order to help students interested in Med-Peds obtain as much information as
possible, the National Med-Peds Residents' Association has teamed up with the Med-Peds
Program Directors Association (MPPDA).
We have compiled answers to questions frequently asked by medical school
students considering Med-Peds. All the answers were written by Med-Peds
Program Directors through the MPPDA. Click on the links
below to see how Med-Peds Program Directors answer the following questions.
What can I do when I finish my training in a Med-Peds residency?
What kind of outpatient practices do Med-Peds physicians enter?
How are combined Med-Peds programs regulated?
How does Med-Peds training differ from Family Medicine training and how do I decide whether Med-Peds or
Family Medicine is right for me?
Aren't Med-Peds Programs more difficult?
Will I be able to pass both boards when I graduate?
Don't most Med-Peds graduates choose one field or the other after they graduate?
Is it possible to keep up with both fields of internal medicine and pediatrics after I graduate?
How many Med-Peds programs are there?
Aren't Med-Peds programs extremely competitive?
Should I rank "back-up" categorical programs?
How do I judge the relative strengths of Med-Peds programs?
Is it important for Med-Peds programs to have combined Med-Peds community clinics?
Is it important for a Med-Peds program to have a Med-Peds trained director?
Should the program I choose have many Med-Peds trained faculty?
Are there geographic differences in Med-Peds programs?
What combined Med-Peds fellowships are available and what advantages are there to combined Med-Peds fellowships?
Additional information about many commonly asked questions can be found in the
Introduction to Med-Peds pamphlet, as well as the
Medical Students Guide to Combined Internal Medicine and Pediatrics Residency
Trainingand the Med-Peds Fellowship Guide.
After reviewing this information if you have additional questions, please e-mail your question to firstname.lastname@example.org.
- What can I
do when I finish my training in a Med-Peds residency?
A Med-Peds residency
is one of the most versatile residencies available. After 4 years of
residency training, med-peds graduates have a wide host of opportunities
available to them including private practice, academics and teaching,
hospital practice (hospitalist), research, public health, global health
(international practice), transitional care (survivors of childhood cancer or
congenital heart disease as examples) and combinations of the above.† Approximately 75% - 80% of our graduates
choose opportunities in this category. This percentage is higher than those
that graduate from internal medicine or pediatrics programs.
can pursue further training (called fellowship) in subspecialties in internal
medicine, pediatrics or both. Because of our dual training, there are over 20
fellowship types and combinations that are available to med-peds physicians.
Examples of fellowships are cardiology, infectious diseases and
allergy/immunology. †Approximately 20%
- 25% of our graduates choose opportunities in this category.
- What kind of outpatient practices do Med-Peds physicians enter?
practice in a variety of environments. In most areas of the country, med-peds
primary care physicians are considered extremely valuable and they have many
job opportunities. About a third of med-peds primary care physicians work
with other dual-trained physicians; while the majority also works with
pediatricians, internists, and family physicians in multi-specialty group
settings. Many stay involved in teaching residents and/or medical students.
- How are
combined programs regulated? What Boards examinations do I need to take?
must be reviewed and accredited by the Accreditation Council for Graduate
Medical Education (ACGME) in a similar fashion as family medicine, internal
medicine and pediatrics programs. Programs that are accredited can recruit
new residents into their programs. The ACGME conducts a paper review and site
visits of all med-peds programs and evaluate each program with regard to its
curricula, outcomes and administrative support.†
your med-peds training successfully, you may take both board examinations
(certification) in internal medicine (American Board of Internal Medicine)
and pediatrics (American Board of Pediatrics). Maintenance of certification
(MOC) in both disciplines and boards is encouraged and desirable. A price
discount is applied towards the cost of maintenance of certification in both
boards. As well, certain parts of the examination in 1 board may be used
towards the other board.
- How does
Med-Peds training differ from Family Medicine training and how do I
decide between the two fields?
Much of the
difference between Med-Peds training and Family Medicine training depends on
your perspective and your personal career goals. The difference is best
appreciated by remembering that Med-Peds is a four-year curriculum that
focuses on two specialty areas. Family medicine however has a broader scope
and includes areas such as obstetrics and surgery in a three year program.
Both are excellent
career choices. Many med-peds graduates that are specialists or primary care
physicians work with or get†† referrals
from family medicine colleagues.
This table below illustrates some of the
requirement differences between the two training programs.
Percent ambulatory (minimum)
Number of required pediatrics
Number of required adult rotations
medicine, orthopedics, rehabilitation†
The amount of outpatient time and ambulatory
rotations in both med-peds and family medicine are comparable by virtue that
med-peds training is 12 months longer.†
Family medicine does require more ambulatory time in their continuity
practice and more instruction in psychiatry.
Med-Peds Programs more difficult?
training incorporates all of the important elements of two, three-year
training programs into one four year Med-Peds program, Med-Peds residencies
can be perceived to be more rigorous. However, only 9% of those that start a
med-peds program transfer out (which is less than internal medicine and
family medicine but equivalent to pediatrics). A great deal of the material
to be learned is shared between the two specialties and a good understanding
of an area in one specialty enhances the understanding of that area in the
other specialty. Residency programs often take advantage of this by offering
combined adult and pediatric electives rotations or conferences.†
Medical knowledge is
only one aspect of being an excellent physician. Being a successful med-peds
physician, requires excellent communication skills and an ability to adapt
quickly and transition well.
