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Discussion in 'Combined Residencies' started by Vytorin77, May 4, 2007.

  1. Vytorin77

    Vytorin77 New Member 2+ Year Member

    Jul 12, 2006
    Anyone thinking about the 5-year combined EM/Peds programs? I am very interested in ultimately doing Peds EM and am going to do several sub-Is in both Peds and EM to decide which path to take. I was also considering maybe applying to these combined programs, but from what I am reading then you are not eligible to take Peds EM boards. Does anyone know how this would impact future employment? Has anyone out there looked into these programs or know what the residents experiences with them tend to be? Thanks.
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  3. EmPedsDo

    EmPedsDo Grad student at KCUMB 2+ Year Member

    Jan 30, 2007
    Century Towers
    I too am really interested in Peds EM. I really like the Em/Peds programs but don't understand why these individuals are not allowed to sit for Peds Em boards. Is it simply b/c they've had no fellowship training? Can Em/Peds residents enter a Peds Em fellowship?
  4. goongirl

    goongirl 2+ Year Member

    Dec 28, 2006
    EM/Peds residents can do a Peds EM fellowship. I've also heard that they can sometimes work in a peds ED w/o the fellowship training, but I wouldn't personally bank on it. I would check out Indy's EM/Peds program website, It has a ton of good info. about the residency and how it's different from the fellowship. It also has a listing of its grads and where they are now. Most are working in Peds EM or EM with a peds focus, it seems...
  5. Tired

    Tired Fading away 7+ Year Member

    Dec 12, 2006
    If you want to do Peds ER, why would go through a combined program? Do Peds, and go on to Peds ER fellowship, or do ER, and go on to a Peds ER fellowship.

    Honestly, I don't get these combined programs. Hard to believe the fad will last long.
  6. ChildNeuro

    ChildNeuro Junior Member 5+ Year Member

    Jun 22, 2005
    San Francisco
    In the past alot of pediatricians could just work in the ED, but today things are getting more and more regulated, I would aim to be BE/BC in Pediatric Emergency Medicine. It will/is getting harder and harder to get a job in a pediatric emergency room without BE/BC in pediatric emergency medicine.
  7. Apollyon

    Apollyon Screw the GST Physician Lifetime Donor Classifieds Approved 10+ Year Member

    Nov 24, 2002
    Politics. Period. From years ago.
  8. DeadCactus

    DeadCactus SDN Lifetime Donor Lifetime Donor Classifieds Approved 10+ Year Member

    Oct 28, 2006
    I'm keeping the idea in mind (along with EM/FP).

    I originally just blew it off as a waste of two years after reading a lot of opinions on it here (with the general concensus being; you never do both so one goes to waste).

    That changed recently though. There is an EM/Peds Doc at the hospital I am volunteering at. At a larger hospital in a bigger city; I can definately see where the "useless" opinion is coming from. I'm at a small town rural hospital however, and the double boarded Doc is a great asset here because he fills two holes in the staff. He works the ER, but is also someone that can be called in at 3am when a pediatric issue arises.

    He's obviously not making as much use of the Peds Cert as a full time Pediatrician, but he can fill a hole when needed and has the personal benefit of being able to practice some pediatrics when EM gets monotoneous.

    Just my $0.02 from my observations...
    KaapstadMK likes this.
  9. coldflare

    coldflare Peds in Florida : ) 10+ Year Member

    Feb 7, 2007
    There are a few reasons why you might want to do a combined program instead of a fellowship. Let's say you're a peds resident interested in emergency medicine. Do you do a fellowship or a second residency? They both take three years. One isn't necessarily better than the other - they are completely different training. True, you may be able to get a job in a peds ER with either set of certifications, but there's no guarantee how long it might be before children's hospitals want only fellowship-trained doctors.

    But what if you aren't interested in living in a large city with a children's hospital? It's pretty tough for a pediatrician to take a sub-board certification into a community hospital, simply because most don't have the volume of pediatric visits to support a peds EM doc who cannot see adults. But a physician with dual-board certification is highly desirable to those same groups - they often need another general EM doc who has peds experience. True, you could do an EM residency and then a peds fellowship and still fill this position, but what happens if you burn out down the road (as many EM physicians do)? If you had done both residencies, you would have a full certification in peds to fall back on.

    Also, many dual-board certified attendings keep appointments in both departments, or work primarily in an ED but also do some work in pediatric clinics, so it's not entirely true that one certification goes to waste. (See "A survey on the graduates from the combined emergency medicine/pediatric residency programs." Journal of Emergency Medicine. 2007 Feb. 32(2):137-140.)

    So if there is some value in having certifications in both EM and Peds, which I think there is, then a combined residency is a good choice - it saves a year, it offers a stable five years instead of having to match all over again halfway through, and it allows you to learn both fields simultaneously, instead of concentrating on one field and then forgetting it as you throw yourself entirely into another one.
  10. elee20

    elee20 Senior Member 7+ Year Member

    Dec 17, 2003
    the best place on earth
    how competitive is the peds/em combined residency?
  11. bks524

    bks524 7+ Year Member

    Aug 31, 2007
    I work in a peds ER and have only peds training. Still is deffinately possible as their are few Peds ER fellowship positions. More demand for people than there are spots.

    I thought about doing the extra training. To me the previous posters comments were my own thoughts. I thought it much more valuable to be dual trained in peds and ER with board certifications in both. Most places including academics look at them equally (that being fellowship trained vs Peds/ER trained). There are many more opportunities for the latter also (peds/er).

    Also, pay is usually better with Peds/ER because you can work with adults. The fellowship is pretty competitive and you are not guaranteed to pass your boards after fellowship since the pass rate is around 60%.

    The downside of Peds/ER- a second residency is a lot harder than a fellowship in terms of hours and call. Also you will not get the academic exposure that the fellowship provides.

    Finally, I do know a girl from my home institution that went to Maryland for the combined program. They are all good though I think there are only 3.
  12. bubbles!

    bubbles! Junior Member 7+ Year Member

    Mar 31, 2006
    EM/Peds resident here and currently job searching so I think I can speak to some of the misconceptions that I commonly hear about the combined residency.

    1. You need to be fellowship trained to work in Pediatric EDs: This is not globally true. The majority of our graduates work in a pediatric EDs and many are at major academic centers. EM/peds combined training is relatively new, with just about 100 graduates nationwide, so I anticipate the dual board pathway will become more acceptable as the specialty becomes more visible. While some centers do prefer PEM fellowship trained physicians, the vast majority across the country would enthusiastically hire an EM/Peds trained physician.

    2. Em/peds training is a waste since most people won't practice in both specialties I am personally familiar with many Em/peds graduates who have careers that make use of both sides of their training. Some split time between adult and pediatric EDs, some are the pediatrics specialists for EM groups, some work in EDs and do pediatric hospitalist, urgent care, or primary care clinic on the side. The job possibilities are really limitless.

    3. You get better academic training in a PEM fellowship All three Em/Peds combined residencies are housed at major academic centers. You would have all the research and educational opportunities available you could dream of and you have five years to take advantage of those opportunities as opposed to the 2 or 3 years of fellowship. Since you have extra electives during those 5 years, you would certainly be able to integrate some dedicated research time if that is of interest to you. Indiana University is also going to offer the opportunity to work towards an MPH as part of the EM/Peds residency.

    4. You lose money by doing a combined residency In most Em/peds programs, you are paid by PGY year so you make equivalent of fellow salary by the time you're a 4th and 5th year resident. There are also moonlighting opportunities available throughout residency.

    I highly recommend IU's FAQ page if you're debating dual-training. You can also PM me with any specific questions.

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