Preparing for the Application Process

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NMPRA Director

NMPRA Director

National Med-Peds Residents' Association
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For the current 4th years I know that many of you are preparing your materials for applications. As September nears, you're probably thinking about what schools to apply to and what are some things that you look for before, during and after your interview. I will highlight some of the FAQ's that I receive and will provide you with some guidance that I and many others have used to find the right program that fits your needs.

I will start with 2 questions:

#1 Where do I start looking to learn more about programs?

I always tell prospective students to start with the program's website. This is the residency's front door and generally provides you with a good overview of the mission and goals of the specific program. While all the Med-Peds programs will train you to be excellent Med-Peds physicians, each one will have a different approach to how they do that. Programs generally highlight their distinguishing features on the website. Another way that I have found useful to learn more about programs is to read the resident and faculty bios on each website. Their interests and future goals should clue you in on why that program was a good fit for you. This, in turn, should provide you with some information about which of these programs will be a good fit for you. One of the underused resources in the process is actually contacting the program to learn more. You can do this by reaching out to the program coordinator or contacting the individual residents to learn why they chose their program. Alumni of the individual programs may also be useful, giving you their personal experience on how their program got them to where they are today. However, I have found it difficult to find contact information for these individuals unless there is someone you personally know.

**Frequently I have found that some programs do not update their websites routinely and thus you must rely on your interview experience and contacts with residents

#2 What do I look for in a good Med-Peds program?

One thing to keep in mind with regards to Med-Peds programs is that they must be strong in both Internal Medicine and Pediatrics to even have a Med-Peds programs. With that being said there are as many different Med-Peds programs out there as there are applicants. Some programs offer a Med-Peds continuity clinic while others have you rotate through the categorical outpatient clinics. There are programs that have you switch between Med and Peds every 4 months while others will do so more or less frequently. Location makes a difference as well. Where a program is situated will dictate the type of patients you will see and the demographics of your community. This is obviously no different for Med-Peds as it is for any other specialty. If you like research, then choose a program that highlights that either on their website or their resident bios. Other factors that residents have used to make their decisions is whether the program has specific strengths in the subspecialty that you are looking for. Probably one of the most important aspects about the process is learning which programs have a good Med-Peds community. While it is one thing to have a Med-Peds program, it is quite another to have a Med-Peds identity on the campus. What this means is that you want people at the hospital to know what the specialty is all about. You want a sense of community and not simply be part internal medicine and part pediatrics... you want to be Med-Peds. Lastly, another factor people consider is whether there is a dedicated Med-Peds program director. I believe most programs now a days have a dedicated PD. Historically PD's of the categorical programs used to run the Med-Peds programs. However times have changed as the number of Med-Peds graduates continue to increase and people enter the academic leadership. Today it is more the exception than the norm to not have a Med-Peds PD.
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Slightly off topic with the above advice, but is there a list somewhere of recommendations for students who won't see a med peds program until interview day? Things like when to take Step 2 CS and CK, what type of (AI, SubI, Electives) are recommended, that sort of thing?
 
There actually isn't a list anywhere unfortunately but the general rule of thumb is that most programs would like to see Step 2 CK before your interview (many instances will not invite until that score is submitted). I have not seen a Step 2 CS score as a barrier for interview but will likely need to be done and passed before match lists are submitted. Most places will want you to do a Sub I in Peds or Medicine. Other than that, all other rotations are up to your discretion. The rest of 4th year is really for your own benefit and should include rotations that will be useful and interesting to you. Hope that helps!
 
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Letter of Rec question:

With a max of 4, I plan to do 2 med and 2 ped letters like most people. Most places on their website specify that 1 must be from Dept. chair of peds, 1 from Dept. chair of med. I don't really like these specifications because in my case, I personally know senior faculty much more than I know the Department Chair (but rules are rules). So here's one question: with 1 peds letter coming from dept chair (who doesn't personally know me that well), would programs like to see my second letter coming from my PI on my research project whom I know very well, or my attending on my peds AI? Which would most programs hold in higher regard?
Second Q: some schools say Dept. chair "or designee". Can someone define what they mean by designee?

Thanks!
 
