I'm a pediatrician. On the way there, I got a BA in English Literature. After
getting good enough grades and a high score on the admissions test, I got
into med school. In med school, after 2 years of about the equivalent of 35
college credits a semester, I took a board exam to get from my 2nd year to my
third. I spent another 2 years (not sleeping) on the wards and then took
another board exam to graduate. I then had completed everything that I
needed to earn my MD. With that MD I was qualified to do nothing. After my
first year of residency, I took another board exam to graduate from my
internship. Passing those 3 board exams, having an MD and completing my first
year of residency I was then OK'd to apply for my license in the state of WI,
which required another test. Passing that did not allow me to write
prescriptions. I was required to apply then to the Drug Enforcement Agency
for a number to write for certain classes of medications. By the time I could
write meds legally, I was about $75K in debt. I finished my residency, did a
year as Chief Resident, did a year of a neonatology fellowship and ran out of
money. I joined a practice which required proof of med school attendance,
reference letters, background checks and "encouraged board certification."
Pediatric board certification is another exam which you can only take after
successfully finishing a residency and needs to be renewed every 7 years.
Only after passing that board exam then can I be a fellow of the AAP. In
order to re-sit for my boards, I have to do a quality improvement project
involving chart review, proof of education (through AAP approved courses) a
test of knowlege (another test) through the American Board of Pediatrics and
a demonstration of decision making skills. I also need to keep up with the
continuing education needed to maintain my state license. And I'm only
licensed in *one* state. Every step of licensure and certification comes with
a fee that needs to be paid.
Before we continue to discuss "ignorant" doctors I thought it may be helpful to
realize that we are far from it. The first day of med school, my dean told us
two things that have stuck with me: you will never be able to catch up with
all the reading you need to do, and 50% of what we are teaching you is
wrong, we just don't know which 50%.
I hear alot in these posts about right and wrong things to do, but what is right
and wrong in healthcare is changing every day, even in breastfeeding. Not all
docs know as much as I do about breastfeeding (and I certianly don't know as
much as others) but I do *not* know a pediatrician who went into the field to
do anything but help children. How they do that may be different than what
you see is acceptable, and may be driven by out of date info, but it is not
maliciously driven. We are not trying to do anything but what we think is best-
- if you disagree, help us learn.
I need you all to understand that my job is more than just breastfeeding and a
lack of knowledge in this area does not deserve "ignorant" nor should there be
an suggestion that a doc is intentionally trying to hurt a child-- if that is the
case, then act. Have them sanctioned, report them. We are accountable to
lots and lots of regulating agencies... most importantly, the children we care
for.
I chose to become an IBCLC, mostly because I wanted to prove that I am
credible to you guys, the population of professionals that I work with that are
hardest on physicians.
Jenny Thomas
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