IM/Peds

diamonddoc · Jul 7, 2003

Hi guys,
I need some help. I am trying to decide between peds and IM or both. I really like treating adults, but I don't like the geriatric population as patients. I love working with kids too. How about med/peds? How can I apply training in both fields to open a New York City practice where there are many pediatricians and internists.
When I mentioned the idea to my pediatrician, he told me that there is no room for such a hybrid in a big city. People want to know that their kids are being treated by a pediatrician, not a "family" doctor like med/peds. He asked me if I would go to an internist with half the office full of screaming kids? And would I send my kids to a pediatrician with half an office of 70 somethings? It just wouldn't look right.
Also, are there any fellowships out there that encompasses both meds and peds?
Any advice will be appreciated.
🙄

mhdousa · Jul 7, 2003

The only fellowship that I know of in which you could do both adult and peds
is allergy and immunology. Most A&I docs I know are double board-certified
(peds and adult A&I).
Someone please correct me if I'm wrong.

-M

HiFi · Jul 7, 2003

diamond;
go on line and check out physician recruiters and see how many jobs there are in NYC for med-peds.

A few of my friends from residency did med peds and they got jobs, but it took a while and they had to move. There are jobs but you usually need to do either solo practice ( VERY VERY VERY rare these days ) or join a small-med-lg group of med peds docs.
Generally, only med-peds can take call for your practice. A pediatrician or an internist is not able to cover all of your patients. An FP can cover for you, but if they do a lot of OB/gyn call, you may not be able to cover for them so this usually doesn't work out. Nobody wants to take call for you as a one way street

The proof will be in searching for jobs in NYC. It's tough to predict the job market 4 or 5 yrs down the road, but at least you can compare the current job market for IM, Peds, Med-Peds etc in NYC so you can get an idea of how things are going and try to make a prediction for future need.

Fellowships: One of my friends did GI, but she only does adult GI now. In fact, a lot of people I knew that started med peds, bailed out after a year and did either straight peds or straight IM

kenfused · Jul 19, 2003

Med Peds ROCKS if it's really what you want to do with your life.
Ask yourself:

Would I be happy treating ONLY kids?
Would I be happy treating ONLY adults?

If EITHER are true, then do Categorical Peds OR IM.

DO NOT choose Med-Peds if you are "not sure" or can't make up your mind. Med Peds is TOUGH. It is ALOT more work, MORE CALL< and more stuff to know, and you will work alot harder than many of your colleagues.

In terms of combined fellowships.

There are many fellowships where you can arrange to do BOTH peds and adult medicine, usually by adding one additional year.
Potentially this can be done with Allergy, Rheumatology, Endocrine, Infectious Disease, and maybe a few more...

These are things many fellowhship programs are willing to negotiate. (but don't base your decision for residency on what fellowship you MIGHT want to pursue later. You will have LOTs of time!

Good luck!

Meeko1452 · Jul 24, 2003

There is a combined med-peds cards fellowship somewhere in Texas. Several people at my medical school arranged to do combined fellowships in endo and infectious disease, but most people I know who were med-peds ended up in either a medical or a peds fellowship. All of them say the extra training in residency really helped them, though.

sanfilippo · Jul 26, 2003

I had also struggled with deciding between IM and med-peds. I am leaning away from the latter for one main reason: in the compacted 4 years of med-peds training, there is virtually NO flexibility to pursue electives or do research. You can do combined fellowship training at many places, especially in areas that will overlap (ID, A and I, endocrinology, GI). Many med-peds programs' websites show where past graduates have gone, and you should try to find those who did combined fellowships and whether or not that program is more or less interested in producing primary-care med-peds docs or offering enough rigor to allow for subspecialty preparation.

-S.

otter41 · Mar 8, 2004

bump....to help get Fermata some basic info

Fermata · Mar 8, 2004

I appreciate it otter.

freelancewriter · Mar 16, 2004

I wondered the same thing, did a Google search, and found a basic explanatory brochure at http://www.marshfieldclinic.org/education/residency/residency_fellow/med_peds/nmpra.pdf

(Note that it's a PDF.)

That same site has a sample of their rotations, which is also revealing:
http://www.marshfieldclinic.org/education/residency/residency_fellow/med_peds/med_peds_residency.asp

The strength of the Med and Peds residency programs are obviously a factor.

dksamp · Mar 24, 2004

Hello,
If you want to see a mixed population of kids and adults, then FP is an option too. However, if you have any intention of specializing (A & I, ID, etc), then FP is NOT for you. You can only do those subspecialties via med-peds. If you are only interested in primary care, then FP is a perfectly valid choice. One advantage is that there is only 1 board certification to maintain. In med-peds, you have to maintain 2 separate board certfications. As far as the coverage and OB issue, FP's can cross cover for med-peds. If the FP in question does OB, then they can usually find another FP who does OB to just cover the OB part. It is usually not an issue in the big cities, as FP's there do not do OB.
Just my $0.02....PEACE!!

-Derek

kristing · Mar 27, 2004

I am fairly certain there's an ID med/peds fellowship at Brown.

freelancewriter · Apr 13, 2004

Found another interesting Med/Peds resource called "THE MEDICAL STUDENT?S GUIDE TO THE EVALUATION OF COMBINED MEDICINE-PEDIATRICS
RESIDENCY TRAINING PROGRAMS":
http://www.im.org/APDIM/medpeds/med-peds_guide.pdf

freelancewriter · Apr 13, 2004

For those interested in Med-Peds, there was an extensive discussion on this very forum over a year ago: http://forums.studentdoctor.net/showthread.php?t=53468

lowbudget · Apr 14, 2004

During my Pedi rotation, I followed a Pedi Neph who had a Med-Ped Neph partner... who was never there because she was always taking care of adults. I guess there are just more DM-ESRD patients than there are Pedi HTN...

There's definitely some truth of being drawn towards one or the other specialty when you get out there.

IM/Peds

diamonddoc

Member

mhdousa

Member

HiFi

kenfused

Senior Member

Meeko1452

Member

sanfilippo

El Gaucho Misterioso

otter41

Junior Member

Fermata

Hold me.

freelancewriter

Senior Member

dksamp

Member

kristing

Senior Member

freelancewriter

Senior Member

freelancewriter

Senior Member

lowbudget

Full Member

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