I have looked at the match stats but have yet to look at scutwork. I have also looked at the websites for all of the combo programs. I saw that em/peds did not fill and also saw on frieda that the average number of PGY1 interviews was 6. But I didn't really understand if this was because they aimed too high with the candidates they interviewed or because people don't want to do the long programs.
I must admit, my line of reasoning for considering em/peds (more so than em/im) is this... I am a US-IMG going to school in Sydney, Australia. Great school
in a great city
which has provided me with the best experience of my life
BUT
not that great for getting back into EM programs. As you may know, only 47 US-IMGs matched to PGY1 programs in 2004 (which I suspect probably had spectacular 260+ on their boards vs my average Step 1).
I am passsionate about doing EM and not settling for a career doing FP or IM (which I could get into easier). If it takes a few extra years and takes care of the fellowship as well, than I am willing to submit to that.
All that said, I have thought about peds EM and don't think it would hurt at all to have done the combo program and come out doing peds EM in the end. Ideally though, I would want to match EM and decide that around fellowship time.
At the end of the day, I will have several US EM letters and, due to better circumstances, probably a better Step 2 score BUT still may not be enough to get the interview. It's all about facing reality and working with what you have.