Didn't match med-peds...now what?!

[loca Dr. chica]

So found out today that I didn't match into Med-Peds. Any PDs on here have any advice on next steps? I will have to scramble tomm for either categorical med or peds, which really sucks b/c i really really wanted to see both kids and adults and had my heart set on med-peds. how feasible is it to transfer into med-peds after a yr in a categorical program? should i try to scramble into a categorical program that also has a med-peds program? any help would be greatly appreciated

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[EXPD]

So found out today that I didn't match into Med-Peds. Any PDs on here have any advice on next steps? I will have to scramble tomm for either categorical med or peds, which really sucks b/c i really really wanted to see both kids and adults and had my heart set on med-peds. how feasible is it to transfer into med-peds after a yr in a categorical program? should i try to scramble into a categorical program that also has a med-peds program? any help would be greatly appreciated

First step back and try to assess why you did not match. The question will be asked when scrambling. If it is because your med school or exam performance was not very good considering the number of openings remaining available this year you may have to think of other ways to see adults and kids such as family medicine where there are lots of openings this year. If you did not match because you are a strong candidate but limited yourself by location, program type etc you may have a good chance of getting something if you are willing to give up those limits.

To start with there are 4 open positions in med-peds. If you want to do med-peds you should contact those programs immediately at the start of the scramble and see if it would be right for you. If that is not possible my recommendation would be to get into a good peds program. They tend to be smaller and will have fewer openings later on from residents dropping out getting off track etc, whereas internal medicine is so much bigger in general and is more likely to have openings later on. I am guessing that if you get there and perform well and make your intentions known up front that you may be able to transition into med-peds during the first year.

Another route would be to consider one of the 35 transitional year positions hopefully at an institution where there is a med-peds program. Again, I would be up front about your intentions to ultimately become a med-peds resident. This has been done before without losing any time and still graduating in 48 months but that was before everything was so strict with accreditation. It might be a little more difficult now. Worst case scenario is that you do 12 months of transitional while reapplying next year. You may be more attractive to programs because of additional training. Other programs may view it as a negative since you burned up a year of full funding so your 4th year would only be reimbursed at half the rate. Again, get into a program, work hard, professionally, and just perform well whatever you do.

 

[sapfrit]

Judging by your other posts it sounds like EM was your first passion and medpeds was a fall back option. Medpeds was very competitive this year. I is usually quite obvious how passionate people are about a career. I am sure this factored into the final outcome. Maybe you should scamble into EM.

 

[winaq]

re: the recommendation to "step back" and assess why someone did not match in med-peds.

4 remaining spots in med-peds is unusual, right? there were 36 unfilled spots in 2008. so this means something about the popularity of the specialty---or perhaps the popularity of the relative comforts and protections of residency in an unstable economy and job market. graduate and post-graduate opportunities in all fields, medicine included, are becoming saturated after the onset of the recession--and a longer period of training, for once, does not seem as repulsive as it might have. to place blame on individuals seems silly and irresponsible.

i went un-matched in med-peds. and i will open myself to critique: have at it.

i come from a top-15 med school. step 1? 243. high passes in my senior medicine sub-I and other 4th year clerkships. two master's degrees from high-falutin' institutions, and multiple publications and presentations at various national conferences in different fields. letters from leaders in their fields--and i had worked with them very closely.

i applied to 39 programs in every region, received invitations to interview at 24, and ultimately ranked 12 in 3 regions, the south, the midwest and the northeast.

blame it on me...really? "step back."

 

[psychotrope]

re: the recommendation to "step back" and assess why someone did not match in med-peds.

4 remaining spots in med-peds is unusual, right? there were 36 unfilled spots in 2008. so this means something about the popularity of the specialty---or perhaps the popularity of the relative comforts and protections of residency in an unstable economy and job market. graduate and post-graduate opportunities in all fields, medicine included, are becoming saturated after the onset of the recession--and a longer period of training, for once, does not seem as repulsive as it might have. to place blame on individuals seems silly and irresponsible.

i went un-matched in med-peds. and i will open myself to critique: have at it.

i come from a top-15 med school. step 1? 243. high passes in my senior medicine sub-I and other 4th year clerkships. two master's degrees from high-falutin' institutions, and multiple publications and presentations at various national conferences in different fields. letters from leaders in their fields--and i had worked with them very closely.

i applied to 39 programs in every region, received invitations to interview at 24, and ultimately ranked 12 in 3 regions, the south, the midwest and the northeast.

blame it on me...really? "step back."

do tell us the "rest of the story".......

it's unusual for someone to mention "high passes" in a couple of fourth year(!) clerkships/electives along with things like a really good step1 score, multiple publications, and going to a top15 medical school.

what were you third year cores like? More importantly, just give us the obvious red flags......

because an AMG who graduates from an elite med school with a 240+ step1 score isn't having problems matching in med-peds unless there are some real...*real*....red flags there.

