Robert C. Bowman, M.D.
The 1987 US MD graduates had over 150 match into medicine pediatrics. Only 14 can be found with medicine pediatrics as their primary specialty in the 2005 Masterfile. About 20% can be found in the 1987 - 1990 graduates. Over 50% for the 1987 - 1999 graduates or 1580 out of 3100 who matched into medicine pediatrics. The pattern suggests a continued deterioration of medicine pediatrics away from primary care and medicine pediatrics with each passing year from medical school graduation. Current health policy and changes in training appear to have eliminated the specialty and also a source of primary care.
Acad Med. 2004 Jun;79(6):591-6.
Internal medicine-pediatrics residency training: current program trends and
outcomes.
Frohna JG, Melgar T, Mueller C, Borden S.
Department of Internal Medicine, University of Michigan Medical School, Ann
Arbor, 48109-0368, USA. jfrohna@umich.edu
PURPOSE: Combined internal medicine-pediatrics (med-peds) residency programs
have existed since 1967. Due to the rapid growth in the number and size of
programs during the 1990s, most current med-peds physicians completed their
residency in the last ten years, making older studies of med-peds programs
obsolete. The authors sought to determine completion rates of med-peds residency
programs and describe the initial career plans for five cohorts of graduating
residents from combined med-peds training programs. METHOD: Program directors of
all U.S. med-peds residency programs were asked to complete a Web-based survey
and base their responses on the records of cohorts of residents completing their
programs from 1998 through 2002. To allow sufficient time to complete both the
American Board of Pediatrics (ABP) and American Board of Internal Medicine (ABIM)
certification examinations, certification status was requested only for the
cohort completing training in 1998. RESULTS: Responses were obtained from 92%
(83/90) of the programs, reflecting 1,595 residents entering med-peds programs.
Of these residents, 91% graduated from a med-peds program. Among the graduates,
82% were seeing both adults and children, 22% went on to subspecialty
residencies, 21% began practice in rural or underserved areas, and 25% entered
an academic position. ABIM and ABP pass rates for the 1998 cohort were 97% and
96%, respectively. Overall, 79% of the 1998 graduates are board certified in
both specialties. CONCLUSIONS: Compared with previous studies, a greater
proportion of residents who recently entered med-peds programs completed their
dual training, and a larger percentage of graduates are seeing both adults and
children. The proportion of residents entering subspecialty residencies
has increased significantly, but the proportion of graduates in academic
careers has remained stable.
Internal medicine-pediatrics combined residency graduates: what are they doing now? Results of a survey. Lannon CM, Oliver TK Jr, Guerin RO, Day SC, Tunnessen WW Jr.
N=1482 Documents half in careers in office based practice and 50% with medical school appointments.
Training experiences of U.S. combined internal medicine and pediatrics
residents.
Melgar T,
Chamberlain JK,
Cull WL,
Kaelber DC,
Kan BD.
Michigan State University/Kalamazoo Center for Medical Studies, Kalamazoo,
Michigan, USA.
PURPOSE: To investigate the demographics and training experiences of internal
medicine and pediatrics (med-peds) physicians. METHOD: A cross-sectional survey
addressing demographics, training experiences, and career plans of fourth-year
residents graduating from combined internal medicine and pediatrics programs
that were identified in the American Academy of Pediatrics database was
initiated in May 2003. Questionnaires were mailed up to four times to
nonresponders through August 2003. RESULTS: Valid responses were received from
212 of the 340 graduating residents (62% response rate). The majority (186/208
[89%]) reported that they would choose med-peds training again. Career planning
(135/210 [64%]), office management (173/212 [82%]), and outpatient procedures
(155/211 [73%]) were the only areas where the majority desired more training.
Neonatal intensive care training was the only topic area that the majority of
residents (142/212 [67%]) reported could have been carried out in less time.
Nearly all residents (183/196 [93%]) planned to care for children and adults.
Residents' self-assessment of their preparation was good to excellent for
evidence-based medicine (192/210 [91%]), caring for patients with special health
care needs (179/209 [86%]), and use of information technology (169/208 [81%]).
Residents felt equally well prepared for postgraduate activities in internal
medicine and pediatrics primary care (170/212 [80%] versus 163/211 [77%], p =
.305, NS) and internal medicine and pediatric fellowships (186/207 [90%] versus
181/208 [87%], p = .058, NS). Only 112 of 209 residents (54%) felt their
preparation for research was good to excellent. CONCLUSIONS: The study findings
suggest that med-peds residents are satisfied with their decision to train in
med-peds and with their level of preparation. They feel equally well prepared to
care for adults and children, and well prepared to care for patients that may
transition to adulthood with complex needs, to assess evidence, and to use
information technology.