1/ Alright guys, w/yet another new clinical year approaching, a new and updated thread on Med-Peds (MP), to help provide some clarity on what MP is/isn't, esp for rising M4s (some of whom may not have had full IM/Peds clerkship experiences), trying to determine their careers!
2/ Let's start w/what MP actually is: a 4 year integrated residency combining Internal Medicine (IM) and Pediatrics training. At the end you are board eligible for BOTH IM and Peds. You condense 6 years of training (3 for categorical IM and 3 for categorical Peds) into 4 years.
3/ You are, and I cannot stress this enough, *both* an IM AND a pediatric resident. You do not exist in a separate universe (though they may think it when you flip back and forth). The IM and peds categorical residents are your coresidents. You are fully IM and fully Peds.
4/ You are ALSO eligible to apply for any IM or Peds fellowship (see list below for a sampling of options). The coolest part? There are even established combined IM-Peds fellowships (Heme/Onc, Cards, Nephro, ID, etc.), and if it doesn't exist yet, you can usually create it! 
5/ There are currently 77 programs (see map). Most programs are pretty similar in training- since you are combining 6 yrs into 4 most schedules look fairly similar as all programs need to meet set ACGME requirements to ensure complete training in both IM and Peds.
6/ MP make up ~5-8% of all IM residents and ~13% of all Peds residents. ~15% of IM and ~40% of Peds programs have an affiliated MP program. There's even some data to show that Peds residencies w/attached MP programs do better on their Peds boards (pubmed.ncbi.nlm.nih.gov/24803632/)
7/ Sound like a lot of work? It is! But it's a blast and it IS doable! Completion rate is comparable to other residency programs, and MP resident have statistically equivalent board pass rates for IM and Peds as either categorical residents.
8/ So why do ppl choose MP? Many reasons: to pursue combined fellowships, interest in transition medicine, career flexibility/versatility, etc. There's a misconception that MP "just couldn't decide" IM v Peds, which is straight nonsense. We made an active choice to train in both.
9/ Just like we don't say that ppl who go into primary care did so bc they "couldn't decide on a specialty"... they made a purposeful decision to continue w/that specific career path. As do MP physicians. No one would choose to double their work w/out just cause.
10/ Another common myth is that you should do Family Med (FM) instead, because "everyone in MP goes into primary care"... lots to pick apart here, but briefly, the split is roughly 50% primary care, 25% subspecialists, 25% hospitalists over last 10-15 yrs.
11/ And over the last 4 years specifically, the percentage choosing to go into fellowship (i.e. subspecialists) seems to be even higher. (Credit: MPPDA Research Committee for the awesome data)
12/ FM and MP training is also very different. FM minimum requirements for IM and Peds rotations are 8 and 4 months, respectively. MP complete 24 months of each. FM also have a higher ambulatory requirement (50%) than MP (36%), and FM also have training...
13/ ...in OBGYN and surgery, which MP does not. Simply put: apples to oranges. It's almost like that's why they are two different residency pathways.
14/ One study found that when MP do go into primary care, they tend to (on average) have much more balanced patient panels than either FM vs IM vs Peds PCPs.
15/ Another myth: "Everyone just ends up picking IM or Peds in the end anyways...". In a 2015 paper 92.2% of MP graduates surveyed saw both adults and kids in practice, including 91% of MP subspecialists and 88.2% of MP hospitalists surveyed. (amjmed.com/article/S0002-…)
16/ Earlier I mentioned all the specialties you are eligible for coming out of MP residency. Do MP residents actually go into a wide variety? You betcha! Here's a sampling of some of last years' fellowship matches. (Credit again to the awesome MPPDA Research Committee).
17/ In summary: 6 years combined into 4, dual board certification, all the fellowships, versatility, and fun!! Want to learn more? Visit medpeds.org, tweet @ or DM me, follow/DM @nmpra, etc! Also stay tuned, as @nmpra in conjunction w/MPPDA and AAP-SOM will be...
18/ ...announcing details of a webinar series as well as Twitter Q&A sessions to help answer questions about upcoming interview season, nuts and bolts of MP, etc., very shortly! FIN. #medpeds #smalltotall