 

[Scaredshizzles]

do tell us the "rest of the story".......

it's unusual for someone to mention "high passes" in a couple of fourth year(!) clerkships/electives along with things like a really good step1 score, multiple publications, and going to a top15 medical school.

what were you third year cores like? More importantly, just give us the obvious red flags......

because an AMG who graduates from an elite med school with a 240+ step1 score isn't having problems matching in med-peds unless there are some real...*real*....red flags there.

If he/she had real red flags, like failed a core clerkship or very negative comment on MSPE, why did he/she get so many interviews? Seems really strange. Do you have some kind of criminal record that could have come up on background checks, like DUI/DWI?

 

[EXPD]

If he/she had real red flags, like failed a core clerkship or very negative comment on MSPE, why did he/she get so many interviews? Seems really strange. Do you have some kind of criminal record that could have come up on background checks, like DUI/DWI?

First, Arrogance and entitlement are simple reasons people might not be ranked so highly. These things are usually obvious in interviews. We had a multiple degree candidate this year with 256 and 260, AOA student waltzing around here during the interview telling everyone including the other candidates how great he/she was and how he/she deserved the position more than any of the others who she never bothered to get to know, brown nosing with the "important people" and treating our office staff and hotel staff like second class citizens. We did not rank that candidate.

Second, Invitations to interviews are generally made in October and are based on very limited data. Waiting longer gives candidates too little time to make travel plans and organize all of their interviews. The MSPE is not available at the time most invitations to interview are made. We occasionally end up interviewing candidates that we wished we had never invited.

 

[psychotrope]

If he/she had real red flags, like failed a core clerkship or very negative comment on MSPE, why did he/she get so many interviews? Seems really strange. Do you have some kind of criminal record that could have come up on background checks, like DUI/DWI?

for specialties like med/peds, interviews are generally given out before the mspe is available.

And quite frankly, for an amg with that step1 score, their interview yield(60%) was sorta low.

Also, the fact that they went on TWENTY FOUR interviews(an astoundingly high number for an amg wanting med-peds) is another sign they knew they had some red flags.

Im guessing there was either one huge red flag(and I don't mean a single failed core clerkship) or multiple smaller red flags(several failed core clerkships)....

 

[drknockboot]

Im guessing there was either one huge red flag(and I don't mean a single failed core clerkship) or multiple smaller red flags(several failed core clerkships)....

Guess away, and who knows, you might be right. But with all due respect, EXPD, I think it's also arrogant to think that it's always the candidate that is defective. As someone who got the feeling by at least one prominent PD (Brad Benson at Minnesota) that he had better things to do than talk to me during my interview day, I would have much rather they waited to offer me an interview than waste everyone's time for a free lunch and a night at the Comfort Inn. I was able to schedule travel and hotels just fine for invitations I got in November, thank you.

I didn't match. I'm an AMG from a top-quartile medical school, with great research experiences, publications, honors and near honors in almost all of my clinical clerkships, and honestly stellar letters of recommendation. However, unlike the OP, my board scores were not impressive and I knew that coming into this process. Nevertheless, even without my MSPE I got several interviews at great programs. What I didn't know was how competitive the process would be because my home institution doesn't have a med-peds program, and when I mentioned that I was pursuing med-peds, I was essentially told I was a fool for not just doing family medicine because med-peds is a dying field. Given the number of applicants this year, obviously this isn't true. What is true is that I could have used some better guidance early

My story ends with me being offered one of the four available med-peds spots in the scramble yesterday. Fifteen minutes later I was given the unique opportunity to choose between two offers and accepted a categorical peds position at a stronger program that also has a med-peds residency I'll attempt to roll into this next year. It could have been much worse, and I will certainly add to the calls for the scramble process to be changed. Simply one of the most stressful experiences of my life. However, I'd like to say I'm grateful and thrilled I got into a spot in a place that I think I can live with for the next three or four years.

Bottom line is: to all the student affairs deans and PDs out there who say that there's more than just board scores to finding the right residents, this is for you.

 

[Scaredshizzles]

Guess away, and who knows, you might be right. But with all due respect, EXPD, I think it's also arrogant to think that it's always the candidate that is defective. As someone who got the feeling by at least one prominent PD (Brad Benson at Minnesota) that he had better things to do than talk to me during my interview day, I would have much rather they waited to offer me an interview than waste everyone's time for a free lunch and a night at the Comfort Inn. I was able to schedule travel and hotels just fine for invitations I got in November, thank you.

