Thoughts on med-peds?

[Bluesaurus]

Is it significantly more competitive than say internal medicine alone?

Also because it's 4 years and some of it goes to Peds, do people miss out on enough Medicine training?

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[drizzt3117]

I think that the run of the mill med peds program is more competitive than the run of the mill medicine program simply because there aren't that many med peds programs yet. That said, I'm not sure that there are well-established top academic med-peds programs yet, so the top medicine programs might be more competitive. I don't think you lose much in training with only two years of IM. Just keep in mind if you want fellowship training in many cases you may need to do extra years to be double boarded as I understand it.

 

[BigRedBeta]

Is it significantly more competitive than say internal medicine alone?

Also because it's 4 years and some of it goes to Peds, do people miss out on enough Medicine training?

In general, it's a less competitive match, but year to year it's dependent on the overall interest from applicants. The popularity fluctuates year to year, perhaps more so than any other residency.

The hard part is that there are very few places that are exceptionally strong in both fields. In many cases, you are sacrificing "great" training in one field. There are some locations that you do med/peds because you like medicine but the real draw is the pediatric training, and in other places, your pediatric training is just kind of tacked on and you get exceptional medicine training.

The med/peds residents I know are some of the most talented doctors I know. Most of them actually say that the pediatrics boards are more difficult than the medicine boards (which is confirmed when you look at the overall board pass rates for each specialty). Do you sacrifice somewhat from being the best internist by doing med/peds? Probably, but you're also not the greatest pediatrician you could be. You miss on electives that round out your education in both fields, but what do you expect from only doing 2 years instead of the normal 3 in both fields?

I think that if you're someone who wants do primary care but has no interest in any sort of OB, than Meds/Peds is by far the best choice. You'll end up being a competent internist and pediatrician. Very few FP programs will be able to match the level of ICU experience a med/peds resident recieves whether it's the NICU, PICU or MICU. And let's face it, the hard part of being a doctor is taking care of the really sick patients.

The other major strength for a med/peds residency is that it keeps your options open. You can go into any fellowship from medicine or peds, from Neonatology to Geriatrics, and you're uniquely positioned to be the specialist that transfers care from pediatric concerns to adult concerns. This is a niche that is growing exponentially as the pediatric cardiologists and pulmonologists are getting better and better at keeping their patients alive to adulthood, while the adult specialists have no experience in the pediatric/congenital disease processes like congenital heart disease or cystic fibrosis.

 

[Pons Asinorum]

OP, you have 65 posts. You've started 30 new threads, most of them asking which residency is more competitive or you should go into. I don't think you're going to find the answers to your problems on this forum, but by all means keep running these "CT surg vs EM vs Meds-Peds" threads up the flagpole.

 

[chiz2kul]

In general, it's a less competitive match, but year to year it's dependent on the overall interest from applicants. The popularity fluctuates year to year, perhaps more so than any other residency.

The hard part is that there are very few places that are exceptionally strong in both fields. In many cases, you are sacrificing "great" training in one field. There are some locations that you do med/peds because you like medicine but the real draw is the pediatric training, and in other places, your pediatric training is just kind of tacked on and you get exceptional medicine training.

The med/peds residents I know are some of the most talented doctors I know. Most of them actually say that the pediatrics boards are more difficult than the medicine boards (which is confirmed when you look at the overall board pass rates for each specialty). Do you sacrifice somewhat from being the best internist by doing med/peds? Probably, but you're also not the greatest pediatrician you could be. You miss on electives that round out your education in both fields, but what do you expect from only doing 2 years instead of the normal 3 in both fields?

I think that if you're someone who wants do primary care but has no interest in any sort of OB, than Meds/Peds is by far the best choice. You'll end up being a competent internist and pediatrician. Very few FP programs will be able to match the level of ICU experience a med/peds resident recieves whether it's the NICU, PICU or MICU. And let's face it, the hard part of being a doctor is taking care of the really sick patients.

