Combined Medicine and Pediatrics Overview, Deciding, Applying *

Outline General Overview History Facts Med/Peds vs Family Medicine Overview of applicants The numbers Why students chose Med/Peds Resources *

General Overview Internal Medicine is a three year residency, completion of which allows one to sit for the Internal Medicine board exam Pediatrics is a three year residency, completion of which allows one to sit for the Pediatrics board exam Med/Peds is a four year residency and completion allows one to sit for both the Internal Medicine and Pediatric board exam. There is no Med/Peds board exam. *

History I 1949 Two year rotating internship at University of Rochester 1960’s One year combined internship at North Carolina Memorial Hospital 1967 Boards approve combined training 1977 North Carolina formalizes training 1982 University of Rochester formalizes training http://www.medpeds.org/medpeds/powerpoint.asp *

History II 1989 First formal training guidelines 1991 Program Director’s Association formed Med- Peds section of AAP created 1997 National Med-Peds Residents’ Association is created 1997 Congress supports med-peds training pay AAP/AMA/ACP support dual listing 2006 Accreditation of med-peds programs Med-Peds program requirements http://www.medpeds.org/medpeds/powerpoint.asp *

Facts I More than half of the pediatric residency programs in the US also have Med-Peds programs. Med-Peds residents score identically to categorical residents on both the Internal Medicine and Pediatrics Boards. Med-Peds residency programs match a higher percentage of US medical students than Internal Medicine, Pediatrics, or Family Practice. Med-Peds has been in existence for 40+ years -- it's as old as Family Practice. http://www.medpeds.org/ *

Facts II Studies show that Med-Peds physicians do continue to practice primary care for both adults and kids. A higher percentage of Med-Peds residents go on to practice primary care than Internal Medicine or Pediatrics residents. More than half of all Med-Peds physicians have some type of academic appointment. Those medical students interested primarily in Med- Peds list Internal Medicine as their most common second choice, followed by Pediatrics and then Family Practice. http://www.medpeds.org/ *

Facts III Currently over 6000 practitioners nation wide with over 1300 current residents We have the largest number of possible fellowships of any specialty *

Med/Peds vs Family Medicine Med/Peds residents generally are interested in primary care but end up having more pediatric training, without obstetric and surgical training. Med/Peds also allows further training in any of the Medicine or Pediatric subspecialties. Versus their Family Medicine counterparts, they generally end up working more as hospitalists. *

Typical Attributes of Med/Peds Residents Enjoy Internal Medicine but can’t seem to get away from Pediatrics Want to do primary care but do not want OB Want to take care of adults with historically pediatric pathologies (sickle cell, CF, congenital heart disease) Want to eventually work in global health or hospitalist medicine Can’t decide *

Why do medical students chose Med/Peds? *

What do applicants consider if not Med/Peds? *

The Numbers I 2011 Data http://www.nrmp.org/data/index.html *

The Numbers II 2011 Data http://www.nrmp.org/data/index.html *

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Typical Curriculum These are months required by ACGME, each program will have a different way to get it done. Due to the shortened 4 years vs. 6 there will be less time of electives and research. *

Med/Peds Residents Low attrition rate of 9% Similar rates of board exam passage as their Internal Medicine or Pediatric colleagues 18-25% of residents go on to fellowship *

What do to before applying Do well first and second year Get the best score you can on Step I Do well in pediatrics and internal medicine clerkship (should get honors) Do a Med/Peds elective Get your LOR in order (chairs of medicine and pediatrics) Get your application in order (100% done) by the first day it is available *

Resources www.medpeds.org http://www.nrmp.org/data/index.html http://www2.aap.org/sections/med-peds/ www.acgme.org http://www.nrmp.org/ *