Careers after Med/Peds training

[weinbers]

Hey all,
I'm a 4th year student planning to apply for Med/Peds residency programs in the very near future. I'm pretty set on the field, but was wondering if anyone could help me out with a couple things that have been on my mind for awhile.

1) Is there any data out there on the type of practices med/peds physicians have? I'm trying to determine the percentage of adults vs pediatric population they are caring for. How many are treating just adults? just kids? or a blend of both? I have worked with two med/peds physicians. One saw about 60% adults/40% peds while the other worked solely with adults. I guess the practice might be up to the physician's preference or demands of his or her community, but was looking for any national data out there if available.

2) One (somewhat unreliable) medicine resident with a skeptical view of meds/peds programs told me that 90% of docs who completed combined residency training programs (all combined programs, not just med/peds) were not re-certified in their combined specialties 10 years after finishing residency. Meaning, say, 10% of med/peds docs would only get re-certified in medicine or peds, but not both 10 years down the road. This was all combined programs so I'm not sure of the breakdown for each combination. I have not been able to confirm this info. Is anyone else aware of this?

Any answers or thoughts or ruminations about this career path would be great.

Thanks!

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[PalmOlive]

Hey all,
I'm a 4th year student planning to apply for Med/Peds residency programs in the very near future. I'm pretty set on the field, but was wondering if anyone could help me out with a couple things that have been on my mind for awhile.

1) Is there any data out there on the type of practices med/peds physicians have? I'm trying to determine the percentage of adults vs pediatric population they are caring for. How many are treating just adults? just kids? or a blend of both? I have worked with two med/peds physicians. One saw about 60% adults/40% peds while the other worked solely with adults. I guess the practice might be up to the physician's preference or demands of his or her community, but was looking for any national data out there if available.

2) One (somewhat unreliable) medicine resident with a skeptical view of meds/peds programs told me that 90% of docs who completed combined residency training programs (all combined programs, not just med/peds) were not re-certified in their combined specialties 10 years after finishing residency. Meaning, say, 10% of med/peds docs would only get re-certified in medicine or peds, but not both 10 years down the road. This was all combined programs so I'm not sure of the breakdown for each combination. I have not been able to confirm this info. Is anyone else aware of this?

Any answers or thoughts or ruminations about this career path would be great.

Thanks!

1. There was a study that was done which you could goggle, sorry I don't have the reference, but said that somewhere near 80 percent of med/peds physicians where seeing both kids and adults.

2. I get the general feeling that more and more effort is being made to make sure physicians are competent later on in their career and that they are now required to take re-certification exams maybe every seven years? This might be problematic for med/peds as you would not only need to pay double recertification fees I guess, but also have to be able to pass recertification exams in both medicine and pediatrics. For a resident just out of training this might be ok, but what about a med/peds doctor who sees like 10% pediatrics like most family medicine physicians?

From what I read med/peds has been around for a while, but all of the med/peds physicians I have seen doing both medicine and pediatrics were in the early to middle part of their career. It could be conceivable that the stress of staying up to date with both pediatrics and adults was too stressful for some. Or that med/peds physicians finally "grow up" and decide whether they want to specialize in just pediatrics or medicine. I think that if you were outside of academics, such as in a private hospital or office settings it would be very hard to keep up to date with both medicine and pediatrics, especially if there were only internists or only pediatrics where you worked.

I haven't seen yet any med/peds physicians who rounded on both medicine and pediatric patients inpatient wise though I am sure they are out there. Sounds like quite the balancing act.

 

[ekydrd]

I am a Med/Peds 4th yr resident and will be going into primary care taking care of both kids and adults. The standard answer to the question of how many Med/Peds docs do both is around 80%. A few will choose one or the other. No, they did not '"grow up" and decide' what they wanted to do, most of them did the combined residency before going in to a subspecialty such as cards where they might see adults with congenital heart disease, or adults with CF, etc so that they would feel more comfortable taking care of them.

We all have to stay up to date with current medical data, reading two articles on blood pressure control, diabetes, or other medical study is not much harder than reading one. Yes, I look forward to having to take boards in two different specialties, but I have ADHD so it's perfect for me.

Some of the jobs that Med/Peds docs do are:

primary care
Hospitalist (esp. small town hospitals)
cardiology (peds, adult, both)
GI (peds, adult, both)
nephrology (...you get the idea)
heme/onc
ID
neurology

Pretty much the sky's the limit on possibilities. I chose a job at a small town hospital working as primary care physician and relief hospitalist located less than an hour from a large metro area. Cost of living is cheap, and income is very good (better than straight peds or FM) and I can get my city fix whenever I need to.

 

[primadonna22274]

I'm a long way from choosing a residency (still applying to med school) but have been interested in Med-Peds for a few years so I appreciate this thread as well.

