1. Interview # 1
2. Interview # 2
3. Interview # 3
4. Interview # 4
5. Interview # 5
6. Interview # 6
7. Disclaimer

• Read Questions & Answers in Another Column
• Read Other Student Interviews.

Dear Readers:
Dr. Warren hopes to help all who ask his advice and to enlighten all who read Ask Dr. Warren. For your own well being please keep in mind that advice you read here may not apply exactly to your own situation, and that if you are sick, no information on the web can take the place of a hands on examination by your physican who knows you and cares about you.

1) How long have you been working as a pediatrician?
2) Describe an typical day at work.
3) What are some of the advantages & disadvantages of being a pediatrician?
4) What type of science background is needed for your career?
5) What chemistry courses did you have to take before becoming a pediatrician? Is chemistry needed at all, why or why not?
6) What made YOU decide to become a pediatrician?
7) What is the salary range for a pediatrician?
8) Do you have a funny or interesting incident that you can share?
9) What kind of future does this job hold for new people entering the field?
10) Would you recommend being a pediatrician to prospective high school students?
11) Are there any job hazards? If so, what are they?
12) Do you mainly work by yourself or with others?
13) Do you feel that there are any particular life skills that are necessary for a person to have in order to be a pediatrician?
14) Do you know of any particular specialty colleges that you would recommend to high school students to attend that would benefit their being hired

1) Is there any funny or interesting events that happened to you on the job?

 2) Are there job hazards?

 3) What future does the job hold for new people wanting to enter this field?

 4) Would you recommend this job to a prospective colleg/high school student? Why or why not?

 5) You mentioned that basic chemistry and organic chemistry are needed...can you tell me why?

1. There are always funny or cute things happening when you're dealing with kids...

Like the kid who wiped his nose with his sleeve and then looked down at it and whined, "I've got boogies on my sleeve!"
Or the 6 year old who talked incessantly during his examination. During the genital exam he said, "By the way, I was wondering what those two little balls are for?"
How about the child who was upset after being given a shot and walked out of the office crying, "He's an ugly man!"-- referring to me.

Unusual diagnoses are always a challenge which make the job interesting.
2. There is always a risk of catching something when dealing with sick kids. Needle sticks are also a hazard.
3. There will always be jobs for doctors including pediatricians, but as the means of paying for health care and delivering health care evolve, I wouldn't make any predictions about income or working conditions, although I think it's safe to say physicians in all specialties will earn a reasonable living even if they won't get rich.
4. I've talked about the advantages (prestige, personal satisfaction, cute kids) and disadvantages (long hours, night call, working holidays and weekends, stress) of being a pediatrician in previous posts. I'd recommend being a pediatrician to anyone who loves kids and gets satisfaction from helping and caring for people. Without those motivations I'd say there are probably better ways to earn a living.
5. When you're actually practicing pediatrics, you really don't need chemistry, but in order to understand molecular biology and pharmacology, you do need to understand the chemistry on which it is based. Physicians are more than technicians who learn the basic skills of medicine. Their broad base of knowledge makes them capable of innovating and understanding advances in medicine. After graduation from medical school on can go in many directions which can include both patient care and research. Knowledge with understanding is power.

Dear Dr. Warren: It's Van and Tina...(we e-mailed you some questions and then we found some of the answers to our question on your website... remember?)... Anyways.... we just wanted to THANK YOU SO MUCH and tell you HOW COOL YOU ARE for answering all those questions for those high school kids like us who are in desperate need of answers for a project. We've tried so many physicians but none of them would take the time to answer our question. Even though you are busy and have a hectic schedual and more important things to accomplish, you take time to answer the questions. I feel that this is a very rare thing to come across someone who is so passionate about what you are doing. When I become a pediatrician I will let the world know that Warren Silberstien was my inspiration. Thanks again.=)

• How much schooling did you have to go through inorder to become a Pediatrician (including internship)?
• What schools did you attend?
• Did you have a very interesting background of pediatrics, or was the road to becoming a pediatrician kind of boring?
• Do you work in a major hospital or a private practice?
• Do you like working there?
• What hours do you work?
• Are you often affected by the results of a child's diagnosis?
• What ages do you see children up to?
• What kind of vacation plan do you have?
• What kind of clothing do you have to wear?
• What type of equipment is used?
• What are the general starting salaries for a pediatrician?
• What type of bonuses are offered to a Pediatrician?
• After the very long educational and self-rewarding road, would you recommend this career to other students (please state some pros and cons)?

