Dr. Katie Lockwood discovered she wanted to become a pediatrician the first time she entered a hospital — not as a doctor, but as a patient. At 5 years old, Lockwood was hospitalized with a blood vessel disorder, but far from being scared, she says she “became fascinated by the process, the detective work of figuring out what was wrong with me by the pediatricians.”
In college, Lockwood shadowed her childhood pediatrician, learning about the job firsthand, and decided she could see herself following a similar path. Today, she’s an attending physician at Children’s Hospital of Philadelphia.
While some pediatricians know from an early age they want to care for children, others come to the realization later in life, even well into medical school. Either way, becoming a pediatrician is a serious decision that requires long years of training and significant financial investment. But for those who love it, the career is an incredibly rewarding one.
Here are some of the things to know about becoming a pediatrician.
What Does a Pediatrician Do?
The American Academy of Pediatrics defines pediatrics as a “specialty of medical science concerned with the physical, mental, and social health of children from birth to young adulthood.”
A primary care pediatrician serves an important role caring for a child from when they are born until about 21 years of age. Pediatricians see patients through a mix of well child visits — regular check ups that include a physical exam, hearing and vision tests and immunizations — and sick child visits, which focus on a particular ailment like a cold, a stomachache or an ear infection.
In some cases, patients will be referred to a specialist when a child is diagnosed with a more serious disease, but the primary care pediatrician continues to play an important role in coordinating care and keeping an eye on the overall health of the child.
While many are drawn to the field because they enjoy working with children, pediatricians also work closely with families.
“It’s the best part of pediatrics that we get to work with families and have a special role listening to parents,” says Lockwood. “I think that’s one of the assets, because while the child is the patient, we work within a family unit.”
How Long Does It Take to Become a Pediatrician?
The path to becoming a pediatrician is a long one, taking at least 11 years from college to medical school through residency.
Training begins for future doctors as undergraduates, where they spend four years completing prerequisite courses, including biology, chemistry and physics, in preparation for medical school. Students who miss those prerequisites can enroll in a post-baccalaureate premedical program, which can take one to three years to complete depending on whether they attend full or part time.
Then it’s on to four years of medical school. For the first two years, medical students take foundational science courses, including anatomy, physiology and pathology. During the second half of their program, medical students take part in clinical rotations where they get exposure to a variety of specialties, like internal medicine, surgery and pediatrics.
[Read: Why It’s Hard to Get Into Medical School Despite Doctor Shortages.]
For doctors unsure whether pediatrics is right for them, a rotation can be an eye-opening experience. That’s what it was for Dr. Zarina Norton.
“I knew I liked kids, but a lot of people like kids and that doesn’t mean you have to become a pediatrician,” says Norton, an assistant professor of pediatrics at Northwestern University’s Feinberg School of Medicine. “But my rotation during my third year of medical school in pediatrics, while it was hard work, felt exciting and I felt engaged and enthusiastic everyday.”
Norton says she encourages medical students to recognize when “there’s a rotation you feel at home or excited about. That can be a really good indicator” of a successful and happy career path.
How Does Pediatric Residency Work?
Following medical school, doctors spend three years in a pediatric residency program, digging deeper into their study of pediatrics.
One of the most important factors when considering a residency is size. Residencies can range from classes of five to 15 doctors in a small program to 45 or 50 in a large one. Some doctors thrive in smaller programs where they can form close relationships with faculty and other residents, while others might appreciate the more diverse mentorship and exposure to more opportunities of a larger program.
While most pediatric residency programs are attached to a standalone children’s hospital, some are incorporated into a larger general hospital. Norton says more important than the type of program is making sure residents have access to a large volume of patients in order to see the full “breadth of pediatric diagnoses.”
Whichever size or type of residency they choose, residents can expect a challenging experience. They will spend their three years rotating on a schedule of roughly four to six weeks throughout different areas of the hospital. When on outpatient, residents can expect a standard workday schedule. But when they are on inpatient and caring for children admitted to the hospital, residents typically work 60 to 80 hours a week, including weekends, with a mix of 24-hour on-call services and night shifts.
Pediatric residents are also exposed to a wide variety of subspecialties, ranging from neurology to more niche specialties like child abuse pediatrics and adolescent medicine. Many of these specialties are still relatively young in the medical field, and there are lots of opportunities for pediatricians to continue to grow and deepen scientific understanding in these areas. Specialty training can take anywhere from one to four years to complete.
What Salary Does a Pediatrician Earn?
Becoming a generalist or a specialist is a personal decision, but one consideration is pay. According to the U.S. Bureau of Labor Statistics, the median annual wage for a general pediatrician was $203,240 in 2022. Like in all medicine, specialists tend to earn more (pediatric cardiologists, for example, earn an average salary of $299,282, according to Salary.com) but it takes longer to become one.
[READ: Are You Ready to Pay for Medical School?]
“At the end of the day, the decision is about what brings you the most satisfaction,” says Nicole Shilkofski, the vice chair of education and residency director in the Department of Pediatrics at Johns Hopkins Children’s Center. Doctors who want to see their patients from birth to adulthood often gravitate to primary care and general pediatrics.
“You see that child for every visit and get to know the family,” Shilkofski says. She’s known pediatricians who have written medical school letters of recommendations for and even attended weddings of former patients. “It’s for the type of person that loves that continuity of relationships.”
But for those interested in honing a particular area of expertise, or in teaching or conducting research, specializing might be the way to go. Although Shilkofski spends part of her time caring for patients in the intensive care unit, the majority of her time is spent teaching. “That’s a huge part of my identity,” Shilkofski says. “Although I liked continuity, it was more important that I felt like I was influencing the next generation of pediatricians.”
What Makes a Good Pediatrician?
While there are a number of skills and attributes that make for a good doctor, there are also specific characteristics that make for a good pediatrician.
Teamwork and communications skills are essential, as pediatricians must not only communicate complex topics in developmentally appropriate ways for their young patients, but they also must work closely with the family unit as well as other health care providers.
“We look for that when we’re interviewing folks,” Shilkofski says. “Not just what predicts a good bedside manner, but communications skills that will make them great communicators with families and children.”
Taking care of sick children is emotionally challenging, so it’s important that aspiring pediatricians actually spend time in a children’s hospital and discover whether being around children in that way brings them joy vs. stress or sadness. College and even high school students can find opportunities to visit for a day, take on longer volunteer opportunities and even shadow a pediatrician. Many academic hospitals also offer summer research projects for students.
“It doesn’t have to be anything crazy, but get the feel of being in a children’s hospital,” Norton says. “There are sad and difficult parts, but the resilience and joy that kids bring even when they are sick is what sustains me and brings me joy in my work even when it’s difficult.”
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How to Become A Pediatrician originally appeared on usnews.com
