Comparing Med/Peds Programs

[Cytarabine]

As a soon-to-be 4th year, I've been trying to think of important characteristics of med/peds programs to compare one to another.

-med/peds presence (Some difficulty determining how to assess this - # of med/peds trained faculty, med/peds chiefs, med/peds continuity clinic)

-size of med/peds class

-High volume training vs training that affords a reasonable amount of time to read

-duration of intern year

-schedule of changing between medicine and peds

-inpatient vs outpatient distribution

-elective time (how much and when it falls in residency)

-what residents do fellowship/career wise

-individual medicine and peds program qualities
---particularly for peds have heard that a weak fellow presence is strongly desired, but delicate balance of also having peds subspecialty services available to rotate on as a resident
---Standalone children's hospital vs not

Etc. Kind of overwhelmed figuring out what to look at, the pros and cons of various things, and how highly each thing should be valued. Would greatly appreciate any input on this!

For other applicants, below are a couple helpful posts I found

Interested in what people

Hello everyone,

I thought it would be helpful if we list questions that should be asked during our interview, either to the PD or those interviewing us or to the residents. Just list whatever you can think of. Some off the top of my head (if they aren't listed on their website):

What is your boards pass rate?
Do you have a boards review plan?
How often do you rotate from medicine to pediatrics?
Do you have dedicated med-peds conferences? How often?
How many of your graduates go into subspecialties? Where do they match?
What is your resident attrition rate?
What is the adult/peds breakdown of the continuity clinic?

Resident Questions:
1. Do you feel behind the categorical residents at all?
2. If you could re-do the match process would you still want to match at this program?
3. Do you feel supported by the administration?
4. What drew you to this program?

PD Questions:
1. Do you envision any changes in the curriculum in the near future?
2. How do the categorical programs view the med-peds program?
3. Do most of your residents end up practicing med-peds or choose medicine or pediatrics?

Important things to ask about or gauge are:
- The overall medpeds prescence (is there a medpeds identity in the program or are you just seperate medicine or peds residents)
- Combined or seperate medpeds clinic
- Is there a medpeds coordinator? (there is a LOT of paperwork that needs to be filled out and as medpeds you double up on everything. Having a dedicated coordinator is very helpful)
- How many inpatient months you do as an intern. In general, as medpeds we do less inpatient rotations than both our categorical counterparts. Building a good foundation is key before you get throw in as a senior with pretty much half the experience as everyone else.
- The overall balance of the medicine and pediatrics program. Unless you are really big M little P or vice versa, the more balanced a program is the better.
- Morale of the residents. At some places, the residents are really worked hard but they are enjoying it and they still find time to have fun. At other places they may not have worked as hard but they were unhappy for other reasons.

My go-to question throughout the entire process was basically "why did you choose this program". It gives them a chance to brag and it takes up some interviewing time

Theres probably more but thats what I can think off the top of my head.

Good luck!

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[chargersfan]

Now that I'm nearing the end of my intern year I can give you a little more insight on what is actually practically important once you're in the program and what's not.

First stuff that's interesting to talk about during interviews but in the long run doesn't really matter:
-Length of intern year - it's inherent in medpeds training that you're gonna feel behind and not prepared no matter how long your intern year is
-Schedule of switching between medicine and peds - it doens't really matter too much, each program has their own reason for their switch schedule, in the long run its not very important. The ones to stay away from are the super long between switches (i.e 6 months)
-Medpeds "presence" - it's nice when you don't have to explain what medpeds is but in reality when you're on medicine you're a medicine resident and when you're on peds you're a peds resident so it really doesn't matter too much. Although what is very important is whether or not the program has it's own medpeds continuity clinic. I think it's very important for medpeds resident to have experience in a medpeds clinic because it is completely different from a medicine or peds only clinic.
-Elective time- it's nice to have more electives but medpeds schedules are so rigid and jam-packed you're not going to get much elective time no matter where you go. You may get 2-3 months.

Important stuff
-Presence of fellows or not- the awesome thing about my programs is that there are not many peds fellows but a lot of subspecialty attendings. This way when you're on consult services you're running the show, not just doing what fellows tell you to do. For the medicine side, pretty much every program is going to have fellows. Some more than others. I don't think its too much of a negative on the medicine side
-Inpatient vs outpatient distribution- in general most medpeds program are geared towards inpatient (one of its drawing point for me above family med), the more important factor is if the program is front-heavy or back-heavy. I prefer to have a front-loaded residency with a lot of inpatient months my intern year as oppose to the other way around.
-Finally you do NOT want to go to a program where you have time to read. Learn by doing!

 

[Cytarabine]

Thank you for the input, that's exactly the type of stuff I was interested in!

 

[Cytarabine]

So, as far as "volume", what are we considering a high volume program? I've heard some of the programs I've been looking at have residents working longer than surg, i.e. breaking 120 hrs on wards months. The need for volume in med/peds makes sense... but at what point are you satisfied with volume?

 

[L72521]

I wouldn't focus too much on volume in terms of hours worked. The plain fact is that you're going to have difficulty securing reliable information on this for many of the programs at which you interview. At every program I interviewed at, the PD said that the hours rules were taken very seriously and that residents usually successfully remained within 80 averaged across four weeks. If you can get a resident to speak candidly to you, they may tell you otherwise, but I doubt you'll be able to get this kind of reliable info on EVERY program, and it will thus be difficult for you to compare.

If you're going to focus on volume, focus on volume of cases. You can verify this information in a lot of ways. Plus, often it just stands to common sense (e.g., f the only large, free-standing children's hospital in a region tells you it gets extraordinary volume, they're probably telling you the truth). Ultimately, I don't even think this is a "more is better" thing. You need a sufficient volume to learn and, in agreement with @chargersfan, you want to learn by doing. That said, I interviewed at a variety of different programs and none of them left me concerned that they had insufficient volume. Also, none left me thinking that I would have ample time to read (at least, not during intern year). One mistake people make (on the peds side especially) is to mistake the number of beds in the hospital as a proxy for volume. It doesn't really matter if the hospital has 200 beds or 2000 beds--it only matters how many patients you personally are managing on your team. Ask how the teams are organized and how many patients are assigned to the team and to each intern.

 

[Cytarabine]

Thank you, that was a very helpful reply