Competitiveness of Med-Peds programs?

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NeedSomeAdviceGuy

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I know Med-Peds isn't an intrinsically competitive field, but it's also quite small with few and far between locations. As such, what makes someone competitive for these spots outside of scores? I imagine at this size connections probably matter more?

What are yalls thoughts? Personally, I wanna return to NYC so Sinai, being the only NYC Med-Peds program, is on the top of the list for me so "shooting" for that but obviously not putting all my hopes in one location.
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NeedSomeAdviceGuy said:
I know Med-Peds isn't an intrinsically competitive field, but it's also quite small with few and far between locations. As such, what makes someone competitive for these spots outside of scores? I imagine at this size connections probably matter more?

What are yalls thoughts? Personally, I wanna return to NYC so Sinai, being the only NYC Med-Peds program, is on the top of the list for me so "shooting" for that but obviously not putting all my hopes in one location.
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There's a med-peds forum you can post on, but I bet it's pretty cold. I can't imagine anything specific to make you competitive for med-peds that isn't relevant to any other field. I don't think connections per say are uniquely important in med-peds, but if there's a particular place you want to end up at, consider rotating there in the future if you feel they don't take applicants out of your region or you don't have the scores to match there.

Try not to focus on one location like you've said. Per doximity, there are 21 med-peds programs in the northeast. Newark, Rutgers, and Stony Brook are also close proximity. Sinai Medicine is definitely up there, but I'm not sure about their meds-peds program. If you care about reputation, there's definitely an order that isn't your standard top 20 US MD schools, Cincinnati, Rochester, and Indiana seem to have reputable training programs.

So overall, not much to do now. When applying you're going to have an advantage having done some stuff in NYC as per your post and can also:

1.) Mark your address as any NYC dwelling you have ties to.
2.) Create a personalized statement for Sinai or any other places you're hellbent on going to.
3.) Send a letter of interest if you don't hear back during the first wave of invites.

Either way...all very low effort things you can worry about in a few years. The important stuff is your clinical grades, Step 2CK, etc. like with everyone else. I suppose one thing to consider (worry about after Step 1) is how you've going to apply for aways and when you're going to take CK and which should come first.
 
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Also probably applying med peds, still learning a lot myself but my understanding is that Sinai is SUPER primary care focused, so you would want to be able to clearly demonstrate that. If primary care isn't your goal it might not be the best fit for you. From what I understand, MP tends to be one of the specialties that focuses heavily on fit rather than just board scores (though of course there will obviously be some programs that care about that). I think having connections can be a big help, but also most applicants probably won't be coming from schools with MP programs and i think programs understand that
 
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Connections don't really matter in residency applications. The things you need for Med-Peds is the same you need for Med or Peds. Good step scores (though they don't have to be outstanding), great letters, a personal statement about what drew you to a combined field (as opposed to either/or) and some sort of research/extracurricular activities related to medicine. It also helps to have an answer on interview day as to where you envision you think your career in Med-Peds is going to go and what type of population you want to serve and why after residency.

Of course, that's for the average applicant. The stand out applicants have dual degrees, have published papers, presented research in conferences, are on committees of some organization at the national level, etc. Those applicants are generally few and far between, but anything you can do to beef up your application will always help.
 
Honestly I don’t think it’s super duper competitive. Probably fairly similar to internal medicine and a bit more competitive than peds (which is not competitive). It can be a bit more chance based with lower numbers of residents, but I wouldn’t stress. It’s not neurosurgery or anything
 
sliceofbread136 said:
Honestly I don’t think it’s super duper competitive. Probably fairly similar to internal medicine and a bit more competitive than peds (which is not competitive). It can be a bit more chance based with lower numbers of residents, but I wouldn’t stress. It’s not neurosurgery or anything
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This needs a lot more nuance. Top Peds programs and top IM programs are every bit as competitive as any other specialty. Yes the average program is easy to get into in either field compared to the competitive fields, but the applicants to the top IM or top Peds programs are on par with their classmates trying to go into Derm or NSGY or Ortho.