I didn't match. I'm an AMG from a top-quartile medical school, with great research experiences, publications, honors and near honors in almost all of my clinical clerkships, and honestly stellar letters of recommendation. However, unlike the OP, my board scores were not impressive and I knew that coming into this process. Nevertheless, even without my MSPE I got several interviews at great programs. What I didn't know was how competitive the process would be because my home institution doesn't have a med-peds program, and when I mentioned that I was pursuing med-peds, I was essentially told I was a fool for not just doing family medicine because med-peds is a dying field. Given the number of applicants this year, obviously this isn't true. What is true is that I could have used some better guidance early

My story ends with me being offered one of the four available med-peds spots in the scramble yesterday. Fifteen minutes later I was given the unique opportunity to choose between two offers and accepted a categorical peds position at a stronger program that also has a med-peds residency I'll attempt to roll into this next year. It could have been much worse, and I will certainly add to the calls for the scramble process to be changed. Simply one of the most stressful experiences of my life. However, I'd like to say I'm grateful and thrilled I got into a spot in a place that I think I can live with for the next three or four years.

Bottom line is: to all the student affairs deans and PDs out there who say that there's more than just board scores to finding the right residents, this is for you.

I'm really astounded and sorry to hear of some of the people here who went unmatched. On the other end, you have like 50 unfilled anesthesia spots. The beginning salary for anesthesiologists is about 2x that of med-peds generalists. Really a very unusual year, I think the number of people who went unmatched total will probably be up at least 25% from last year, many in primary care specialties.

 

[psychotrope]

I didn't match. I'm an AMG from a top-quartile medical school, with great research experiences, publications, honors and near honors in almost all of my clinical clerkships, and honestly stellar letters of recommendation. However, unlike the OP, my board scores were not impressive and I knew that coming into this process. Nevertheless, even without my MSPE I got several interviews at great programs.

if you were given an interview and then treated like you didn't have a chance to match there because of poor board scores, thats a fault of the program. They have that information ahead of time before they give out interview invites. An exception would be if it was a very poor/failing step 2 score that came in between the offer and the interview date.

But most of the time this occurs(at least what people have told me) with candidates who look "ok" on paper, are from an allopathic american school, and then their mspe is pretty negative. The program can't take away the invite, and it's not the programs fault for inviting a candidate they know by interview day they will not rank.

 

[Scaredshizzles]

First, Arrogance and entitlement are simple reasons people might not be ranked so highly. These things are usually obvious in interviews. We had a multiple degree candidate this year with 256 and 260, AOA student waltzing around here during the interview telling everyone including the other candidates how great he/she was and how he/she deserved the position more than any of the others who she never bothered to get to know, brown nosing with the "important people" and treating our office staff and hotel staff like second class citizens. We did not rank that candidate.

Second, Invitations to interviews are generally made in October and are based on very limited data. Waiting longer gives candidates too little time to make travel plans and organize all of their interviews. The MSPE is not available at the time most invitations to interview are made. We occasionally end up interviewing candidates that we wished we had never invited.

Hotel staff? Really? Must be a small town if you're getting feedback from the hotel staff. I got into at least two spats with hotel staff over billing on my interview tour. Granted, both hotels were not provided for by the program. (Do med peds programs really pay for hotels?)

I think people who brown-nose are hit or miss. Some people, like yourself EXPD, get ticked off by it. Some people get a really strong impression from it. I think a person who is quiet and socially awkward unfortunately, probably is worse off in terms of interview impression than someone who is arrogant.

 

[Teamplaya]

I also went unmatched in Med/Peds this year and it's all very hard to understand.

I only applied to 20 programs in one region, interviewed at 10 but only ranked 8, since I was told by my dean that I would not need more to match given my qualifications (High passes in all 3rd year core clerkships and honors in all 4th year clearkships, 225/231 scores, excellent MSPE and great letters, with one publication and solid activities)

I'm a AMG from a top public school with no "red flags". However, I think I was hurt by the fact that people at my school are not very familiar with Med/Peds; although last year we had 2 students (with similar records as mine) match into very good programs, both of which interviewed me.

when will we have data from this year's match? I'd like to know how competitive it was this year...

