I have been looking at some specialties, and the one that grabbed my eye was Med-Peds, which is a combined program where u finish up becoming a Internal Medicine practitioner as well as a Pediatrician. This program is approved and u can apply for both boards. My question is if it will be easy for me to find a job as a MED-PED and if the people that have this education what are they doing know, are they practicing both Med and Peds ? Please do help. I would also like to know what is the exact diference between MED-PEDS and Family Medicine.
Med-Peds
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These forums might provide some insights:
SDN Combined Residencies Forum
SDN Family Medicine Forum
My knowledge is clearly limited as an MS-0. However, I did some research on a dual IM/Peds residency, as it is something I am interested in pursuing. You posted a thread in pre-allo a little while ago that is related to this one, and I provided what I know about some of the differences:
http://forums.studentdoctor.net/showthread.php?p=5093440
SDN Combined Residencies Forum
SDN Family Medicine Forum
My knowledge is clearly limited as an MS-0. However, I did some research on a dual IM/Peds residency, as it is something I am interested in pursuing. You posted a thread in pre-allo a little while ago that is related to this one, and I provided what I know about some of the differences:
http://forums.studentdoctor.net/showthread.php?p=5093440
D
deleted77919
As you will find elsewhere on this site (do a search, this one has been discussed in a few forums more than once) it is hard to try to do two things at once. Recruiters and groups have no idea what to group you as. If you start your own practice (or join a group) you will need coverage for both IM and Peds, so unless you find another IM/Peds that means getting two physicians to cover for you, unless 24 hour call is ok with you. (Statement on dual practice withdrawn, oldbearprofessor's study was more recent than the one last one I read).
As far as a comparison with FM, FM covers Ob that won't be covered in IM/Peds. However, you will learn more inpatient/critical care stuff doing IM/Peds than you will in FM. You will also spend more time with peds doing IM/Peds than with FM.
Finally, to quote a member of the EM forum, "You can't be a stem cell forever, eventually you will need to make a choice" as to what you are going to practice. This is not true for everyone, and it's great to hear that many are able to use their combined training. The point, I suppose, is that you need to have a clear goal in mind for the type of practice you envision. Then spend time with people who have the credentials you are considering. This will help you see what a real practice environment is like and also help you determine the feasibility of your original idea. Best of luck.
As far as a comparison with FM, FM covers Ob that won't be covered in IM/Peds. However, you will learn more inpatient/critical care stuff doing IM/Peds than you will in FM. You will also spend more time with peds doing IM/Peds than with FM.
Finally, to quote a member of the EM forum, "You can't be a stem cell forever, eventually you will need to make a choice" as to what you are going to practice. This is not true for everyone, and it's great to hear that many are able to use their combined training. The point, I suppose, is that you need to have a clear goal in mind for the type of practice you envision. Then spend time with people who have the credentials you are considering. This will help you see what a real practice environment is like and also help you determine the feasibility of your original idea. Best of luck.
N
njbmd
Moving to Combined Residencies (Med-Peds included there) for replies from folks who are in the field. Allopathic students can follow and reply there.
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The philosophy between Family Med and Med-Peds is different. Family Med is definitely community/public-health oriented. Med-Peds can be, but it can also be inpatient/hospitalist oriented.
Med-Peds lets you specialize in GI, cardiology, pulmonology, endocrinology, etc. Family Med does not.
Family Med residents must rotate through OB/Gyn and surgery. Med-Peds residents do not have any formal surgical or OB/Gyn training.
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I'll let the actual med-peds folks respond to your other statements.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=pubmed
2004 paper looking at the most recent grads who've had enough time to set up practice...
RESULTS: Responses were obtained from 92% (83/90) of the programs, reflecting 1,595 residents entering med-peds programs. Of these residents, 91% graduated from a med-peds program. Among the graduates, 82% were seeing both adults and children, 22% went on to subspecialty residencies, 21% began practice in rural or underserved areas, and 25% entered an academic position. ABIM and ABP pass rates for the 1998 cohort were 97% and 96%, respectively. Overall, 79% of the 1998 graduates are board certified in both specialties. CONCLUSIONS: Compared with previous studies, a greater proportion of residents who recently entered med-peds programs completed their dual training, and a larger percentage of graduates are seeing both adults and children.
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One way to compare FP and Med/Peds is what you can do with one degree but not the other, i.e.
Family Practice: You have the possibility via extended training in ob/gyn during residency to deliver babies in certain controlled settings, i.e. some FP programs have a big focus toward ob/gyn. Or you could do minor surgeries, some FP programs have a focus in minor surgeries. You could go on to get one of the few fellowships offered to Family Practice residency graduates like sports medicine, geriatrics or adolescent medicine and that is all!