To the OP, unfortunately for you, the degree of excellence needed is often program specific and depends on how involved the PD's from IM and Peds choose to be in the selection of the Med-Peds program residents. At some locations, Med-Peds is a backdoor into programs that might otherwise have been out of reach for a particular candidate were they going just for one field or the other. In other situations, where the IM and Peds PD's are involved, it's every bit as tough to get in through the M/P program as the singular fields. Any med-peds program that has at least one half that's stellar is going to be harder than a program in which both halves are middling.
 
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I’ve looked into this and have found little info. I’m trying to use NRMP data and then going Hard on my personal statement
 
The NMPRA site mentioned above is a fantastic resource. Agree in general with above. There are strong med peds programs based on their categorical programs (eg Penn, Vandy, BWH) and those that have more of a reputation based on their medpeds identity and history (eg Christiana, UNC, Indiana). In general overall competitiveness I think tends to be more weighted by the reputation of the categorical programs
 
BigRedBeta said:
This needs a lot more nuance. Top Peds programs and top IM programs are every bit as competitive as any other specialty. Yes the average program is easy to get into in either field compared to the competitive fields, but the applicants to the top IM or top Peds programs are on par with their classmates trying to go into Derm or NSGY or Ortho.

To the OP, unfortunately for you, the degree of excellence needed is often program specific and depends on how involved the PD's from IM and Peds choose to be in the selection of the Med-Peds program residents. At some locations, Med-Peds is a backdoor into programs that might otherwise have been out of reach for a particular candidate were they going just for one field or the other. In other situations, where the IM and Peds PD's are involved, it's every bit as tough to get in through the M/P program as the singular fields. Any med-peds program that has at least one half that's stellar is going to be harder than a program in which both halves are middling.
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Top peds really isn’t that competitive compared to the top of other specialties (atleast in my experience). Top Im is much more competitive.
 
NeedSomeAdviceGuy said:
I know Med-Peds isn't an intrinsically competitive field, but it's also quite small with few and far between locations. As such, what makes someone competitive for these spots outside of scores? I imagine at this size connections probably matter more?

What are yalls thoughts? Personally, I wanna return to NYC so Sinai, being the only NYC Med-Peds program, is on the top of the list for me so "shooting" for that but obviously not putting all my hopes in one location.
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How about an in-house program, I’m guessing this can help quite dramatically? Is research needed for Med-Peds?
 
diamondkings said:
How about an in-house program, I’m guessing this can help quite dramatically? Is research needed for Med-Peds?
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1) there is certainly advantage to having an in-house program, just like any specialty. You have faculty who have connections in the field as well as more opportunity to become familiar with the training. But I wouldn't say the benefit is dramatic, as you'll get exposure to both fields separately. The main thing I'd want to see is someone who's able to verbalize why they want to pursue the combined training

2) Research never hurts, and this becomes progressively more and more true if you pursue a fellowship or academic career. How important it is is going to be program dependent, with more competitive programs generally emphasizing it more, like with most other residencies
 
WheezyBaby said:
1) there is certainly advantage to having an in-house program, just like any specialty. You have faculty who have connections in the field as well as more opportunity to become familiar with the training. But I wouldn't say the benefit is dramatic, as you'll get exposure to both fields separately. The main thing I'd want to see is someone who's able to verbalize why they want to pursue the combined training

2) Research never hurts, and this becomes progressively more and more true if you pursue a fellowship or academic career. How important it is is going to be program dependent, with more competitive programs generally emphasizing it more, like with most other residencies
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Is wanting to work with both populations, in particular adolescents and young adults, and those with chronic lifelong conditions that present early on a 'good enough' reason or should I be focusing on a more specific niche?

I also have a particular interest in housing-insecure populations / PWID / sex workers, which I feel could benefit from Med-Peds (though certainly not necessary, but I imagine this work would be on a volunteer basis)
 
NeedSomeAdviceGuy said:
Is wanting to work with both populations, in particular adolescents and young adults, and those with chronic lifelong conditions that present early on a 'good enough' reason or should I be focusing on a more specific niche?

