Med/peds training

[dfafda]

Anyone have any thoughts regarding how complete training is for med/peds. I know you get board certified in both but in 4 years do you feel you're getting the same quality medicine training or peds training that a straight categorical gets.

Also regarding specific programs, anyone have any thoughts on UCLA's program? I ultimately want to do peds heme onc but love medicine and also want the training to hopefully be able to deal better with long term survivors etc. Just trying to see if i'd be losing any peds training by doing med peds vs. peds categorical.

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[PalmOlive]

Anyone have any thoughts regarding how complete training is for med/peds. I know you get board certified in both but in 4 years do you feel you're getting the same quality medicine training or peds training that a straight categorical gets.

Also regarding specific programs, anyone have any thoughts on UCLA's program? I ultimately want to do peds heme onc but love medicine and also want the training to hopefully be able to deal better with long term survivors etc. Just trying to see if i'd be losing any peds training by doing med peds vs. peds categorical.

Supposedly the medicine years compliment the pediatrics years, but obviously you get two of peds and two of medicine, versus say three solid pediatrics years. . . I would say if you want just pediatrics then do that. I think if you have a high USMLE scores and have great fund of knowledge and plan to go into med-peds then you would be okay, at least in terms of confidence of completing the program and passing both board examinations. I think that med-peds programs are more difficult than regular categorical programs, i.e. more intense just to try to learn about both fields. A person to ask would be a med-peds residency graduate who is taking care of kids and ask him/her how well prepared they feel compared to their peds categorical counterparts.

 

[group_theory]

Anyone have any thoughts regarding how complete training is for med/peds. I know you get board certified in both but in 4 years do you feel you're getting the same quality medicine training or peds training that a straight categorical gets.

You end up doing 2 years of pediatrics instead of 3. However, this is due to decrease number of electives and decrease number of redundant rotations. As a med-peds resident, you will have fewer electives compare to your categorical colleagues. You will also do fewer redundant rotations (fewer PICU/NICU, fewer ward months, etc).

However, your training in one field does complement training in another field. For peds heme/onc, your exposure to adult hematology and adult oncology will be helpful. Your training in adult cardiology will help you (esp with heart kids, or reading EKGs). Your training in MICU or cardiac ICU will help you in PICU. Your training on procedures on adults (central line, thoracenthesis) should help you with the pediatric population.

Your exposure to sickle cell in kids will help you take care of them as adults. Your exposure to CF will help you take care of adults with CF exacerbation.

 

[PalmOlive]

You end up doing 2 years of pediatrics instead of 3. However, this is due to decrease number of electives and decrease number of redundant rotations. As a med-peds resident, you will have fewer electives compare to your categorical colleagues. You will also do fewer redundant rotations (fewer PICU/NICU, fewer ward months, etc).

Why is a second or third month of Peds wards considered redundant? Don't you need a good number of ward months to be a good pediatrician or is it redundant for categorical peds residents??

 

[group_theory]

Why is a second or third month of Peds wards considered redundant? Don't you need a good number of ward months to be a good pediatrician or is it redundant for categorical peds residents??

I didn't mean redundant in the negative sense but more "instead of doing 3 PICU rotation, you only do 2". Combined programs have to dedicately balance their curriculum to meet both specialty board's requirements. Sometimes the limitation comes from the boads itself (limited how many required rotation a med-peds resident can do)

For example
UCSD Peds Residency
General Peds Ward - 9 rotations
PICU/NICU - 5 rotations
http://www-pediatrics.ucsd.edu/Clinical Rotations/default.aspx

UCSD Med-Peds
General Peds Ward - 6 rotations
PICU/NICU - 3 rotations
http://www.medicine.ucsd.edu/med-peds/program/curriculim.html

UNC Peds
General Peds Ward - 8-10 months
PICU/NICU - 6 months
http://uncpedsres.org/pmwiki.php?n=Curriculum-Schedules/HomePage

UNC Med-Peds
General Peds Ward - 6 months
PICU/NICU - 4 months
http://uncmedpeds.org/pmwiki.php?n=Curriculum-Schedules/HomePage

 

[ekydrd]

Why is a second or third month of Peds wards considered redundant? Don't you need a good number of ward months to be a good pediatrician or is it redundant for categorical peds residents??

You actually have more total months of inpatient care compared to either Peds or IM since you do both. In my program we have for Peds 6 months wards, 1 month PICU, 3 months NICU, 1 month inpatient heme/onc required; and on IM we do 7 months wards, 2 months MICU, 2 months CCU, 1 month neurology inpatient along with various and sundry electives (some of which are required, and others are suggested) which are either inpatient, outpatient, or a combination of both but do not require overnight call. This totals 13 months of wards, 8 months ICU, and 2 additional months of Q4 inpatient call.

Of all my friends who recently graduated and went on to primary care all wished they had more clinic experience, but none felt inadequately trained as a pediatrician or as an IM doc. Only two people of the 3 years worth of grads went on to do fellowships (both are doing GI), not because the others couldn't, but because they didn't want to, and both are doing some form of a combined fellowship.

Our training on both sides compliments the other, and builds on what we learn. I have a better grasp on things such as adolescent hypertension or diabetes because I have adults with the disease, and at times my Pediatric attendings will ask how we manage some chronic conditions in the adult world (and visa versa).

Your idea of doing Med/Peds followed by heme/onc is a perfect example. You will be seeing many childhood cancer survivors growing up and you may even have to take care of adults in a pediatric hospital because adult specialists will not have a clue. We have people over the age of 21 admitted to the heme/onc unit or cardiothoracic surgery service all the time.