Choosing a pediatrics residency is a rewarding and impactful decision that often comes from a passion for nurturing the health and well-being of children. It’s a speciality that offers diverse patient populations and a dynamic experience, and pediatricians can witness tremendous growth and development while providing comprehensive care for their patients.

The opportunity to form lasting relationships with both patients and their families, coupled with the chance to be an advocate for a child’s health and happiness, makes pediatrics a deeply fulfilling specialty, one that you should be glad you’ve chosen.

Currently, there’s an ocean of advice for applying to residency in general. We know to look at program’s location, size, and reputation as main criteria when ranking our top programs.

“Yes, that’s all well and good,” you may be saying to yourself, “but what about the particular specialty I’m going into? Where can I find information on how to select a program in my specific field?” In fact, over my past few years as an advisor, I‘ve received more and more requests from students about specific recommendations for particular specialties.

So, by popular demand, we’re going to continue this series that details specific things to keep in mind when selecting residencies in YOUR desired specialty. We’ll do a post for each specialty (or most of them), and to continue the series…let’s have a look at considerations for selecting a pediatrics residency program.

Pediatric Residencies by the Numbers

First, some data about the field of pediatrics. During the most recent match cycle (2022), the field of pediatrics had a total of 3,153 applicants and 3,016 available spots. Of the 1,655 U.S. MD seniors who applied, only 27 didn’t match.

Pediatrics hasn’t been a particularly competitive speciality in the past and it remains so today. This is good for you! There are nearly enough slots available for the number of applicants and over 95% of U.S. grads (MDs and DOs) matched into a pediatrics residency spot. Compare this to orthopedic surgery which had under a 70% match rate the previous cycle (all data from NRMP).

I mention these statistics to show that you should be confident in your application to pediatric residency. Confidence in your application and during interviews means you can be selective in which programs you rank and have more say in where you ultimately end up training.

As an applicant, you can expect interviews to take place from October to early January. Reach out to programs you have an interest in or signaled if you haven’t heard from them by mid-November (do it before the holiday season). Once you have about a dozen interviews under your belt, you can consider being a bit more selective about the future interviews you do and the programs you rank.

When deciding on pediatric residency programs, several factors should be considered to determine which are the best fit for your career goals and personal preferences. It’s an immensely personal decision, but here are some things to keep in mind when it comes to choosing a program.

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8 Things to Consider When Selecting a Pediatric Residency Program

1. Are you interested in primary care pediatrics? 

Most pediatricians who graduate end up practicing outpatient generalized pediatrics. As a general pediatrician, you’ll provide comprehensive healthcare to infants, children, and adolescents. The majority of your visits will involve routine checkups, preventive care, and early detection of developmental, behavioral, and health issues.

Pediatric primary care providers emphasize the importance of growth and development milestones, nutritional guidance, and counseling for both patients and their families. If this is your interest and main reason for selecting pediatrics, make sure you attend a program that has rotations dedicated towards general pediatrics, as well as good options to establish continuity clinics.

Naturally, consider the setting you wish to practice in (rural vs. suburban vs. urban) as that can affect the patient population and disease processes you deal with. Some programs may even offer a primary care track that allows for more community involvement!

2. Are you thinking about specialization?

If primary care doesn’t align with your career aspirations and you’re leaning towards sub-specialization, prioritize programs with a robust track record in subspecialty match rates. Inquire about the post-graduation paths of former program graduates. Did most pursue fellowships? If so, how successful were they in securing these positions and where were they?

For individuals inclined towards fellowships or those discovering a newfound interest in specialized training, it’s pivotal to select a program with a strong historical track record (I generally consider rates over 80% as highly favorable) in placing candidates into various fellowship programs nationwide. Many of these programs also provide dedicated faculty mentors tailored to guide and support those seeking fellowship training, further enhancing the prospects of securing coveted fellowship positions.

Pediatric Fellowship Options

Currently, the American Academy of Pediatrics certifies the following fellowships:

1. Adolescent medicine
2. Child abuse pediatrics
3. Developmental and behavioral pediatrics
4. Diagnostic laboratory immunology
5. Neonatal-perinatal medicine
6. Pediatric cardiology
7. Pediatric critical care medicine
8. Pediatric emergency medicine
9. Pediatric endocrinology
10. Pediatric gastroenterology
11. Pediatric hematology-oncology
12. Pediatric infectious disease
13. Pediatric nephrology
14. Pediatric pulmonology

Having access to dedicated mentorship with seasoned faculty members will play a pivotal role in shaping your experience and development as a resident. Consider faculty credentials, their engagement in research and mentorship, and their reputation as educators.

If possible, find and use the opportunity to converse with a faculty mentor specializing in your desired subspecialty, such as pediatric critical care, to glean more insights into the program and evaluate their involvement in guiding current residents towards the path of fellowship. This interaction not only provides a deeper understanding of the program dynamics but also demonstrates your genuine interest and commitment to the specialty.