Hello! That is an excellent question. Your plan is actually quite solid. I understand your concerns regarding the department chair letters. This is actually not specific to Med-Peds but a necessary one. What some people do to address the issue is that they would have a letter that is co-written by the faculty member who knows you and the chair (Probably someone who has worked with you on the clinical setting). That way you can actually have a letter from your PI as well. Some people have a 5th letter just in case the letters don't come together and you have to use another to fill in for whoever is late. Each program will have different preferences for letters, in general, a person who has worked with you clinically and the longest, that would be preferred. In the end you want someone who knows you the best and can speak to your attributes as a person.

Designee can be can be many people but most people will say your clerkship director is a good alternative or a good "co-writer" as explained above. I hope that helps! Good luck!
 
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NMPRA Director said:
Hello! That is an excellent question. Your plan is actually quite solid. I understand your concerns regarding the department chair letters. This is actually not specific to Med-Peds but a necessary one. What some people do to address the issue is that they would have a letter that is co-written by the faculty member who knows you and the chair (Probably someone who has worked with you on the clinical setting). That way you can actually have a letter from your PI as well. Some people have a 5th letter just in case the letters don't come together and you have to use another to fill in for whoever is late. Each program will have different preferences for letters, in general, a person who has worked with you clinically and the longest, that would be preferred. In the end you want someone who knows you the best and can speak to your attributes as a person.

Designee can be can be many people but most people will say your clerkship director is a good alternative or a good "co-writer" as explained above. I hope that helps! Good luck!
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Thanks for the reply! I'll be sure to come back to this board during this application cycle if I have more questions
 
I cannot think of an example where they would want both but the best place to check are the websites. Unless they explicitly say they want both, one or the other is just fine.
 
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@NMPRA Director,
Do you have thoughts or advice to offer on applying to categorical programs (i.e. IM or Peds) as back-up plans? "Charting Outcomes..." makes it seem as though individuals that apply solely to Med-Peds programs are more likely to match to Med-Peds. Additionally, previous threads have stated that some PDs rank candidates lower if they have applied to categorical programs, as that may indicate a lower level of commitment. I am having some difficulty balancing my very strong commitment to Med-Peds and the fear of not matching.
Thanks for any insight you can provide!
 
Hello! I certainly understand your concerns about the match. I know several people who have gone through the process who have done the same as you. I am not sure about the accuracies of PD's ranking applicants lower because they are applying to other categorical programs. I can say that people apply to both categorical and combined Med-Peds all the time but it's not necessary in most cases. Of course this depends on a lot of factors including your application as a whole, where you are applying from etc. Most people who apply broadly and don't have a regional requirements and rank at least 10 programs will have no issues matching. I feel that the most important aspect of the match is to apply smartly. Enlisting the help of a med school advisor should allow you to better assess how competitive you are.
 
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What kind of numbers do you see as far as to how many programs applicants apply? IM averages about 35 per the recent AAMC study and it is 25 for Peds. Any ideas about real life numbers for Med Peds? Thanks!
 
Hey! thanks for your question. I wish I had precise data to be able to give you but I don't think anyone has those numbers. I know that statistically people who rank 10 Med-Peds programs consecutively have more than a 90% chance of matching at a Med-Peds program. Of course the magic number of how many to apply to initially is dependent on many factors. I would say if you're applying to a broad range of programs from academic centers to non academic centers to places around the country, then apply to 20-25 is probably more than you need if you are an medical student at an American allopathic medical school. The problems that people run into is applying to only "competitive" programs and then not having enough interviews for a safe rank list. Hope that helps. If you have more questions, please feel free to keep posting!
 
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I have a question about timing. I have completed my application except for a couple letters of recommendation that I am still waiting on. Will submitting later hurt my application? Is there anything I can do in the meantime til the letters get submitted?
 
Hey! Thanks for your question. I know you must be anxious. I first have to say that I am not a program director so I cannot speak on their behalf. However, most programs accept applicants for interview on a rolling basis so the later it takes to complete the application, for those programs, interview days will be limited. Ideally it is important to get things in as early as possible. Sometimes it may help to contact the individual programs and their coordinators to see if there is anything to further things along.
 
Nothing set in stone yet but some programs have started to recruit Med-Peds faculty.
 
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