Pediatrics is a domain of medicine that deals with child health, illness and well-being . The word “children” may itself be difficult for many doctors, but pediatrics isn’t simply about a word. Here the word “children” includes – neonates, infants, toddlers, shool-age children and adolescents. Every age groups have own horizon.
Why studying pediatrics needs a lot of determination and interest?
As we all know, children are not easy to deal with and many people don’t have the patience and passion and the rest find it hard to build a rapport with children.
Children are scared of the white coat and the hospital environment. As soon as they enter, they begin to resist and the doctor may have a very hard time getting his or her co-operation.
Signs are more important than symptoms in pediatrics. Children may not give a subjective complain; instead the doctor has to detect his/her problem. When all that a small children do is cry, a pediatrician has to find a meaning out of his/her cry. Sometimes, it may be a simple colic or as bad as an intussusception or meningitis.
Most difficult thing is the change in biophysiology in children. Right from birth, there is daily to monthly change in vitals, clinical findings, reflexes, behavior. Without a proper experience, detecting an abnormality might be impossible. Pediatric residents have pockets full of growth charts, reference values and drug dosings.
Even the management is totally different in newborn and older children. Maintainance fluid requirement, nutritional requirement, dose dosing and interval, whether the drug can be used in children, drug formulations- syrup, drops, DT, ect. makes it mandatory for residents to carry a drug dosage formulation books. There is no fixed dose as in adults.
Another difficult part is the growth and development part. I have seen even pediatrician surrender to this domain. It is a mighty domain and is a core pediatric subject. Even we are pissed off when we encounter a developmental problem case. It is a matter of dedication and patience.
Next one is congenital anomaly, dysmorphology and spectra of genetic and metabolic diseases that are an add-on to medicine. Dysmorphology is an unrewarding subject. You are a detective and you find the culprit but its unpunishable most of the times. There is always a differential when a child is not growing, seriously or recurrently ill or has other problems and it is this part.
The adolescents to say aren’t a different species, but its time when they act different. Aggression, rage, frustration, emotions are all exaggerated during this time and taking them in confidence and giving them the right path is the real challenge.
It is the most sensitive field in medicine. Everyone value children dearer than their life. When a child is critically ill, counselling the parents is harder than the treatment. Breaking a bad news is a different story. Lot of mishaps have occured.
Last but not the least, no matter how ever you are, you have to act funny.
Still, the children make your everyday special. You cannot be a pediatrician and sad. There is only one option. They dazzle you no doubt. So treating these gift of god is a novel job. Pediatrics however difficult may it be, is worth it.
I may be missing points. you are always welcomed to add in.
is an MD in Pediatrics (IOM) and a Fellow in Neonatology (GRIPMER). He often writes his views online as well as share few important topics for medical students, doctors and specially parents. He has shared few of his experiences in Epomedicine which might be worthy of a reading.