CHELSEA REYNOLDS

Internal Medicine- Pediatrics (Med-Peds)

Introduction to Med-Peds

A Med-Peds physician’s, “ training and practice synthesizes the disciplines of both internal medicine and pediatrics” (Internal Medicine-Pediatrics).

Med- Peds physicians see and care for patients throughout their life, which results in, “understanding family dynamics, epidemiology, and the impact of illnesses all in the context of family systems” (Internal Medicine-Pediatrics).

Though Med-Peds residents have reduced redundancy in their schedules, exposure to both these specialties allows you to appreciate the tremendous similarities and common fundamental skills necessary to be an excellent internist and pediatrician (Friedland and Frohna, 2012).

History of Med-Peds

The Med-Peds specialty, “started in 1941 in the combined residencies of internal medicine and pediatrics and was recognized officially after the American Boards of Internal Medicine and Pediatrics recognized a training avenue in 1967”(Friedland and Frohna, 2012).

Med-Peds training programs began to sprout in the 1960s and grew significantly beginning in the mid-1980s.  Currently there are approximately 1400 Med-Peds residents were in training and approximately 6300 Med-Peds physicians in practice who have completed Med-Peds residency training (Chamberlan and Frohna, 2008).

Combined four-year Med-Peds training developed in the late 1960s in response to the primary care movement with its emphasis on health instead of disease and to the recognition by the profession of family medicine as a legitimate specialty (Kimbell, 1997).

Possible Graduate Programs and Requirements

Medical University of South Carolina

Located in Charleston, SCRequired course work includes:

There’s no specific required course work but at least 90 credit hours are

required

MCAT scores are required and should be taken no later than

spring or fall of the year preceding admission

(Medical University of South Carolina)

University of South Carolina School of Medicine-Greenville

Located in Greenville, SCRequired course work includes

Two semesters of biology with lab Two semesters of general chemistry with lab One semester of organic chemistry with lab

One semester of Physics with lab Three semesters of humanities 90 credit hours are required

MCAT scores are required and should be taken no later than spring or fall of the year

preceding admission

(University of South Carolina School of Medicine- Greenville)

Med-Peds Residency Programs in the United States

After the 3rd year of medical school, I will begin applying to residency programs to continue my education in after I graduate from medical school.

There are 79 Med-Peds programs that offer 362 first- year resident positions (Friedland and Frohna, 2012).

Med-Peds residency programs in South Carolina include locations at University of South Carolina School of Medicine (Greenville) as well as the Medical University of South and the University of South Carolina School of Medicine (Columbia).

Residency and Training

Residency is a 4 year program that requires a year of training in each specialty with rotations every 3-6 months (Friedland and Frohna, 2012).

Rotations include general internal medicine and pediatrics, normal newborn care, neonatal, pediatric and adult intensive care; emergency care; behavioral pediatrics, adolescent medicine, geriatrics and other subspecialty areas such as cardiology, allergy, endocrinology, nephrology, etc. (Friedland and Frohna, 2012).

Med-Peds programs also provide experiences and guidance in topics such as child advocacy, risk management, cost effective care, quality improvement, evidence based practice, substance use disorders, informatics, medical genetics, health care financing, ethics, end of life care, organization and structure of practices. (Friedland and Frohna, 2012).

After residency, accreditation in each pediatrics and internal medicine is required because there isn’t a combined board examination.

Practice Options

Med-Peds physicians are found in every type of location.Some physicians open up their own practices, work in hospital, emergency

departments or urgent care clinics. “A recent survey of almost 900 board certified Med-Peds graduates confirms these

physicians are heavily involved in clinical practice; 71% report that at least 70% of their time is devoted to direct patient care… 88% are in group practices with other primary care physicians, including general internists (51%), general pediatricians (42%), family practitioners (40%), and other Med-Peds clinicians (38%)…” (Henry, 1997).

More than 94% of Med-Peds residents expected to care for pediatric patients. Among residents seeking generalist positions, Med-Peds residents sent half as many applications to get the same number of interviews and offers as pediatric residents, were more likely to be offered their most desired position, and were more likely to accept a position in a rural area/small town (Chamberlan, Cull, Melgar, Kaebler & Kan, 2007).

Growth potential

Med-Peds– trained physicians have an easier job search experience and greater market valuation (Chamberlan et al, 2007).

Med-Peds community is growing and it is likely these broadly trained physicians will have little trouble proving their worth or fitting into clinical practice (Kimbell, 1997).

The, “population growth and aging will increase family physicians’ and general internists’ workloads by 29 percent between 2005 and 2025” (Colwill, Cultice, and Kruse, 2008).