- Will I be
able to pass both boards when I graduate?
Review of data from
1997-2007 from both the American Board of Internal Medicine and American
Board of Pediatrics continue to show that the passing rate for graduates of
our med-peds programs is the same as categorical medicine and categorical
most graduates choose one field or the other after they graduate?
Most graduates that
are in primary care practice in both fields. Depending on the community
needs, ratio of physicians to patients and interest of the physicians, the
ratio of pediatric to adult patients might vary.
- Is it
possible to keep up with both fields of internal medicine and pediatrics
after I graduate?
Although it is more
challenging, it can be done. In fact, being familiar with the advances of one
area enhances your practice of the other area. Most of us feel that the extra
effort to keep up with two fields is well worth the trade-off for the ability
to care for patients of all ages, including families and patients with
complex medical problems.
- How many
Med-Peds programs are there?
Currently, there are
over 79 Med-Peds programs offering around 350 first year resident positions
each year - this makes up almost 7 percent of the medicine and 13 percent of
the pediatric categorical positions.
Med-Peds programs extremely competitive?
Med-Peds programs have
been more competitive than Internal Medicine programs as a group, and
generally comparable to Pediatric programs as a group. The competitive nature
will vary, however, from one program to the next and will also depend on the
record of the individual applicant.
- Should I
rank "back-up" categorical programs?
It all depends. If
you must be in a certain geographic location or hospital then ranking certain
categorical programs might be wise. Overall there are more med-peds positions
offered in the match than there are people that match into med-peds. If you
have a well rounded portfolio then getting a med-peds position should not be
too difficult. Most program directors want to see well rounded people who can
handle both age groups and who are good with transitions and communication
Please make sure
that your letters of recommendation do not confuse program directors. If you
do choose to apply and/or rank other programs, make sure your letter writers
understand this. We sometimes see letters of recommendations that clearly
state ďhe/she would be an excellent Obstetrics/gynecology residentĒ.
have a nice representation of allopathic physicians, osteopathic physicians
and international medical graduates.
- How do I
judge the relative strengths of Med-Peds programs?
There are no ratings
of med-peds programs. A med-peds program relies heavily upon both the
departments of Internal Medicine and Pediatrics to provide the resources for
successful training. Therefore, in evaluating the quality of a Med-Peds
program, one should carefully evaluate the two categorical programs.
Applicants should also look at the Med-Peds specific portions of the program
(curricula, combined meetings, faculty, and resources). Coordination,
communication and cooperation are essential components to a successful
program.† Each med-peds program has its
own personality and it is the fit of your personality with the programís that
makes the relationship and match work.
- Is it
important for Med-Peds programs to have combined Med-Peds continuity
advantages/disadvantages to a combined clinic and advantages/disadvantages to
attending Medicine and Pediatrics clinics on alternating weeks. The
Accreditation Council of Graduate Medical Education allows both types of
experiences and focuses programs to maintain a minimum amount of patients
seen in both age groups in either experience.
- Is it
important for a Med/Peds program to have a Med-Peds trained director?
currently have a combined director. There are, however, excellent programs
that are led by internists or pediatricians. In both cases, programs are
reviewed by the Accreditation Council of the Graduate Medical Education to
assure a minimum standard regardless of the type of training of the program
the program I choose have many Med-Peds trained faculty?
Regardless of how
many Med-Peds faculty a program has, a large part of your teaching will be
done by faculty from the categorical programs. Be sure to evaluate the
categorical faculty in both departments. The additional benefits of having
Med-Peds trained physicians on faculty or in the community are to help be
role models and mentors for you in practice and to provide career counseling.
- Are there
geographic differences in Med-Peds programs?
As you can see,
med-peds has many more programs and resident positions in certain parts of
the country. Graduates from our programs are located virtually in every
combined fellowships are available and what advantages are there to
have entered virtually every subspecialty (fellowship). Fellowship program
directors will often combine adult and pediatric fellowship programs for our
graduates where both adult and pediatrics fellowship programs are available
in the same academic center. Examples have included: infectious diseases,
allergy/immunology, critical care, cardiology, endocrinology, rheumatology,
pulmonology, nephrology, gastroenterology and more. Those that choose this
path will usually take 4 boards: General Pediatrics, General Medicine,
Subspecialty (adult), and Subspecialty (pediatric).
combined fellowships can fill unique niches and unique needs. A Med-Peds
nephrologist, for example, can provide pediatric nephrology care to a
community that might not have nor afford a full-time pediatric nephrologist
while also providing adult nephrology. A Med-Peds subspecialist may serve as
director of specialized centers serving adults and children such as bone
marrow transplant units, congenital heart disease clinics or cystic fibrosis
centers. More information about Fellowships for Med-Peds can be found in the
Med-Peds Fellowship Guide.