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The Informed Parent

The Making of a Pediatrician (1 of 2)

by John H. Samson, M.D., F.A.A.P.
Published on Apr. 03, 1999
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In the past six months I have received numerous e-mails from our readers inquiring as to what it takes to become a pediatrician. At first I responded individually, but as the queries continued it became clear that there was a demand for a more detailed answer. To this end, the following two-part article was authored.

The field of medicine called pediatrics is an upbeat, active and, for the most part, a happy way to practice medicine. The pediatrician provides care for patients from birth until they outgrow the practice.

In the past, when the patients exceeded 12 years of age it was time for them to leave the aegis of the pediatrician. However, when the special needs of the adolescent were recognized the age of pediatric care advanced to 18 years. In my own office, and in many others, patients are followed until they graduate from college. This broad age range provides a myriad of problems to be solved, diagnoses to make and subjects to teach to patients and their parents. One never gets bored in this field.

The pediatrician does not perform surgical operations but can suture lacerations and cast simple fractures. The medical field is covered by the pediatrician for children as the internist does for adults. I like to think of an internist as a pediatrician for adults!

The road to becoming a physician, and ultimately a pediatrician, may seem long and arduous. Every profession or trade has a time period of training and apprenticeship, marked by lower pay and extended hours. This is true of the lawyer, electrician, engineer, actor or athlete. In medicine, it takes dedicated self-discipline to master the enormous amount of information needed to understand the workings of a human body, physically and mentally.

What is the time investment in the making of a pediatrician? Upon completing high school the candidate faces four years of university study. Courses are taken that prepare you for medical school. These need not be all biology oriented, but the better understanding of the life sciences the smoother will be the transition to medical school.

During the final year, leading to a bachelors degree, one may apply to medical school. It is required that the candidate has completed the MCAT examination, which is a set of tests that the medical schools use to evaluate the applicants. These tests are knowledge and analytical skill evaluations which allow the medical schools to judge the candidates from an aspect other than their university grades. The medical schools place great value in these arduous examinations. It allows them to predict which students will be able to handle the rigors of medical school, a concept which is debatable.

Provided one's grades in college, MCAT scores and interview evaluations are considered good enough the medical school will offer you a position in the freshman class. When I began medical school we were told only two out of every three freshmen would make it! We did not need a stronger incentive. I was determined to be in the two out of three group! Fortunately, this philosophy is no longer practiced. Once accepted to medical school, barring some overwhelming problem, you will graduate.

It is costly to attend four years of medical school. The vast majority of students and/or their families cannot fund themselves. Today's common practice is to execute a loan in order to cover the four years, with payment beginning after your training is completed. Lack of funds should never deter one from applying to medical school today. The average student usually graduates with an approximate debt of $100,000.00. This is to be paid off in installments when one enters practice.

The first two years of medical school involve daily classes covering the anatomy, physiology and biochemistry of the human body and disease states. The typical student spends three-to-five hours of reading and studying daily, in addition to classes, in order to acquire the volumes of information that form the basis for the practice of medicine. This also sets the tone for the mental discipline needed to be a physician.

By the end of the second year the student has had significant interaction with patients. This prepares the fledgling doctor for the last two years of medical education. Now begins the best part of medical school; the clinical years. One works side-by-side in clinics and hospital wards with residents, attending physicians and professors to provide care for the sick and disturbed. The student has arrived! This is what all the "book learning" was about.

It is a time of stress, long hours and often humbling experiences. But the rewards come as you see patients do better because of your work. This is the compensation for the long hours spent. When a patient thanks you for your efforts one is reimbursed for all the midnight oil burnt.

In these clinical years time is spent in pediatrics, internal medicine, obstetrics and gynecology, surgery and emergency medicine. In addition time is spent in sub-specialty services and electives as chosen by the student.

Remarkably, four years have quickly passed and you are the recipient of a diploma and a M.D. degree. Now the real work begins. To be continued next week.




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