 

[loca Dr. chica]

thank you for those who have shown sympathy. didn't match - I came from a lower-tier state school, step scores 231/226, a few clinical honors, but very good evals and mspe/letters of rec very favorable according to multiple folks incl. the dean of my med school, applied last year, but decided to take a yr. off late in the game and didn't rank any programs to focus on international work - this was b/c this was a large reason I came into med school and being in a combined 4 yr MD/MBA program didn't help the scheduling of international exp. too much. During my year off, did 2 months abroad, did an extra ICU rotation, did some data gathering which was supposed to yield a huge paper but didn't. Applied to 20+ med-peds programs, only got 6 interviews, ranked them and didn't match. Tried to scramble into a IM/Peds prelim/categorical pretty much anything yesterday and failed. Added on family med and surgery prelim too and cast my net pretty wide. Had the peds pd at my school call on my behalf to people and still no contract for next year. i don't know what to do...i've called everyone i can think of for positions. I want to do clinical medicine. I haven't failed anything and people know that i'm compassionate and genuine. I've never been told i'm arrogant and i got very positive feedback from my interviewers/programs. i also historically have tended to interview well and besides the theory that i am somehow socially inept doesn't seem to hold considering all of the extracurriculars i've done and the experiences i've had within and outside of medicine. My dean is perplexed b/c he can't find anything wrong with my application. If any of you know of any positions open in IM or peds, please pm me. Thanks

 

[psychotrope]

these stories just aren't making a lot of sense to be honest. Several 230ish type amg students with no red flags and excellent core clerkship grades not matching in med-peds? Just doesn't add up......I don't think we are getting the whole story.

 

[.edu-MD]

these stories just aren't making a lot of sense to be honest. Several 230ish type amg students with no red flags and excellent core clerkship grades not matching in med-peds? Just doesn't add up......I don't think we are getting the whole story.

Every place I interviewed at said both the number and the quality of apps were up this year.

I think the # of programs ranked is misleading. Charting outcomes does a disservice by charting only the number of programs ranked vs match rate. I think it would be more helpful to see the number of spots ranked vs match rate. Ranking 10 programs having 4 spots each is much different than ranking 10 programs having 8 spots each. You're ranking twice as many spots in the latter scenario.

 

[psychotrope]

Every place I interviewed at said both the number and the quality of apps were up this year.

I think the # of programs ranked is misleading. Charting outcomes does a disservice by charting only the number of programs ranked vs match rate. I think it would be more helpful to see the number of spots ranked vs match rate. Ranking 10 programs having 4 spots each is much different than ranking 10 programs having 8 spots each. You're ranking twice as many spots in the latter scenario.

yeah, I agree with that point....

that said, if these posts are really true and med-peds amg "decent" applicants are having problems matching in med-peds, that is *bad* for the future of med-peds as a pure match specialty......

because these applicants(again if they are telling the whole story) could EASILY slide into a good peds program, or a good IM program.

I guess what will happen is candidates will rank 5 or so med-peds programs, 5 peds programs, and 5 IM programs......I know some do that now, but the whole thing just seems kind of sketchy. I mean peds is noncompetitive in general, IM is noncompetitive just to match, so why should med-peds be any different?

 

[psychotrope]

Every place I interviewed at said both the number and the quality of apps were up this year.

just a quick sidebar: every program in every field every year says this. You could be interviewing for family medicine at a program on probation three times in the last 5 years in montana, and they would still tell you that they are "amazed" by the quality of the applicants this year.

I interviewed in a not that competitive field at some not that competitive places, and they all told me the same thing. I wanted to say...."ummm, if the quality of the candidates are so great this year, what the heck am I doing here?"

 

[Teamplaya]

just a quick sidebar: every program in every field every year says this. You could be interviewing for family medicine at a program on probation three times in the last 5 years in montana, and they would still tell you that they are "amazed" by the quality of the applicants this year.

I interviewed in a not that competitive field at some not that competitive places, and they all told me the same thing. I wanted to say...."ummm, if the quality of the candidates are so great this year, what the heck am I doing here?"

Not sure what the numbers will show in the end but just based on the fact that there were only 4 spots left in the entire country this year, probably means that the number of apps went up. Also, 2 program coordinators told me they had to add interview dates compared to last year in order to accommodate all the qualified applicants...

I know that when I reapply next year, I'll also go for IM and maybe even Peds...

 

[johnnywalker]

So why can't MedPeds be more competitive? And how is more competitive apps worse for MedPeds?

I chose and matched into MedPeds and not medicine or Peds exclusively and while there is obvious overlap it is a separate entity as recognized by nrmp. so if there is actually an increase in applicants and already a limited number of spots, isn't this what may happen?


The nrmp stats to be released later will hopefully shed some light on number of apps. So far I know that the number of scramble spots a year ago was 15.

 

[psychotrope]

So why can't MedPeds be more competitive? And how is more competitive apps worse for MedPeds?

I chose and matched into MedPeds and not medicine or Peds exclusively and while there is obvious overlap it is a separate entity as recognized by nrmp. so if there is actually an increase in applicants and already a limited number of spots, isn't this what may happen?


The nrmp stats to be released later will hopefully shed some light on number of apps. So far I know that the number of scramble spots a year ago was 15.

because med/peds doesn't provide anything outside of what a peds or IM residency does(and some would say it does less, but Im not going to go there).....

look, med-peds is not some distinct entity. It's medicine and pediatrics. Medicine and pediatrics are *easily doable* in terms of the match. Everyone knows that.