I went to college for 4 years, medical school for 4 years, and residency (including internship) for 3 years.
I went to RPI for my undergraduate degree and SUNY Downstate for medical school. I did my residency at Montefiore Hospital, Bronx, NY.
I loved my college years. Medical school is a bit of a chore, but the subject matter is interesting. I had friends I studied with, and I was married by the time I started my second year.
I work in a private office. Once a week I also work in a clinic.
The people I work with are like a second family to me, so I do love working there, but work is called work for a reason, and I'm glad when I can get some time off.
I work from 8:30 AM to 9 or 9:30 PM Mondays and Tuesdays. Wednesday I work from 8:30 AM to 5 PM. Thursdays 12:30 PM to 6:30 PM, Fridays 8 AM to 12 noon. I work every other weekend, Saturdays 8:30 AM to 5 PM, Sundays 10 AM to 12 noon. Plus I am on call during the hours the office is closed on Monday and Tuesday and Friday through Sunday on my weekends on call.
Most of the diagnoses I make are routine colds, gastroenteritis, asthma, injuries, headaches, abdominal pain, etc. These are things I take care of regularly and I can generally help my patient, so it doesn't have a profound affect on me. It is rare for a pediatric patient to have a serious or terminal disease. All of us in the office are deeply affected and involved when one of our patients is seriously ill.
I see children until they decide to go to a "real" doctor. Usually that means through college. Many insurance companies only permit patients to see a pediatrician until 19 or 21 years of age. My practice is happy to see patients into their 20s.
My office doesn't have a specific vacation plan. If I take time off, my partner has to work alone and cover my hours. If he takes time off, I have to do the same. We usually take about 3-4 weeks off per year. Since I'm my own boss, I can take time when I need to, but I have to clear it with my partner, and it's best to plan it far enough in advance so that I don't have to cancel any patient appointments.
I wear wash and wear shirts and pants and a tie. No special uniform and nothing fancy.
We use stethoscopes, flashlights, sphygmomanometers (blood pressure machines), thermometers, otoscopes (for looking in ears), and ophthalmoscopes (for looking in eyes). We also use syringes, needles, and instruments for suturing. Is an exam table considered equipment?
I don't know about salaries for pediatricians.
There are no bonuses in private practice. I couldn't tell you if there are bonuses any place else.
I've talked about the advantages (prestige, personal satisfaction, cute kids) and disadvantages (long hours, night call, working holidays and weekends, stress) of being a pediatrician in previous posts. I'd recommend being a pediatrician to anyone who loves kids and gets satisfaction from helping and caring for people. Without those motivations I'd say there are probably better ways to earn a living.

1) Why do you choose to become a pediatrician?
2) Can you tell which medicine can suit which children? How?
3) What new technology do you have?
4) Do you attend any emergency cases at night?
5) Give two reasons why you dislike being a pediatrician?
6) Give two reasons why you like being a pediatrician?
7) What major responsibility does a pediatrician have?
8) What is the annual income of a pediatrician?
9) What is very important for a pediatrician to remember?
10) When does a responsibility of a pediatrician increase?
11) Do U provide any entertainment programs to the children in hospital?
12) What are the common sickness among the children?
13) How should U react with the kids?
14) What are the minimum passing marks required when you give an entry test at university?
15) How many years does it take to become a pediatrician?
16) What courses do we have to take to become a pediatrician?

1. I chose to be a pediatrician because I like children and I like helping people.
2. Your question is unclear. Most children should not be on any medication. Medications are prescribed only to treat specific conditions. The choice of medication depends on what the doctor is treating and how the patient is responding to treatment.
3. There are new technologies being developed in medicine all the time, but there are no special new technologies in my office except for Dermabond, a glue for closing lacerations.
4. I do have to see patients for emergencies during the night.
5,6,7,8 Please see previous interviews.
9. It is important for any physician to remember as much medical knowledge as he can. It is equally important to remember that patients come to us for our help. We have a responsibility to provide the best care to the patient no matter what the circumstance of the visit are.
10. This is a weird question. Pediatricians and all physicians have an awesome responsibility. I've discussed specifics of those responsibilities in previous interviews. There is not some point at which a pediatrician's responsibility increases. From the moment he sees a patient he becomes responsible for doing whatever is necessary to provide the patient the best care possible.
11. I do not provide entertainment for my patients. I do fool around with them.
12. The most common childhood illnesses are URIs, gastroenteritis, fevers, asthma, earaches, belly aches, and injuries.
13. One should be gentle with children.
14. I wouldn't know the minimum passing marks required for entry into university, but competition to get into medical school in the USA is fierce and only the best students get in.
15, 16. I've answered these before. Take the time to look it up. My web site has specific instructions for students wishing to send Dr. Warren questions. If you'd like to go to medical school, some day, or go to university for anything else for that matter, now's as good a time as any to learn to follow instructions.

 Thank you for your time and God Bless.

 Health care is a necessity. As long as there are children there will be a need for pediatricians. There are certainly areas of the US where there is a shortage of pediatricians and other areas where there is an abundance. Overall, I doubt the field is either growing or declining. Some years the birth rate may be down and some years more medical school graduates may choose pediatrics creating a glut of pediatricians, but the thing that is most likely to influence the future of the health care industry (and therefore pediatrics) is the way health care is paid for. Routine health care as well as routine childhood illnesses are handled by Nurse Practitioners and Physician Assistants in doctor shortage areas. For the most part, patients want to see physicians for their health care, but should reimbursement for routine care change to only allow physician visits for complicated care and require Nurse Practitioners or Physician Assistants to be the first stop, that would shift the pediatrician's role from primary care to specialist. I don't think that will happen because the insurance industry must also answer to market forces, but then, I don't think most people prefer the HMO model for health care, yet it has become the predominant type of insurance because it is more affordable.