I've practiced as a PA in family & emergency medicine for the past 8 years. I like FM best but there are a lot of things I feel like I want to know as best I can--especially inpatient medicine. I can see myself as a hospitalist or in a group practice with other FPs but am not sure how this would work. My favorite group (which I left because I was temporarily insane moving from Oregon to South Carolina 2 years ago) is a multispecialty group of 14 docs now (4 IM, 4 FP, 5 peds, and 1 general surgeon). If I were to go home after a decade and practice there, I'd probably fit "best" in the FP group (where I worked before), but this is such a close-knit group that the FPs cover for both IM and peds for overflow, hospital etc. Not sure how that would work with call schedule etc. Not that I have to know the answer to this yet.

A dear friend of mine (and first supervising doc) is a general FP with OB. Sure I'd like to work with her but I HATE OB. We didn't do OB when we worked together 8 years ago...she re-upped in it when she moved to a community health center a few years ago and likes it, so she does it. We'll see. For now the hospital subsidizes her malpractice so she can afford to do it. Still I have ZERO interest in OB so FP/OB is out.

So just wondering: why did you pick Med-Peds over FP?

thanks in advance

Lisa

 

[soonereng]

So just wondering: why did you pick Med-Peds over FP?

Still not settled on a residency yet and reserving the right to change my mind if a rotation catches my eye, but for me the draw is that if I don't see myself doing OB after residency why do the mandatory training in it for FP? Ditto for the surgical rotations.

The other thing that appeals to me is more rotations doing the things I would be doing after residency (ie medicine and pediatrics inpt and outpt).

 

[The Med-Peds Dude]

1. There was a study that was done which you could goggle, sorry I don't have the reference, but said that somewhere near 80 percent of med/peds physicians where seeing both kids and adults.

2. I get the general feeling that more and more effort is being made to make sure physicians are competent later on in their career and that they are now required to take re-certification exams maybe every seven years? This might be problematic for med/peds as you would not only need to pay double recertification fees I guess, but also have to be able to pass recertification exams in both medicine and pediatrics. For a resident just out of training this might be ok, but what about a med/peds doctor who sees like 10% pediatrics like most family medicine physicians?

From what I read med/peds has been around for a while, but all of the med/peds physicians I have seen doing both medicine and pediatrics were in the early to middle part of their career. It could be conceivable that the stress of staying up to date with both pediatrics and adults was too stressful for some. Or that med/peds physicians finally "grow up" and decide whether they want to specialize in just pediatrics or medicine. I think that if you were outside of academics, such as in a private hospital or office settings it would be very hard to keep up to date with both medicine and pediatrics, especially if there were only internists or only pediatrics where you worked.

I haven't seen yet any med/peds physicians who rounded on both medicine and pediatric patients inpatient wise though I am sure they are out there. Sounds like quite the balancing act.

1. Agree. Can find the reference if you can't. Its here on my desk somewhere.

2. Not sure how the aforementioned IM resident has data that neither ABIM nor ABP has. There is effort underway to find out the answer re recertification, but no one knows for sure. A lot of people are either exempt from recertification requirements, or just now in the process. I have to recertify for Peds this year.

 

[preventingdeath]

plenty of my attendings round on both medicine and pediatric patients. they usually do ~2 weeks of peds and then ~2 weeks of medicine, both inpatient teaching. all while having their own med/peds resident clinics. they handle it beautifully but it does sometimes feel like they're spinning plates.

 

[rtmcad2319]

plenty of my attendings round on both medicine and pediatric patients. they usually do ~2 weeks of peds and then ~2 weeks of medicine, both inpatient teaching. all while having their own med/peds resident clinics. they handle it beautifully but it does sometimes feel like they're spinning plates.

thanx

 

[ruthmd]

1. answering the question of med-peds vs. family- for me, it was important to be a board-certified pediatrician. the 4-6 months of peds that family medicine residents get just didnt' seem to be enough to me to truly be comfortable caring for kids. plus, i too dislike ob and surgery and didn't feel that i wanted to spend my time in residency doing those.

most of the graduates from my program (at least in the last 5 or so years) are practicing some combination of both. I think the reason few people do med-peds hospitalist is that (at least in this part of the country), those opportunities are scarce, although we did have a graduate 2 years ago who is doing exclusively m-p hospitalist.

 

[howelljolly]

Im under the impression that, after having done certain fellowships after med or peds, it is not longer required to recertifiy in one or the other.

Meaning, if a med-peds resident decides to do fellowships in adult and pediatric nephrology, for example (Im making up the specialty)... down the road, the adult nephro board will require recertification in IM, but the pediatric nephro will not require cecertification in peds, only in pediatric nephro itself.
I dont know if thats true or not


Just out of curiosity, What fellowships take either Internal Med or Peds applicants? This would make it possible to practice both specialties without doing two separate fellowships. Allergy-Immunology and Medical Genetics come to mind.