Med/Peds: You are board certified in both peds and medicine, and therefore can receive a fellowship training in any area offered to pediatrics or internal medicine residency program graduates i.e. cardiology, pulmonology/ICU, critical care, hematology/oncology, infectious disease, nephrology, GI. If you do do a fellowship, let's say in hematology, then you could see a patient with sickle cell disease when he is 1 year old, 5 years old, 18 years old, 35 years old. You basically have more fellowship options, but you can't deliver babies, and you can't do minor surgeries.
Family Practice: You have the possibility via extended training in ob/gyn during residency to deliver babies in certain controlled settings, i.e. some FP programs have a big focus toward ob/gyn. Or you could do minor surgeries, some FP programs have a focus in minor surgeries. You could go on to get one of the few fellowships offered to Family Practice residency graduates like sports medicine, geriatrics or adolescent medicine and that is all!
Med/Peds: You are board certified in both peds and medicine, and therefore can receive a fellowship training in any area offered to pediatrics or internal medicine residency program graduates i.e. cardiology, pulmonology/ICU, critical care, hematology/oncology, infectious disease, nephrology, GI. If you do do a fellowship, let's say in hematology, then you could see a patient with sickle cell disease when he is 1 year old, 5 years old, 18 years old, 35 years old. You basically have more fellowship options, but you can't deliver babies, and you can't do minor surgeries.
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Secondly, on which will offer better employment opportunities, i.e. Med/Peds versus Family Practice, I would not base a decision on which field to enter based on which might be more employable. Bottom line, if you are a Family Practicioner or Med/Peds residency graduate then you will be able to find work in your desired area of the country, especially with the aging of the baby boomers more doctors to care for elderly patients will be needed. Best to base your decision on what field you like best, and which offers the type of fellowships you may be interested in, because that is what you will be practicing day in and day out. There is a huge need for FPs in rural areas, so if you want to practice in a rural area where doctors are sorely needed then it might be helpful to have ob/gyn under your belt.
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As a current Med-Peds resident I felt the strong urge to post on this thread. There still seems to be a lot of confusion and misinformation about the combined residency. One poster even went so far as to say that you had to pick one side over the other to be successful (or something like that). This is not true anymore. Graduates of the combined residency can go on to primary care, be a hospitalist, work in most smaller ERs, or go on to subspecialize by either applying to or creating a combined fellowship. The market has discovered the combined residency and hospitals love us!
I recently interviewed at several different locations. All of them were excited by med-peds doctors, and the possibilities. Yes, it's true that if you start a private practice you would need to find coverage for both your adult population and peds, but unless you are in BFE there will be FPs and maybe even a Med-Ped or two in your area you can work with. Rurual or urban, there are lots of opportunities.
Some other things to consider when making a decision of FP vs Med-Peds is whether you like inpatient care over primary/clinical care. FP training is stronger in clinical care and outpatient management, whereas Med-Peds is stronger on inpatient care including ICU. Also keep in mind that FP spends very little time on peds, and Med-Peds spends half the time on peds so tend to be more comfortable with kids. If you have a strong desire to take care of patients in the hospital, or are drawn to critical care, Med-Peds is better suited, but this does not mean you cannot also do primary care as Med-Peds if you so desire.
Yes, FP does to OB/GYN and surgery, and offers additional training in those areas. They are the quintescencial "Jack of all trades..." but sometimes it's better to be taken care of by some one who specializes in kids AND adults.
To get to the heart of most people though I need to pass on some info about income. If you compare the current average income of a primary care FP vs Med-Peds physician in an employed position you will find that the Med-Peds trained physician will often make more. But as a private practice physician the incomes are very similar and are strongly dependent on the overall number of patients, and patient mix. More older people = more medical problems = more visits, but can also = more medicare and less income.
I recently interviewed at several different locations. All of them were excited by med-peds doctors, and the possibilities. Yes, it's true that if you start a private practice you would need to find coverage for both your adult population and peds, but unless you are in BFE there will be FPs and maybe even a Med-Ped or two in your area you can work with. Rurual or urban, there are lots of opportunities.
Some other things to consider when making a decision of FP vs Med-Peds is whether you like inpatient care over primary/clinical care. FP training is stronger in clinical care and outpatient management, whereas Med-Peds is stronger on inpatient care including ICU. Also keep in mind that FP spends very little time on peds, and Med-Peds spends half the time on peds so tend to be more comfortable with kids. If you have a strong desire to take care of patients in the hospital, or are drawn to critical care, Med-Peds is better suited, but this does not mean you cannot also do primary care as Med-Peds if you so desire.
Yes, FP does to OB/GYN and surgery, and offers additional training in those areas. They are the quintescencial "Jack of all trades..." but sometimes it's better to be taken care of by some one who specializes in kids AND adults.
To get to the heart of most people though I need to pass on some info about income. If you compare the current average income of a primary care FP vs Med-Peds physician in an employed position you will find that the Med-Peds trained physician will often make more. But as a private practice physician the incomes are very similar and are strongly dependent on the overall number of patients, and patient mix. More older people = more medical problems = more visits, but can also = more medicare and less income.
