Starting a pediatric emergency medicine fellowship is exciting – and, let’s be honest, a little overwhelming. That’s why we pulled together advice straight from current and recent PEM fellows. In Part 1, they shared practical tips, mindset shifts, and a dose of humor to help you find your footing.
But our fellows weren’t done talking. The advice kept coming, so here’s Part 2 – more insights, more honesty, and more hard-earned wisdom from the people who’ve been exactly where you are now.
Have your own nugget of PEM wisdom to share? Send us an email at HipPEMcrates@gmail.com
Jump on the patients with chief complaints that you dread! For example, I used to dread nailbed repairs but then forced myself to sign up for every one I saw on the board, asked for and got some great coaching, did a bunch of them, and now love doing them. (Weird, I know.) It might be single ventricle physiology, or doing an LP, or counseling a family with a new cancer diagnosis… doesn’t matter. The point is: the stuff you fear or dislike is often driven by a lack of confidence. Getting reps on those patients will boost your confidence and make it so you no longer dread seeing that chief complaint on your board. You got this!
Anonymous Fellow
I would tell myself to not compare myself to anyone else. We each come to learn and from different backgrounds (EM/Peds) which makes the process unique and beautiful. Understand that we all have different strengths and use that to your advantage to learn from your peers!
Kelsey Byrd, UC San Diego
It’s hard to know the best time to intubate a child in status epilepticus. Let your PCO2 guide you, but your RN can likely tell you when.
Robbie Daulton, Cincinnati Children’s Hospital
It’s OK to not know but admit it and be ready to learn. Some days are like drinking from a fire hydrant but just keep the pace you’re comfortable with, see the kids who are the sickest, and the rest will be OK.
Anonymous Fellow
Take the hard ones. If you read the chief complaint / triage note for a patient waiting to be seen, and it makes you uncomfortable — maybe you don’t know much about a diagnosis or an approach to that particular problem and are worried you won’t know what to do, or you feel uncomfortable with a certain procedure — that’s a sign. Pick that patient up. You’ll learn a ton from it, and it’ll be less intimidating next time.
Bobby Rosen, Boston Children’s Hospital
Think about what kind of attending you want to be in the future and stick to it. Don’t let the style of others distract you.
Anonymous Fellow
Dr. Andzelika Dechnik, MD, is a 3rd year Pediatric Emergency Medicine Fellow at NewYork-Presbyterian Hospital/Columbia University Medical Center. She can be reached at ad4154@cumc.columbia.edu.