Interest-Centered Training

Also, consider programs that offer a training environment and experience tailored to your interests. Programs may offer this in the form of various, specialized training tracks: global health, genetics, pediatric scientist /research, leadership/advocacy, to name a few, which often start as early as intern year.

Each track allows for additional training and experiences that delve deeper into specific areas of pediatric medicine, providing expertise in diagnosing, managing, and treating complex conditions within that specialized field. Programs offer these tracks in order to provide a cohesive experience centered around a population or type of pediatric care and signing up for a track generally will not restrict your ability to explore other types of pediatric practice.

3. Elective time matters when selecting a pediatrics program.

Another aspect in customizing your residency experience revolves around elective time. Prospective applicants naturally examine the program’s curriculum and schedule. However, when revisiting this information, consider the following:

Clinical Hours and Patients per Hour (PPH)

Assess the duration of clinical hours and PPH to understand the workload and intensity of the program.

Patient Load for Residents

Evaluate the number of patients that interns typically care for in a clinic day to gauge hands-on experience and exposure.

Learning Curve

Determine how quickly trainees gain responsibilities and autonomy within the program. How does the clinic and inpatient service ramp up in terms of patient load?

Elective Duration

Inquire about the allowance for elective months to tailor your learning experience and explore specific interests. Are these months purely dedicated to your desired elective, or will you have other residency duties as well?

Subspecialty Exposure

Look for programs that offer a robust exposure and elective offerings for various pediatric subspecialties such as neonatology, pediatric cardiology, critical care, hematology/oncology, etc.

Research Opportunities

Check if the program offers dedicated research months for those interested in scholarly pursuits. Again, are these months purely dedicated to your research, or will you have other residency duties during that time?

NICU/PICU Experience

Consider the quality and quantity of experiences in neonatal intensive care unit (NICU) and pediatric intensive care unit (PICU) rotations. 

Inpatient vs. Outpatient Rotations

Understand the balance between inpatient and outpatient rotations to comprehend the diversity of training offered. If you want to be a pediatric hospitalist, you’d naturally want more pediatric hospital medicine (PHM) months. If your flavor is outpatient practice, then choose somewhere that offers more of that.

Vacation Time

Simply put, more is better!

4. Consider the program’s diversity, equity, and inclusion (DEI) efforts.

If it’s important to you, find a program that also values and actively promotes DEI within their program. This will be evident in the program’s efforts to improve diversity and inclusion and there is usually a DEI committee that does so. Most academic programs or residencies tied to a medical school will have an office of DEI. 

5. The reputation of the program matters.

Every pediatric residency has a similar core structure that adheres to Accreditation Council for Graduate Medical Education (ACGME) requirements.

However, some hospitals have better reputations than others. Consider the children’s hospital that you’ll train in, from its overall reputation to its ER,. Is it a renowned trauma center? Does it have the best pediatric nephrology programs, etc. Reputation matters, so consider the program’s standing within the medical community and its history of producing quality pediatricians.

6. What will your patient population be?

Consider the patient population the program serves. Exposure to a wide variety of cases, including complex and diverse patient populations can prepare you for broader practice as an attending.

Also, think about the program’s standing within its community. If it’s important for you, seek programs that provide opportunities for community engagement, advocacy training, and experiences in underserved areas. This exposure can deepen your understanding of pediatric public health and community-based care.

7. What sort of “vibe” did you get when visiting?

Give the program a vibe check. Observe, as much as you can, interactions among residents, between residents and faculty, and residents and staff on your interview day and at any social events hosted by the program.

This is tougher with virtual interviews, but do your best to ask questions and see how residents and faculty respond. Their engagement can give clues into their comfort levels and overall relationship with the program. A supportive and collaborative atmosphere fosters learning and personal development and both resident and faculty satisfaction is important to the future of the program.

8. Does the pediatric residency have good support systems?

Pediatrics can be demanding, with emotional cases and long hours. Assess the program’s support systems for resident wellness, including mental health resources, counseling services, and efforts to prevent burnout.

Lastly, trust your instincts and consider how well you resonate with the program during interviews and interactions with current residents and faculty. A good fit can contribute significantly to your overall satisfaction during residency.

Further Reading

Each program will present pros and cons. Your pediatric mentors, clinical advisors and upperclassmen can offer valuable insight into finding the right pediatric residency for you.

Most importantly, the interview process will help crystallize priorities and clarify options. Ask questions and use the tips above to evaluate pediatric residency programs, ensuring that the program you select aligns with your career aspirations and provides a well-rounded training experience in pediatric medicine.

Looking for more (free!) tips for Match season? Check out these other posts from Blueprint tutors on the Med School blog!

• Going Back to In-Person Residency Interviews: How to Prepare & What to Expect
• How to Make A Residency Rank List That Puts Your Happiness First
• 6 Stress Management Tips for Residency Match Week