And obviously if you want to do med-peds you would also be ok with doing IM or peds, since thats what you are going to be doing all your residency.

I'm not speaking bad about med/peds, but I think meds/peds programs becoming "more competitive" wouldn't neccessarily be a good thing for med/peds....

And really, I think when the data comes out will see it was still noncompetitive. Also, all the data for med/peds is so altered because of the nature of med/peds. Say someone ranks a med/peds program #1, a peds program #2, an Im program #3....they match at the peds program. They get counted as a failed match for med/peds when in reality they may have been debating back and forth all night between their 1 and 2 before the submission deadline.......

 

[johnnywalker]

Also, at least at my program, it is a red flag if an applicant applies in either medicine or pediatrics additionally. We value dedication to MedPeds specifically, so those that apply, as a previous poster in this thread, mentioned would be unlikely be ranked very highly by many programs

 

[johnnywalker]

MedPeds is a distinct entity. Recognized by the nrmp. We have our own website, committees, and both national and regional conferences. But feel free to submit a poster at the next conference with your indepth knowledge of who we are.

 

[psychotrope]

MedPeds is a distinct entity. Recognized by the nrmp. We have our own website, committees, and both national and regional conferences. But feel free to submit a poster at the next conference with your indepth knowledge of who we are.

oh give me a break....Im not talking committee issues or "your own conference" issues here....I could care less about that, and so could most everyone else. Medicare and private insurance could too btw.

If a candidate wants to do peds they will do peds. If a candidate wants to do IM they will do IM. If a candidate can't decide or wants to do both, they may consider IM/peds......which is why if that is a qualified candidate it is in med-peds best interest to be noncompetitive.

 

[johnnywalker]

A future psych resident commenting essentially gibberish on a field he or she didn't apply to and currently knows little to nothing about. Sweet. Did I mention we have t shirts too?.

 

[Scaredshizzles]

oh give me a break....Im not talking committee issues or "your own conference" issues here....I could care less about that, and so could most everyone else. Medicare and private insurance could too btw.

If a candidate wants to do peds they will do peds. If a candidate wants to do IM they will do IM. If a candidate can't decide or wants to do both, they may consider IM/peds......which is why if that is a qualified candidate it is in med-peds best interest to be noncompetitive.

Two points:
1. According to NRMP data, med-peds has traditionally been a little more competitive than both medicine and pediatrics. Higher USMLE scores (225,235 the average last year) and more AOA (i.e. >20% are AOA Vs. 15% in im, 10-15% in peds, 10% in anesthesia, etc.)
2. Most med-peds programs are at university programs and generally speaking, a lot of high quality university programs. This is probably what makes it more competitive than categoricals in general. Additionally, med peds programs have gone down less far on their match list than categoricals. (i.e. 4.5 ranks per spot filled versus 5.5 or 6 per spot for medicine.)


If med peds was this competitive this year, I think it is high time to do something about IMGs pre-matching. The number of US grads is increasing, whereas the number of funded residency programs is not. I know IMGs are competent, but it is the tax dollars of American citizens that fund these programs, and IMGs as a result should be treated as second class citizens. If they want equal treatment, they should come to the US for undergrad and medical school, and incur the same debt that AMGs incur. That is the bottom line as far as I'm concerned.

 

[drknockboot]

these stories just aren't making a lot of sense to be honest. Several 230ish type amg students with no red flags and excellent core clerkship grades not matching in med-peds? Just doesn't add up......I don't think we are getting the whole story.

Psychotrope: since you obviously weren't applying into med-peds, I sure hope you matched into private investigation. That really appears to be your calling. I would have thought that in your all investigations you would also note that it's NOT simple to just slide into a categorical medicine position - this year's 53 open scramble spots was incredibly low. 47 in pediatrics also is not very high.

The fact is that med-peds is becoming increasingly competitive, and for good reason. It's a great field with good training with great opportunities beyond residency. They even have T-shirts.

 

[sunset823]

psychotrope, before you go calling med-peds uncompetitive (and claiming it should be), look at the bios of people who matched to the social medicine residency at BWH, most of whom are med-peds:

http://www.brighamandwomens.org/socialmedicine/gheresidency.aspx
http://www.brighamandwomens.org/residency/MedPeds/CurrentResidents.aspx

Yes, this is the most prestigious program out there, but it's true that most med-peds programs are at prestigious medical centers. It is going to get more competitive, not less, because the people who go into it are in general superstars with interest in community/global health, etc.