The other major strength for a med/peds residency is that it keeps your options open. You can go into any fellowship from medicine or peds, from Neonatology to Geriatrics, and you're uniquely positioned to be the specialist that transfers care from pediatric concerns to adult concerns. This is a niche that is growing exponentially as the pediatric cardiologists and pulmonologists are getting better and better at keeping their patients alive to adulthood, while the adult specialists have no experience in the pediatric/congenital disease processes like congenital heart disease or cystic fibrosis.

I've always wondered about this too. Thanks for your very insightful answer.

 

[DrKnowLittle]

BigRedBeta,

Well summarized. I did have one comment though about the assertion that programs lack exceptional training in both categorical specialties.

There are currently 77 Med-Peds programs with an average of ~5 residents per program. With separate accreditation standards for Med-Peds residency the onus is on these programs to make sure that neither the Peds or Medicine experience is neglected. As a result, it's caused the demise of some Med-Peds programs (there used to be about 100 programs). With that being said, not all Med-Peds programs are equal, though they're certainly more streamlined and organized across the board than the wide spectrum of categorical Medicine or Pediatric programs. While none may be considered exceptional in terms of notoriety, residents are well-equipped for fellowship opportunities because of what you stated in your post - the med-peds residents tend to be very on the ball.

I think the answer to this question really needs to be qualified. There is a very distinct tier system in internal medicine and pediatrics. There are exceptional (famed) programs, good programs, decent programs, and 'heck, I'm doing internal medicine at least' programs. The same goes for pediatrics. I don't think that tier system is there as much for med-peds. As a result, I think the average candidate will find it to be a more competitive process than that same person applying to a comparable internal medicine or pediatrics residency program.

 

[drizzt3117]

It seems like some of the programs are pretty elite at both medicine and peds (bwh/bch) and I'd imagine they'd be pretty competitive...

BigRedBeta,

Well summarized. I did have one comment though about the assertion that programs lack exceptional training in both categorical specialties.

There are currently 77 Med-Peds programs with an average of ~5 residents per program. With separate accreditation standards for Med-Peds residency the onus is on these programs to make sure that neither the Peds or Medicine experience is neglected. As a result, it's caused the demise of some Med-Peds programs (there used to be about 100 programs). With that being said, not all Med-Peds programs are equal, though they're certainly more streamlined and organized across the board than the wide spectrum of categorical Medicine or Pediatric programs. While none may be considered exceptional in terms of notoriety, residents are well-equipped for fellowship opportunities because of what you stated in your post - the med-peds residents tend to be very on the ball.

I think the answer to this question really needs to be qualified. There is a very distinct tier system in internal medicine and pediatrics. There are exceptional (famed) programs, good programs, decent programs, and 'heck, I'm doing internal medicine at least' programs. The same goes for pediatrics. I don't think that tier system is there as much for med-peds. As a result, I think the average candidate will find it to be a more competitive process than that same person applying to a comparable internal medicine or pediatrics residency program.

 

[Radonkulous]

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[BigRedBeta]

It seems like some of the programs are pretty elite at both medicine and peds (bwh/bch) and I'd imagine they'd be pretty competitive...

There are a few which would be exceptional at both, but how do you rank a place that has fantastic medicine and only average or even mediocre peds training? Or what about the opposite - outstanding pediatrics but unremarkable medicine? How do you go about comparing them to each other?

I think if you are interviewing at places where both programs are special, then yes, it's a more competitive location than the single programs would be on their own due to the fewer number of spots and the fact that so few programs are great in both.

For the rest of the locations, the competition for med/peds is probably greater than the competition for the poor program, but less than the competition for the good program.

As far as Radonkulous's post is concerned...it's quite possible that my own personal version of hell would involve me being trapped in the reading room and forced to do nothing but read films. Medicine takes all types, and I'm thankful that someone wants to do rads, but dear lord you couldn't pay me enough money in the world to do that for a living.

 

[Radonkulous]

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[justdoit31]

I had looked at it but in the end I would just want to do Peds anyways and the physicians I talked to said it wouldn't help me reach my goals. You might want to truly evaluate where you see yourself practicing and what you want to do and see if it is really a program that would have benefits for you.