offices should be able to recommend hospitals, clinics, HMOs, and group practices that are hiring pediatricians.
The most common method of advancement for pediatricians is subspecialization. There are several subspecialties open to the pediatrician who is willing to spend the additional time training for one. A subspecialty requires three more years of residency training.
Some subspecialties a pediatrician might train for include neonatology (the care of sick newborns), adolescent medicine, pediatric cardiology (care of children with heart disease), pediatric critical care (care of children requiring advanced life support), pediatric endocrinology (care of children with diabetes and other glandular disorders), pediatric neurology (care of children with nervous system disorders), and pediatric hematology/oncology (care of children with blood disorders and cancer).
Some pediatricians pursue careers in research. Possible research activities include developing new vaccines for infections, developing treatments for children with heart disease, and developing treatments for infants born with severe abnormalities.
Another way for pediatricians to advance is to move into the field of education, where they can teach medical students and resident physicians about particular areas of pediatrics.
Pediatricians, while at the low end of the earning scale for physicians, still have among the highest earnings of any occupation in the United States.
According to the U.S. Department of Labor, pediatricians had median earnings of $134,170 in 2003. Pediatricians receive starting salaries that range from $95,000 to $130,000. Those with three years of experience earn salaries that are as high as $201,086. The earnings of pediatricians are partly dependent upon the types of practices they choose. Those who are self-employed tend to earn more than those who are salaried. Geographic region, hours worked, number of years in practice, professional reputation, and personality are other factors that can impact a pediatrician’s income.
Pediatricians that are in general practice usually work alone or in partnership with other physicians. Their average workweek is 50 to 60 hours, most of which is spent seeing patients in their offices. They also make hospital rounds to visit any of their patients who have been admitted for treatment or to check on newborn patients and their mothers. Pediatricians spend some time on call, taking care of patients who have emergencies. A pediatrician might be called to attend the delivery of a baby, to meet an injured patient in the emergency room, or simply to answer a parent’s question about a sick child.
Some pediatricians choose to pursue pediatric sub-specialties, such as the treatment of children who have heart disorders, kidney disorders, or cancer. Subspecialization requires a longer residency training than does general practice. A pediatrician practicing a subspecialty typically spends a much greater proportion of his or her time in a hospital or medical center than does a general practice pediatrician. Subspecialization permits pediatricians to be involved in research activities.
Pediatrician Career Outlook
According to the Occupational Outlook Handbook, physician’s jobs are expected to grow about as fast as the average through 2014. The employment prospects for pediatricians—along with other general practitioners, such as family physicians—are especially good. This is because of the increasing use of managed care plans that stress preventive care.