 

[winaq]

drumroll please...my redflag was a pass in my 12-week junior medicine clerkship. no other red flags. high passes in my other junior medicine clerkships.

oh, but i am a little soft-spoken, which didn't help much when i proceeded to get trashed at the pre-interview residents' dinners and then offered to drive everyone home.

joking aside, if there is a "problem," it is NOT the number of applicants, IMG, AMG or anything else. the problem is that rigorously trained physicians who can be primary care providers across a spectrum of ages, diseases and degrees of severity is not a priority for the powers-that-be. this is particularly troubling given that med-peds practices (fortuna, ting et al academic med 2009) take care of the populations most marginalized by the current medical system. last i heard, med-peds gme programs have not been included in the specialties that would receive increased funding--for more trainees--that other primary care specialties will.

 

[psychotrope]

Ok.....then I'll spin this around another way. If med-peds spots are competitive, then why doesn't every non-superstar candidate just rank a bunch of their favorite peds or IM programs(depending on which they prefer)?

If med-peds is competitive, you guys are getting the short end of the stick.....because when you see a kid you can't do anything a general pediatrician can't do, and when you see an adult you can't do anything an internist can't do.

My point was that *each patient encounter* is either as a primary care pediatrician or a primary care internist, and neither of those are competitive.

I guess I just don't get it. If I was gung ho on med-peds I would also be gung ho on medicine and pediatrics obviously, so I would apply to all three.....

also, can med-peds people do fellowships in cardiology or GI(either for medicine or peds)?

 

[Teamplaya]

Ok.....then I'll spin this around another way. If med-peds spots are competitive, then why doesn't every non-superstar candidate just rank a bunch of their favorite peds or IM programs(depending on which they prefer)?

In my case, I did not expect Med/Peds to be this competitive based on my personal research into the speciality and information my dean provided (again, my school is not very familiar with Med/Peds). Next time, I'll rank categorical programs as well.

Also, from my experience this year in the interview trail, the specialty attracted very smart, dedicated people who were either all about Global Health and/or a particular subspecialty (and yes, you can do any subspecialty in either IM, Peds or in some cases combine the two). Very few people I met were interested in primary care, in general.

 

[psychotrope]

In my case, I did not expect Med/Peds to be this competitive based on my personal research into the speciality and information my dean provided (again, my school is not very familiar with Med/Peds). Next time, I'll rank categorical programs as well.

Also, from my experience this year in the interview trail, the specialty attracted very smart, dedicated people who were either all about Global Health and/or a particular subspecialty (and yes, you can do any subspecialty in either IM, Peds or in some cases combine the two). Very few people I met were interested in primary care, in general.

if very few were interested in primary care, it makes even less sense to me to do med-peds.

Say someone does med-peds, then an adult GI fellowship. Why not just do IM and then an adult GI fellowship?

You've spent an extra year of training, and if you do the adult GI fellowship you're not going to see kids anyways in your practice.......

plus, the *vast* majority of GI, cards, etc directors are IM trained(or peds trained if they are peds GI or peds cards), not med-peds. Not sure how big of a disadvantage that is, but it certainly can't help

 

[Cirrus83]

I know someone with an even higher Step 1 score than yours and great clinical grades, went on a ton of interviews, and barely got a normal IM residency at all and only got one because their home program took them in. And really what did this person in was what must have appeared to the programs as quite a bit of arrogance, although they themselves may have been under the belief that their attitude was "hilarious" or something of the sort. Either way, this person even got a chance beforehand to at least try to tone it down because they were told multiple times by close friends but I guess it was to no avail.

 

[group_theory]

Ok.....then I'll spin this around another way. If med-peds spots are competitive, then why doesn't every non-superstar candidate just rank a bunch of their favorite peds or IM programs(depending on which they prefer)?

If med-peds is competitive, you guys are getting the short end of the stick.....because when you see a kid you can't do anything a general pediatrician can't do, and when you see an adult you can't do anything an internist can't do.

My point was that *each patient encounter* is either as a primary care pediatrician or a primary care internist, and neither of those are competitive.

I guess I just don't get it. If I was gung ho on med-peds I would also be gung ho on medicine and pediatrics obviously, so I would apply to all three.....

also, can med-peds people do fellowships in cardiology or GI(either for medicine or peds)?

There are certain advantages. There are common medicine problems that can show up in the pediatric population, and there are complex pediatric kids who are becoming adults. There are diseases than span all age-ranges (and can be rare in either extremes). I think the dual training is helpful and brings an interesting perspective to each side of the table.

