Paediatric Super Specialities or Subspecialities Available in India

There are two exams conducted in India. One exam, which is held once a year- NEET super specialty is held once a year. After securing a rank in this, one can go for DM or DNB across various medical colleges in India. Two exams, which are held twice a year- To pursue the DM from central institutes like AIIMs, One has to appear for INI-SS, held twice a year.

Specialities Available In India Via NEET-SS

• DM: Neonatology ·
• DM: Pediatric Gastroenterology 
• DM: Pediatric Hepatology ·
• DM: Pediatric Nephrology 
• DM: Pediatric Neurology 
• DM: Pediatric Cardiology 
• DM: Pediatric Oncology 
• DM: Pediatric Critical Care 
• DrNB: Neonatology 
• DrNB: Pediatric Neurology 
• DrNB: Pediatric Critical Care

Overlapping Specialities Available Via NEET-SS In India

The following three specialties are available under this category for which MD pediatric and MD medicine people can apply.

• Medical genetics
• Clinical immunology
• Clinical rheumatology 

Specialities Available In India Via INI-SS

• DM: Neonatology 
• DM: Pediatric Nephrology 
• DM: Pediatric Neurology 
• DM: Pediatric Cardiology 
• DM: Pediatric Oncology 
• DM: Pediatric Critical care

Certain specialties are common across NEET-SS and INI-SS like

• DM-Neonatology
• DM-Pediatric Nephrology
• DM-Pediatric Neurology
• DM-Pediatric Cardiology
• DM-Pediatric Oncology
• DM-Pediatric Critical care

Specialties that exclusively come under INI-SS are-

• DM-Pediatric pulmonology and intensive care: It is available only at AIIMS, Delhi. It’s a single degree.
• DM-Pediatric Gastroenterology and Hepatology: These are not separate, but a combined degree is available only at PGI, Chandigarh. It is one of the sought-after degrees.
• DM-Pediatric Clinical Immunology and Rheumatology.
• DM-Pediatric Hematology and Oncology: It is available only at PGI Chandigarh.
• DM-Pediatric Pulmonology: It is available only at PGI Chandigarh.
• DM-Pediatric Endocrinology: It is available at AIIMS, Delhi, as well as PGI Chandigarh.

There are a few Institute specific specialties, which can be either year-specific or session-specific.

Also Read: Super Speciality in Medicine : Merits, Demerits, Scope, Career Outside India

Is DM After MD/DNB In Pediatrics Is Recommended?

• The answer to this question can be opinionated. Doing it or not is a highly personal and controversial decision.Here personal means the decision should be made considering pros and cons and based on where one stands and whether one wants to do it. Here controversial means if anyone asks why it has been done, the person should be clear with the thoughts and able to answer them.

Under The Circumstances Below, One Should/can Do MD/DNB In Pediatrics

• Suppose a person has passion or interest in a particular specialty. The person should pursue DM/DNB in pediatrics to be a subject expert in a focused area. The pediatric field is vast and expanding daily, and one cannot be a highly expert in all those areas only with a general physician degree. For example, while prescribing biologicals, a pediatric rheumatologist is better suited for it than a general physician as the general physicians have comparatively less exposure to the use of the biologicals.
• If a person wants to settle in a metro town because rapidly,with only an MD or DNB degree, settling in cities like Delhi, Mumbai, Chennai, Bangalore, Hyderabad, etc., is slightly tough. Though one will not get placed through a campus interview with a particular specialty, there will be less competition to get placed in a corporate hospital for a specific super specialty post. Having expertise in a particular subject, one gets confidence about treating patients in a particular area. One can settle faster in a bigger town.
• Suppose a person wants to have an institutional practice or work in a corporate setup. Here, a backup person will be available to take care of the patients, whereas in private practice, one can loose the patients in case of going on a holiday for a few days.
• If a person wants to join as a central institute faculty with relative ease: It’s not easy to become a faculty in a government or private medical college as very few seats are released yearly, and many postgraduates come out yearly. In central institutes, simple MDs or DNBs are not eligible for a seat in a particular specialty.
• If a person wants to have one more degree, which matters: Having multiple degrees makes a difference, especially in private practice. If the market gets saturated in the future, it will help the person to survive.

Under The Circumstances Below, DM Is Not Mandatory

• If a person is only keeping in mind the financial benefits: always remember that it’s not true that having a DM degree will help a person to earn more. The following things matter when it comes to monetary benefits area: Location, Patient behaviour and availability, Clinical skills, Luck. Not only academics but also patient management, interpersonal, and communication skills are vital to monetary success.
• If a person is unclear and wants to do it just because everyone is saying: Do not fall for herd mentality. You are mature enough to decide what suits you, so do not pursue it just because everyone else is going for it.
• If a person wants to have a long line of OPD patients in private practice within 5 years: Though there are exceptions, doing DM in a specific subject has its cons. The field one is working in gets narrowed down. For example, working longer in private practice for an MD, DNB, or DCH sitting in a smaller town usually has a larger patient base than a specialist in bigger towns. In private practice, it’s not the degree but the number of years one practices at a place that decides the patient volume.
• If a person already has a small setup or resources available, doing DM is not so essential. If a person is confident enough with MD or DNB degree, the person is tired of giving exams, and if a person has done an SR ship from a good place and handled a variety of patients, then one can opt for not pursuing DM.

Trending Subspecialties In DM

• Trending subspecialties change every year, and they are based on general perceptions in the medical as well as the pediatric community. Here are a few trending specialties as per the experts:

1. Neonatology
   • It’s one of the oldest and ever-trending subspecialties in pediatrics. Maximum seats are available under this specialty. But there is a drawback. In some metro cities, there is a saturation in this field, and hence it will take an almost similar time to set up a practice or join a prominent institute in this specialty as that of a non-DM person.
2. Pediatric gastro
   • It’s a procedure-based branch. Remember that a procedure-based branch is always rewarding in terms of financial remuneration compared to a non-procedure branch. For an MD or DNB person, OPD fees per person lie below Rs 1000, whereas for a DM, the fees can range between Rs 1500 to 2500 per patient, but here the patient base also will be smaller.
   • For DM, the remuneration part becomes larger when it's an admission-based or procedure-based branch. Pediatric gastro has slightly better financial returns in the case of owned setup or a partnership-based setup.
3. Pediatric Neurology
   • It is also called the thinking branch. It’s a slightly difficult branch, but at the same time, it’s a thrill to reach a diagnosis and start any treatment with the help of a skill set before receiving the EEG results. It has a widening scope as more and more behavioural disorders are coming into the fold.
4. Pediatric Endocrinology
   • It’s an elite branch as it has been introduced recently, and very few DM pediatric endocrinologists are present, even in larger towns. It’s a rare branch. It has very little saturation and can have a relatively fast  thriving practice. The number of emergencies or late-night duties will be rare in this branch. And as India is the diabetic capital, there is an explosion of cases. Though it’s a sad fact, as per WHO UNICEF projections, the number of diabetic pediatric patients will increase disproportionately compared to the population growth over the next few decades. And it will provide a good patient base in the future.
5. Pediatric critical care
   • It has a good scope in bigger towns. One practicing under this specialty is a boon for the kids by taking last-minute critical decisions and saving their lives.  It has good corporate hospital prospects. Pediatric ICUs are the need of the future, and many corporate hospitals are investing in building these setups so it has a good futuristic scope. Here, there will be comparatively less interaction with the patients/parents. Having one’s critical care set up is very difficult, so private practice is difficult and almost non-existent.

Also Read: Super Speciality in Cardiology - Merits, Demerits & Career Scope