Acting internship

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Certainly not required.

Would a strong letter from a 2nd sub-I help you? Probably. How much it helps depends on how you did on your core rotations, your board scores etc..
 
Most applicants to med-peds will not have done both acting internships/sub-internships in both internal medicine and pediatrics. Since most schools require AI/subIs in medicine, that's the one most commonly done (and an elective in pediatrics, although some 4th year peds elective are automatically counted as a peds AI/subI)

Many applicants get interviews and match into great med-peds programs without having done both AIs/SubIs in medicine and pediatrics

good luck
 
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