Pediatric rheumatology is for doctors who are good at teamwork, problem-solving and becoming experts in nebulous problems. Dr. Jay Mehta joins me to explain. Jay is actually the fellowship director at Children's Hospital of Philadelphia (CHOP) for pediatric rheumatology and out of training now for 10 years.
Jay actually didn't know about this specialty until he rotated during residency. This is exactly the goal of this podcast is to expose you to specialties out there that you may or may not know about. So listen every week and take some notes. Figure out what you want to be
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Jay remembers liking every rotation he was on but he just kept coming back to pediatrics. He loves the people he gets to work with both patients and the other residents and faculty.
He went through a small medical school and they didn't have real exposure to pediatric rheumatology. The only exposure he had was at an adult room when he took an elective in medical school. He initially thought it was interesting but didn't have any sense that kids actually got rheumatic diseases.
When Jay started his residency, he wanted to do pediatric hematology-oncology because he loved the elective for this subspecialty that he also did back in medical school. Particularly, he loved the diagnostic aspect of it.
So he assumed he would like Pediatric Oncology because the diseases are interesting, the kids are sick, and you get to create great relationships with families. He thought it was something he would enjoy.
Then after doing an oncology rotation on his second year of residency, he realized he didn't love the practice of oncology for various reasons.
A lot of the biopsies were made through biopsies or imaging. The oncologists themselves weren't making the diagnosis and the treatments were protocolized. This is great since the mortality from childhood cancers dropped incredibly since treatments have become protocolized.
As an oncologist, you're not making a lot of decisions about treatments. So he decided this wasn't what he wanted to do.
Meanwhile, Jay had a couple of interesting patients who were kids with autoimmune disease. He loved the problem-solving aspect of rheumatology. This was also when the biologic era was starting in the mid-2000s when biologics were coming into the scene.
[Related episode: Discussing Pediatric Oncology with an Academic Doc]
Collegiality is one of the biggest things. Just by the very nature of autoimmune diseases, all organs can be affected. So they end up working with every specialist in the hospital.
You must want to think about your patients. There are a lot of things they see in a day that they're able to put a name on in terms of the specific diagnosis.
So you have to reach back to your knowledge of immunology to think about what might be going on in the disease. Then you use that to try and come up with targeted treatments.
You must love to form relationships with families. Jay has been seeing patients for years and watching them grow up. So you have to be that kind of person that wants to have a long-term relationship with families. You need to work with them through a lot of things that