1) Do you find yourself sick more often than other people since you are a pediatrician? If so, do you think this is harmful to your long-term health? About what percentage of the year do you find yourself sick?

 2) Approximately how many hours per day do you find yourself doing the following things?

____Seeing children with a cold or flu (in office)
____Completing routine physicals and immunizations (nothing is wrong with the children) (in office)
____Seeing children for nutrition, orthopedic injuries, sleep problems, behavhior, diabetes etc. (in office)
____Total hours spent with patients in office
____Hours spent in hospital
____Hours spent calling pharmacies
____Hours spent doing paperwork
____Anything else you spend a lot of time doing

3) Do routine physicals ever seem repetative and boring?

 4) Do you feel that your stress, irregular sleeping patterns, and exposure to disease due to being a pediatrician have a negative impact on your overall and lifelong health? If so, which of these factors pose the greatest problem?

 I have never kept track of how I spend my time and as a result always hate answering survey questions of this sort. At best, I'm giving you an educated guess on how I spend my time. My average office day is 6 to 10 hours with the bulk of it spent with patients. There is, of course, a lot of paperwork during patient encounters since I must write a note for each visit and record all immunization information. Patients who require referrals add another bit of paperwork. The bulk of my paperwork is done outside of office hours and accounts for another 2-4 hours per week.

 I guess about 50% of my patient visits are for well care and the other 50% for illness. The exact division of those illnesses.... Maybe 35% URIs including Ear Infections and Sore Throats, 15% Gastroenteritis, 25% Fever, 10% Asthma, 5% Injuries, 5% Pain, the remainder everything else. Most counseling questions including nutrition, feeding, and behavioral issues are considered at checkups. Parents rarely come in just for behavioral problems. They do call for advice, however. My office has telephone time for ½ hour every morning.

 I spend very little time in the hospital, but that can vary widely. Most of my hospital visits are newborns with an average of about 1 hour each week not counting the trip to and from the hospital. On the other hand, on the rare occasion when I admit a sick child to the hospital, I could spend 1 to 2 hours each day in the hospital until the patient is discharged.

 Many illness visits require a prescription. Telephone calls to the pharmacy can take 1 to 5 minutes. The amount of time I spend on hold has increased since many of the local pharmacies have disappeared and the large chains have taken over. If you must have an hourly figure consider an average of 4 patients per hour, 2 of whom are ill = average 7 minutes on the phone X an average 8 hour day = 56 minutes. I could see 4 more patients a day if I could speed up the prescription process. Of course, we don't end the day until all patients are seen, so it's a moot point.

 Routine physicals are never boring. In fact nothing in pediatrics is boring. It is true that dealing with the same things day in and day out can make one stagnate. It is important to keep reading so that you're prepared to deal with the rare occasions when you see something out of the ordinary. The long hours and constant stress can sometimes lead to a feeling of burnout, so it's important to have a personal life to look forward to which is separate from your professional life, and someone to share the call schedule with so you can have time off. But boredom is not a problem. No matter how routine the process of doing an examination is, each examination involves an interaction between doctor and child and doctor and parent. Each human interaction is guaranteed to be unique.

 I don't feel that exposure to disease has had a negative impact on my health. As I said, I rarely get ill. I would have to consider the risks to be greater if a significant portion of my patients were HIV positive or had tuberculosis, but I do exercise appropriate precautions to protect myself and my patients.

There are some aspects to my job which probably do have a negative impact on my health, but they are not unique to pediatrics or even medicine. Even though I spend a lot of time on my feet, my job is basically sedentary. Since the hours are long and leave me fatigued, I don't make a point of getting adequate exercise. Since I am not an athlete, even my leisure time does not give me exercise. Combine that with the stress of the job, and it's probably not great for my cardiovascular health.

 Irregular sleep hours take their toll. After a rough night I may be significantly exhausted the next day but still have to work. Fortunately, I rarely have trouble falling right back to sleep after the middle of the night phone calls, so I really only lose sleep when a patient is sick enough for me to have to see the patient in the middle of the night.

 I'm not sure how to quantify the stress factor in my job. Being a physician is an awesome responsibility. There are times I worry about my abilities, about my decisions, about my sick patients, etc. But stress is not unique to being a pediatrician, and most studies suggest that stress is higher for people in jobs where they have no control over what's going on around them.

You might also contact some of the physicians in your community to see if they have any job openings or know of any programs. Since you're interested in pediatrics, your own pediatrician might be an excellent person to point you toward programs in your community.

If your questions haven't been answered here, perhaps you would like to
ask Dr. Warren a  question?!?