Med-Peds is popular because it gives its graduates the widest range of possibilities. You can work in an outpatient setting (and can tell anxious parents that they are board certified pediatricians). You can become a hospitalist in Medicine, Pediatrics, or both. You are eligible for fellowships in either medicine, pediatrics or both. Some Med-Peds graduates go on to become neonatologist, while others have gone on to become geriatricians. There have been peds cardiologist, adult cadiologist, and a few have done combined adult-peds cardiology fellowships. There are med-peds rheumatologist, pulmonologist, ID, nephrologists, etc. There are many in medicine who cannot handle pediatrics. There are those in pediatrics who cannot handle medicine. But for those who enjoy both, the price of an extra year of training compare to the flexibility it offers along with that additional knowledge can be alluring.

While it is obvious that Med-Peds does not interest you, as you can see from the match numbers as well as the numbers of available programs, there are plenty of people who see the benefits of Med-Peds.

 

[psychotrope]

There are certain advantages. There are common medicine problems that can show up in the pediatric population, and there are complex pediatric kids who are becoming adults. There are diseases than span all age-ranges (and can be rare in either extremes). I think the dual training is helpful and brings an interesting perspective to each side of the table.

Med-Peds is popular because it gives its graduates the widest range of possibilities. You can work in an outpatient setting (and can tell anxious parents that they are board certified pediatricians). You can become a hospitalist in Medicine, Pediatrics, or both. You are eligible for fellowships in either medicine, pediatrics or both. Some Med-Peds graduates go on to become neonatologist, while others have gone on to become geriatricians. There have been peds cardiologist, adult cadiologist, and a few have done combined adult-peds cardiology fellowships. There are med-peds rheumatologist, pulmonologist, ID, nephrologists, etc. There are many in medicine who cannot handle pediatrics. There are those in pediatrics who cannot handle medicine. But for those who enjoy both, the price of an extra year of training compare to the flexibility it offers along with that additional knowledge can be alluring.

While it is obvious that Med-Peds does not interest you, as you can see from the match numbers as well as the numbers of available programs, there are plenty of people who see the benefits of Med-Peds.

it seems like most of the advantages you list above deal with "keeping your options open" longer. To me thats not worth the extra year. If you're undecided on peds cards or cards, that must mean you like both. So just take the plunge and pick IM or peds.

Also, for those that don't do a fellowship, how many actually see both 1 year olds for scheduled checkups and 75 year olds for refills on their htn meds? If they do that's fine. Thats also what my family medicine physician does.

 

[group_theory]

it seems like most of the advantages you list above deal with "keeping your options open" longer. To me thats not worth the extra year. If you're undecided on peds cards or cards, that must mean you like both. So just take the plunge and pick IM or peds.

Also, for those that don't do a fellowship, how many actually see both 1 year olds for scheduled checkups and 75 year olds for refills on their htn meds? If they do that's fine. Thats also what my family medicine physician does.

If it's not worth it to you, then don't do it. Med-Peds isn't for everyone, and it is obvious that you're not interested.

As for your follow-up question - there are studies in academic journals that answer your questions.

 

[psychotrope]

If it's not worth it to you, then don't do it. Med-Peds isn't for everyone, and it is obvious that you're not interested.

As for your follow-up question - there are studies in academic journals that answer your questions.

I'm sure there are....there are studies in journals that answer 99% of the questions on here. But some questions(ie my curiosity over how many med-peds primary care physicians see both infants and adults) is not such a question that requires me doing a massive journal search for....

that's sorta what forums are for.

 

[johnnywalker]

pubmed and the like are "massive journal searches?"

 

[johnnywalker]

.http://www.medpeds.org/resources/MedPedsBibliography.pdf

 

[johnnywalker]

if you are actually interested in the answers to your questions.....

http://www.medpeds.org/resources/MedPedsBibliography.pdf

go nuts

 

[drknockboot]

it seems like most of the advantages you list above deal with "keeping your options open" longer. To me thats not worth the extra year.

This is a debate that has been had many times before, and is out of place in this thread. If you'd like to know why people choose med-peds, start a new thread...or better yet, read the plenty prior to this that discuss that topic.

Otherwise... :troll:

 

[civic4982]

... think of other ways to see adults and kids such as family medicine where there are lots of openings this year.

+1

Have you thought about going to family medicine? It may be a good alternative to med-peds depending upon where you see your career going and as a strong candidate you'll be sure to be able to get your pick.

I thought about going to internal medicine from my ob/gyn PGY1 residency this year but decided that I wanted to stay doing OB and so I picked FP.

I have only middle of the road scores but ended up having the pick of the litter when it came to FP programs and got into my top choice at a program that is exactly what I wanted (lots of operative OB opportunities and unopposed).

I have been trying to assist another friend of mine who is going through a similar situation as you here in Houston and it's been super tough. He was a top notch candidate without a doubt and is trying to find another place to go for next year.

If you end up looking in Texas for Family Medicine programs let me know. I've basically done the shake down on almost all of them by this point.

