Peds or Med Peds??

[Corali]

I just completed sub-i's in both internal medicine and pediatrics and am really struggling to make the decision between peds and med/peds. I really love taking care of teenagers and young adults and am intrigued by the med/peds "niche" of treating teens with chronic medical conditions as they transition into adulthood. However, from talking to med/peds residents at my hospital, it seems that most of them end up picking one or the other post-residency, unless they go into primary care (which I am less interested in) and the kind of "niche" I am looking for is much more difficult to find in practice. I know that I would be happy doing categorical peds as well (and could specialize in adolescent med from there anyway if I wish) but would love to hear from others whether they think someone in my situation would benefit from doing med/peds instead!

---

Members don't see this ad.

 

[obiwan]

Yeah based on my observations, would agree that the majority choose either/or and in this instance, all of them have gone the IM route. Basically just ask yourself, can you handle residency where the majority of the patients that you are taking care of are 65-85 year old chronically co-morbid patients

 

[SurfingDoctor]

Very few do both. It’s only one extra year of training so the opportunity cost is small… but it’s also not zero.

 

[gyngyn]

Peds

 

[TelemarketingEnigma]

I think I already commented on another version of this thread, but coming back to add some additional thoughts from a med peds perspective now that I’ve actually completed my adolescent med rotation: I actually now feel more strongly that med peds sets you up to have an advantage if you choose to specialize in adolescent medicine. My categorical co residents on the rotation (and even some of the newer fellows) were far more uncomfortable with some of the things that were major components of the rotation: abnormal uterine bleeding/birth control, STIs, pelvic exams, substance use…. We see all those things a lot more on the adult side and I was actually surprised how uncomfortable it made some of the peds-only folks. That said, I think it would be easy enough to learn those things from a peds only background, that if you really can’t see yourself working with people older than like 24, you should just pick peds.

 

[pccmapplicant1]

Hi Corali, I recently completed MedPeds residency at a program where nearly all the MedPeds physicians and recent graduates practice both. I would say approx 1/3 do exclusively outpatient on both sides, 1/3 a blend of both inpatient and outpatient on both sides, and 1/3 go on to fellowships with either the intention to focus on AYA populations or to do combined practice even if choosing just one side (ie. adult congenital cards, PHM to do inpatient on both sides). I got the same advice during med school with most people at my institution telling me I would pick one or the other, but I think it is very institution and culture dependent. Some hospital systems are set up in a way that makes it virtually impossible to do both (different EMRs, different admin, no desire to collaborate at all between adult & peds services), while some are very fluid and have hired MedPeds physicians in both capacities for decades, are in fact somewhat reliant on MedPeds services to run specialty clinics and consult services, and have a lot of MedPeds physicians in leadership roles. I encourage you to apply both if you think you are interested in MedPeds and talk to each individual program on if they have a history of placing students like you into the job niches you might be looking for. YMMV if you are geographically restricted and the programs you're interested in do not have what you're looking for. You can always rank exclusively peds programs if you change your mind. Message me if you have any specific questions!