I also have a particular interest in housing-insecure populations / PWID / sex workers, which I feel could benefit from Med-Peds (though certainly not necessary, but I imagine this work would be on a volunteer basis)
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The best med-peds candidates are all in for both populations - that your professional life would have a void if you couldn't work with both kids and adults. If one group is just a "nice to have", then you are better off going to the one that is really a need for you. That's mostly because the residency training doesn't give you a chance to cut corners in either field. You do the NICU time and the geriatrics rotations, you come out ready to be a pediatrician and an internist. This is not FM where inpatient/critical care/EM time is abdicated in favor of more clinic.

Adolescent medicine board certification is approachable from IM, peds and FM separately so that doesn't necessitate doing the combined program. Your chronic disease presenting early model is also not as compelling given the bigger issue right now is chronic special needs kids outgrowing their children's hospital medical homes and not being able to find adult providers to graduate to. You'll likely get more mileage approaching it from that angle rather than what you've described. For example saying you're interested in doing peds cardiology with an adult congenital heart disease super fellowship will make sense why you are doing med/peds more than saying you want to do an adult endocrine fellowship and focus on Type 1 diabetics.

Do you have volunteer/clinical/research experience with those populations? They are certainly at-risk populations in need of individualized care, but they may strike some as an unusual interest without some sort anchoring experience to share. Depending on the faculty on your interview day, that may work against you (thinking of some of my pediatrics faculty who had been deputized into helping the Med/Peds PD)
 
BigRedBeta said:
Do you have volunteer/clinical/research experience with those populations? They are certainly at-risk populations in need of individualized care, but they may strike some as an unusual interest without some sort anchoring experience to share. Depending on the faculty on your interview day, that may work against you (thinking of some of my pediatrics faculty who had been deputized into helping the Med/Peds PD)
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Thanks for the insight! And yes almost exclusively (at least while in med school), I'm in charge of a student-run clinic that serves these populations.
 
NeedSomeAdviceGuy said:
Is wanting to work with both populations, in particular adolescents and young adults, and those with chronic lifelong conditions that present early on a 'good enough' reason or should I be focusing on a more specific niche?

I also have a particular interest in housing-insecure populations / PWID / sex workers, which I feel could benefit from Med-Peds (though certainly not necessary, but I imagine this work would be on a volunteer basis)
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It's a subjective thing, I'd want to talk more with you about things like where your interest in those things arose, potentially which chronic conditions, do you want to be just involved in the transition period for this population or ongoing care from youth to middle or even older age, etc. Not necessarily expecting you to have precise answers to these questions but wanting to see that you've given it thought. Med peds people are notoriously non-committal about what they want to do with their lives, but I would at least want to know from where the interest is arising and that some thought has been put into why pursuing an extra year of overall training but less individual categorical training is the thing you want to do. People do it for a million different reasons and then change their minds in residency anyway, I just like to know someone has a mature thought process on their current rationale

But short answer yes seems reasonable, agree with BRB would want to know why med peds and not one of those alternatively mentioned pathways
 
NeedSomeAdviceGuy said:
Thanks for the insight! And yes almost exclusively (at least while in med school), I'm in charge of a student-run clinic that serves these populations.
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...are you secretly me or do we just have the same resume and residency interests (I'm not in charge of our clinic anymore though, I've passed that baton to the underclassmen). We have a lot of med peds residents who volunteer at our clinic! I don't know that it's a part of all of their long term career goals, but it's definitely an interest you can pursue and they were always great to have in clinic
 
TelemarketingEnigma said:
...are you secretly me or do we just have the same resume and residency interests (I'm not in charge of our clinic anymore though, I've passed that baton to the underclassmen). We have a lot of med peds residents who volunteer at our clinic! I don't know that it's a part of all of their long term career goals, but it's definitely an interest you can pursue and they were always great to have in clinic
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Hahaha, I think clinics like those certainly attract the same people who want to enter Med-Peds. And oh boy, the physicians that volunteer at the clinic are like my role models - some of the greatest people I've ever met, definitely have helped shaped my path.
 
