Career PPT for HLTH 4190

1. C H E L S E A R E Y N O L D S
Internal Medicine- Pediatrics (Med-Peds)

2. 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).

3. 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).

4. Possible Graduate Programs and Requirements
Medical University of South Carolina
 Located in Charleston, SC
Required 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, SC
Required 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)

5. 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).

6. 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.

7. 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).

8. Growth potential
 There are currently more positions for Med-Peds than there are all U.S. seniors (Friedland
and Frohna, 2012).
 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 .

9. 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).

10. Why choose Med-Peds?
 1. Age spectrum
 2. Variety/ depth of training
 3. Both medicine and pediatrics
 4. Flexible career options
 5. Primary care focus
 6. Ability to sub-specialize
 7. Role Models
 8. Did not want obstetrics or surgery
 9. Transition and adolescent
medicine
 10. More pediatrics training
(Friedland and Frohna, 2012)

11. 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.

12. O-Net Profiler Results
Investigative
 In 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.

13. 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.

14. 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 .