A Med-Ped is, “capable of emphasizing whichever component of their skill set [that] an individual patient or community requires…” (Chamberlain and Frohna, 2008).

Med-Peds are not stuck in one type of place but are flexible in their location of work and their practice style. This makes Med-Peds very valuable in the healthcare field that is experiencing shortages in primary care physicians .

Salary Range

The average starting salaries reported by Med-Peds physicians going into practice in 2003 and 2004 was $118,892 (Chamberlan and Frohna, 2008).

Med-Peds physicians earn an median salary around $168, 985 with an mean salary around $180,008 in 2006 (Chamberlan and Frohna, 2008).

Med-Peds residents had substantially greater starting salaries as hospitalists or generalists compared with pediatric residents (Chamberlan et al, 2007).

Why do physicians choose Med-Peds?

1. Age spectrum2. Variety/ depth of training3. Both medicine and pediatrics4. Flexible career options5. Primary care focus

6. Ability to sub-specialize7. Role Models8. Did not want obstetrics or

surgery9. Transition and adolescent

medicine10. More pediatrics training

*This slide describes some of the many reasons that physicians choose to specialize in Med-Peds. (Friedland and Frohna, 2012)

O-Net Profiler Results

Social In the social category, I would be helping patients achieve the best health that

they can, and I would do this by encouraging them and supporting them throughout their process of achieving a level of high quality health.

Being social would require me to interact with others and develop relationships with them, and this would be especially important in the field of Med-Peds since I am going to be dealing with families.

Med-Peds is a specialty of flexibility and diversity, since it deals with a broad spectrum of patients and cases, and as someone who is social, I will be able to discuss with them their case in a way that emphasizes understanding by the patient.

I have shown this social quality through shadowing and volunteering at Greenville Health System and Rosa Clark Medical Clinic. In volunteering, I have built up social skills that are necessary for proper and efficient communication. In shadowing, I have learned the different ways that physicians interact with their patients depending on the patient’s and their needs.

O-Net Profiler Results

InvestigativeIn the investigative category, I will investigate the relationship

between an illness and a certain health outcome. From this information about the illness, I will come up with a plan for treatment. In this plan of treatment, I will assess the patient and see what path of treatment would result in an increase in the quality of health and an adherence to the treatment by the patient.

I have shown this investigative quality through my success in science classes and labs. I shadowed multiple physicians and many times they allowed me to look at their patients’ records before and after an appointment to determine the illness that the patient had and what it was a result of.

Conclusion

The field of Med-Peds is a growing field due to the demand for primary care physicians in the health care field.

Med-Peds have a lot of flexibility in their fields and can sub-specialize if they chose to in the future.

Med-Peds deal with a wide array of patients and health issues due to their specialization in both Pediatrics and Internal Medicine.

This is a very rewarding occupation in the health care field not only due to helping the patient’s needs but also because of the relationships formed with patients and their families that can endure throughout generations.

I am qualified for this occupation because my experiences in and out of the classroom. I volunteered and shadowed at Rosa Clark and Greenville Health System. Also my job at the Neurology Centers of the Carolinas has allowed me to see and get first hand experience in how the medical field works. I can apply this knowledge to my occupation one day. I have a good, competitive GPA that will help me get into medical school and begin the steps required to become a Med-Ped.

Sources

Chamberlan, J., Cull, W. L., Melgar, T., Kaebler, D. C. & Kan, B. D. (2007). The effect of dual training in internal medicine and pediatrics on the career path and job search experience of pediatric graduates. The Journal of Pediatrics, 151 (4), 419-424.

Chamberlan, J. & Frohna, J. (2008) Med-Peds 101. Retrieved from: http://www2.aap.org/sections/med-peds/med-peds101.cfm

Colwill, J. M., Cultice, J. M. & Kruse, R. L. (2008) “Will generalist physician supply meet demands of an increasing and aging population?” Health Affairs, 27(8).

Friedland, A. & Frohna, J. (2012). Medical Student Guide to Combined Internal Medicine and Pediatrics Residency Training. National Med-Peds Resident s’ Association. Retrieved from: http://www2.aap.org/sections/med-peds/Standing%20Committees/StudentGuide.pdf

Kimball, H. R. (1997) The med/peds physician in contemporary medical practice Retrieved from: Http://mppda.org/wp-content/uploads/2013/10/Kolarik102-20.pdf.

Internal Medicine-Pediatrics (n.d.) Retrieved from: https://www.aamc.org/cim/specialty/list/us/339580/internal_medicine-pediatrics.html

Medical University of South Carolina. Retrieved from: http://academicdepartments.musc.edu/com/admissions/applying_college/

University of South Carolina School of Medicine.- Greenville. Retrieved from: http://greenvillemed.sc.edu/admission.shtml .