WheezyBaby said:
It's a subjective thing, I'd want to talk more with you about things like where your interest in those things arose, potentially which chronic conditions, do you want to be just involved in the transition period for this population or ongoing care from youth to middle or even older age, etc. Not necessarily expecting you to have precise answers to these questions but wanting to see that you've given it thought. Med peds people are notoriously non-committal about what they want to do with their lives, but I would at least want to know from where the interest is arising and that some thought has been put into why pursuing an extra year of overall training but less individual categorical training is the thing you want to do. People do it for a million different reasons and then change their minds in residency anyway, I just like to know someone has a mature thought process on their current rationale

But short answer yes seems reasonable, agree with BRB would want to know why med peds and not one of those alternatively mentioned pathways
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can you explain what you mean by “less individual categorical training”.?

residency terminology isn’t my strong suit
 
ohmanwaddup said:
yes, but the numbers are so small, its less than 50 applicants if memory serves. something like 4 DOs did not match Med Peds, I just have a hard time putting to much stock in the numbers besides board scores. idk
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The actual results of 40 people is a much better evidence than the opinions of 15 people,
 
WheezyBaby said:
To be fair 4 of those people with opinions are a peds attending, 2 picu attendings, and a med peds attending. At any rate I do think charting outcomes has valuable information
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And I (one of the PICU attendings) went through this thought exercise as a student late in my 3rd year to the point I did a medicine Sub-I in July and had a personal statement drafted for peds programs and med/peds programs...then I did PICU in August of 4th year, knew that was everything I wanted in a career and my Med/Peds advisor told me I'd be better served with the third year of peds training than any adult time.
 
I don't suppose anyone has any tips for finding a med peds mentor? My school (DO) doesn't have a program here. I've tried reaching out to the NMPRA but haven't heard anything back.

I'm considering cold DMing people on med twitter at this point.
 
BigRedBeta said:
And I (one of the PICU attendings) went through this thought exercise as a student late in my 3rd year to the point I did a medicine Sub-I in July and had a personal statement drafted for peds programs and med/peds programs...then I did PICU in August of 4th year, knew that was everything I wanted in a career and my Med/Peds advisor told me I'd be better served with the third year of peds training than any adult time.
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Out of curiosity, what about PICU drew you in? That's something in thought I feel I'd be interested in, but haven't gotten to get any exposure yet.
 
NeedSomeAdviceGuy said:
Out of curiosity, what about PICU drew you in? That's something in thought I feel I'd be interested in, but haven't gotten to get any exposure yet.
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Procedures are usually what draw people in... but its the (patho)physiology that makes them stay interested.
 
NeedSomeAdviceGuy said:
Out of curiosity, what about PICU drew you in? That's something in thought I feel I'd be interested in, but haven't gotten to get any exposure yet.
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So I had been set on pediatrics of some sort going into MS3 year, quickly realized I didn't like the OR so that ruled out surgical fields. Was surprised how much I liked the multisystem management of inpatient Internal Medicine as I had always thought I liked that peds had one issue to work through. Confirmed that I liked that sort of management while on Peds Pulm mini-rotation with the CF patients. Thought that med-peds and being the specialist to manage that transition between pediatric and adults would be a great career. Having bronchs for at least some type of procedure was also appealing.

Realized during my PICU rotation that it hit all my criteria but even better than Pulm did - complexity, multiple systems, lots of varied pathology, more procedures. NO CLINIC! And then to @SurfingDoctor 's point, the physiology got to be really interesting and made the pre-clinical work all of sudden a whole lot more relevant. And the 3-4% mortality rate in the PICU is a lot more fun than the 25-40% rate in the Adult MICU (and it's still pretty common that adult Pulm/Crit Care jobs have clinic component which I don't miss in any way).
 
SurfingDoctor said:
As a caveat and somewhat unrelated, the job markets are quite different between PICU and adult ICU. Of course, that could all change in the future and I don't think anyone should bass their career path on a hypothetical endpoint, but just so it is known.
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How are the job markets different ? One is notably stronger than the other ? One has more opportunity ?
 
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