<p>A friend of the family will soon begin his residency in "med-peds", a new specialty to me although I guess it isn't really new. I asked his mom for more info on his chosen path and she was somewhat unclear herself. Am I right that it's a combination of internal medicine and pediatrics? Is it a new concept in family medicine/primary care? Anybody know the thinking behind this specialty? How popular/common is it? I understand it's a four year program rather than the typical three years for either pediatrics or internal medicine. I'm curious about this and would appreciate any insight you may have.</p>
<p>Sheesh. 
Apparently I get dumber by the day. I’ll watch this thread for an answer to another residency/fellowship question I didn’t know I had.</p>
<p>Ask and a librarian will always find the answer…</p>
<p>[NMPRA</a> - What is Med-Peds?](<a href=“http://www.medpeds.org/medpeds/definition.asp]NMPRA”>http://www.medpeds.org/medpeds/definition.asp)</p>
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<p>It’s a 4 year residency program which when completed allows the resident to sit for either the IM boards or the ped boards or both.</p>
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<p>Med-peds has been available as an option since 1967 (when it was approved as a residency program).</p>
<p>Here is an informational pamphlete produced by National MedPeds Resident’s Assoc. that explains the rotations included in the residency program and additional training options.</p>
<p><a href=“http://www.medpeds.org/medpeds/NMPRApamphlet.pdf[/url]”>http://www.medpeds.org/medpeds/NMPRApamphlet.pdf</a></p>
<p>Why? I can’t imagine how it would be an advantage in private practice. Perhaps it is an advantage in research or academia?</p>
<p>Oh; I see </p>
<p>"While Med-Peds residency provides exceptional training for primary care, Med-Peds training also leaves open the option of pursuing a subspecialty in either Internal Medicine or Pediatrics or both (e.g. cardiology, infectious disease, pulmonary/critical care, women’s health, sports medicine, etc). This allows over 20 fellowship possibilities for graduates as well as the primary care option and hospitalist medicine.</p>
<p>Note that while this is a form of comprehensive primary care, it differs both structurally and philosophically from Family Medicine. A physician trained in Med-Peds can care for the newborn to the geriatric patients. Med-Peds prepares a physician well for private practice, academic medicine, hospitalist programs, and fellowships."</p>
<p>I started out in a peds/psych/child psych triple board program, and while I am eternally grateful for my peds part of my six years , I can’t imagine actually practicing peds.</p>
<p>Clarification, please…If one trains in ‘just’ pediatrics, aren’t they qualified to continue their training and complete a fellowship in any of these sub-specialties as well?–cardiology, infectious disease, and the like? Not sure of the advantage of the combined Med-Peds program. </p>
<p>I was under the impression that good Family Medicine practices care for patients from newborns to geriatrics. I know the practice my family has seen for over 20 years sees all of these patients and does a good job with them all. Perhaps my confusion is the diff between family and internal medicine. Just one year difference in their training, right?</p>
<p>–I don’t feel so ‘lame’ in asking these questions, given the fact that Curm is also curious!! Although, I’m not sure he’s getting “dumber by the day” as he suggests!!</p>
<p>I belive that if one has peds residency , they could continue their training with fellowship BUT it would be limited to pediatric cardiology or pediatric neurology, pediatric intensive care etc. One of the resident experts can correct me (and please do…), but switching from peds to general [adult] cardiology would be rare and difficult to do.</p>
<p>According the NMPA pamphlete:
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<p>As the board’s in-house pediatrician and current fellow in a pediatric sub-specialty, allow me to weigh in.</p>
<p>A couple of things…</p>
<p>If it were up to me, there’d be a severe reduction in family medicine programs and concomitant increase in med-peds residency spots. I think that the Obstetrics portion of FM is a huge issue, and something that most FM providers give up on pretty easily. There is a need in rural communities, but considering that most FM providers in larger communities don’t do any OB, it’s a waste. On the other hand, M/P provides better training in both medicine and pediatrics than FM does, actually allowing M/P residents to become board certified in both fields. If you have to choose someone who can take care of you from being a preemie newborn up to the most elderly of patients in the medical ICU, you’d want a med/peds trained physician. </p>
<p>As far as fellowship goes: the fellowships in things like cardiology, GI, Pulm and the rest are separated into peds and adult paths. In peds, we often say that children are not just little adults, and this is even more readily apparent in the subspecialties. For example in cardiology, while there is some overlap, the majority of work peds cardiologists deal with involves heart defects and the associated sequelae while adult cardiologists worry about heart attacks, focus more on abnormal arrhythmias and rarely - if ever - have to worry about the difference in hemodynamics that arise from having blood move places it shouldn’t when there is a hole in the heart. As a peds resident, you simply don’t get exposed to those sorts of adult problems, while the medicine residents (and even adult cardiology fellows) are generally clueless regarding heart defects and their subsequent repairs. In fact, one of the more rapidly growing sub-sub-specialties (at least at the larger peds cardiac centers) is adult congenital heart disease, focusing on the care of kids who had heart defects that have survived into adulthood. I’ve even seen middle aged patients (40+) who were found to have previously undetected congenital heart disease get admitted to children’s hospitals so that the peds cardiothoracic surgeons can do the procedure because the adult CT surgeons don’t frequently perform the operation.</p>
<p>Those who do a med/peds residency can go into any fellowship from either the medicine or pediatrics side, that’s where the flexibility comes into play (and very different than FM). I know people who finished who have finished m/p residencies and subsequently gone into a neonatology fellowship, while also knowing another who went into a geriatrics fellowship. One of my co-fellows (peds critical care is the fellowship I’m doing) did a m/p residency. There are some combined fellowships available, but most that do a fellowship, will pick an single age group. Those who have done m/p residencies may be more likely to focus on those patients transitioning from pediatric to adult care, but not necessarily.</p>