 

[Bernito]

it seems like most of the advantages you list above deal with "keeping your options open" longer. To me thats not worth the extra year. If you're undecided on peds cards or cards, that must mean you like both. So just take the plunge and pick IM or peds.

Also, for those that don't do a fellowship, how many actually see both 1 year olds for scheduled checkups and 75 year olds for refills on their htn meds? If they do that's fine. Thats also what my family medicine physician does.

It is not just about options.

Cards example: A generalist can still treat cardiac issues, but often refer to specialists for expertise. A med peds-ers with subspecialty training in adult or peds is still licensed to treat the other demographic and can do so in many cases with cross-over knowledge. There are many fields with significant cross-over (ID, Allergy, Rheum).

Also, many med-peds trainees are interested in helping the underserved and international health and they don't like the idea of being able to treat the parents and not the children or vice versa.

 

[Teamplaya]

So it seems like Med/Peds was indeed much more competitive this year based on prelim numbers. I have copied & pasted this report on this year match from the MPPDA (http://www.aap.org/sections/med-peds/Med-Peds_MatchSynopsis_2010.pdf) I apologize for any problems with formatting.​

Internal Medicine-Pediatrics Match Synopsis 2010​

​

What a fantastic year for Med-Peds! The 2010 recruitment season was a busy time for both program directors and applicants. We saw an overall increased interest in Med-Peds with applications significantly higher than last year with overall fantastic success with the match.

The 2010 Main Residency Match included 78 combined internal medicine-pediatrics programs, which is a decrease by one from the 2009 match. There were 359 positions offered this year, which is an increase from 354 positions in 2009. The total number of applicants to combined Med-Peds programs was 661, of which 389 (59%) were US seniors. In the 2009 match, there were 585 total applicants (50% US seniors). This is an increase of 76 applicants, 12% overall. This increase is something we should all take pride in and celebrate.

Regarding the fill rate, 355 of the 359 positions filled for a success rate of 99%. In the scramble, all programs were successful in filling! US seniors are responsible for 299 (83.3%) of our successful matches. The 2010 data reveal that Med-Peds matches represent 1.6% of the total positions offered in the match. This rate is stable over the past five years, with the total number of positions this year decreased by 17 from 2006 (see table below for historical data). Med-Peds residents represent 7% of the total pool of incoming categorical medicine interns and 15% of the incoming pediatric residents.

2010​

2009​

​

2008​

​

2007​

​

2006​

​

359 (1.6%)​

​

354 (1.6%)​

​

362 (1.6%)​

​

378 (1.7%)​

​

376 (1.7%)​

​

Our categorical colleagues had the following results:

Internal medicine: The total number of programs was 377 with 4,999 positions offered. The total number of applicants was 9,552, which is a 3% increase compared with 2009. US seniors will occupy 54.5% of these positions in 2010, which is relatively unchanged from last year.

Pediatrics: The total number of programs was 209 with 2,428 positions offered. The total number of applicants was 3,668 which is a 4% increase compared with 2009. US seniors will occupy 70.5% of these positions in the next academic year, which is the same as last year.




Looking at the family medicine statistics, there were 454 programs that entered the match, offering 2,608 positions. This is an increase of 3% in the number of available positions; there was one less program in the match compared with 2009. Their success in filling this year was 91.4% which is the same as last year. US seniors will occupy 44.8% of the total positions.

Overall, there were 16,427 US allopathic seniors who participated in the match this year, which is an increase from 16,008 last year. Osteopathic schools were on target with 70% of their students successfully matching in PGY-1 spots for next year.


Take-home points include (all those numbers can be confusing!):

• <LI class=MsoNormal>Med-Peds had an increase in applicants this year by 22% overall. <LI class=MsoNormal>Med-Peds had a 99% initial success in the match this year with 100% success in scramble efforts! <LI class=MsoNormal>There was one less Med-Peds program but five more positions in 2010. <LI class=MsoNormal>US seniors make up 83.3% of our incoming applicants this summer, compared with 54.5% in internal medicine and 70.5% in pediatrics.
• Applications to Med-Peds, categorical internal medicine, categorical pediatrics, and family medicine were all up this year.

While there is still some outstanding information, such as the number of applicants taken outside of the match, the above data are very positive. We should all take pride in the efforts we expend every day on behalf of training residents in Med-Peds. We need to sustain these efforts and continue to actively recruit students. The past two years have been very busy for program directors with initial accreditation, site visits, paperwork, budget cuts, more paperwork, and the challenges of life each day. And things will stay busy as we are about to undergo the review and revision process of our accreditation requirements (take a big breath and look for email from me soon). However, we make a huge difference to residents and this year we all need to celebrate our fantastic success!


Suzanne K. Woods, MD
President
Medicine-Pediatrics Program Directors Association