Why Do Doctors Choose Pediatric Rheumatology?

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I spent the summer between my first and second years of medical school rotating in medical weight-management clinics, boastful that I would someday be an adult gastroenterologist. I first met Melissa Mannion, MD, in the pediatric clinic; at the time, she was a second-year pediatric resident and always wore cool pants. Born a chatterbox, I asked her about her life plans, and without hesitation, she told me she wanted to be a pediatric rheumatologist.

Full disclosure: I immediately thought she was weird. I knew very little about the specialty and assumed it was a rather bland career path. I couldn’t process how someone as intelligent as Dr. Mannion could get excited about such a dull career choice.

Over the next two years, I migrated toward pediatrics with an interest in oncology or allergy. My advisor suggested I schedule a one-month rotation in pediatric rheumatology. I took her advice, but only because it was one of the few pediatric rotations available, and I remembered Dr. Mannion, the then-fellow who always wore cool pants.

That rotation was without a doubt the most memorable month of medical school. Seeing the passion the department had for rheumatology was, perhaps, the main reason I fell in love with the field. Randy Cron, MD, PhD, and the rest of the University of Alabama at Birmingham crew taught me to treat aggressively, an approach that has earned worldwide attention from fellow rheumatologists. They taught me to trust my exam skills and educated me on the clinical usefulness of ancillary testing. By the end of the month, I was confident in my ability to diagnose and work up a child with arthritis. I even felt bold enough as a medical student to recommend treatment, albeit not always the correct one. And yes, I once arrogantly argued with Dr. Cron about escalation of therapy. He might deny it, but I’m pretty sure I won.

My confidence persisted, and my love for the specialty blossomed during residency. I trained in New Orleans, a city unable to keep up with the growing demands of pediatric rheumatology. In those three years, I remained up to date on the literature and sought out potential rheumatology patients, eager to maximize my exposure.

Why Pediatric Rheumatology

My enthusiasm and knowledge were obvious, and many people inevitably asked the “why” question. Everyone asks me why and how I chose this subspecialty; I struggle to understand why everyone else has not.