Sunday, February 19, 2012

What Is Med-Peds?

Most people understand the specialty of pediatrics: the care of children.  The advocacy group for pediatricians is the AAP, or the American Academy of Pediatrics.  Fewer understand the specialty of internal medicine (“medicine” for short), which is the care of adults.  The specialty society for this group is called the ACP, or American College of Physicians.
I am both of these.  I am both a pediatrician AND an internal medicine doctor (called an “internist”).  The name of the “specialty” given to what I do is called “Med-Peds”.
Med-Peds training is relatively unique, in that it incorporates half of its time (2 years) in internal medicine and the other half (2 years) in pediatrics.  After this training, doctors are eligible to go into practice in internal medicine, OR in pediatrics, OR in both (this last is ideal).  They can also choose more subspecialty training in internal medicine, OR in pediatrics, OR in both.  This flexibility in career options is quite attractive to those who choose our field.
Med-Peds is considered a primary care field.  Obviously, family medicine is a primary care field, as is pediatrics and internal medicine.  But in all of these options, trainees can choose further training.  This article (focus on Table 1) highlights the percentages of each which go into primary care.  Many forget that Med-Peds is a great option for those interested in primary care.  Others consider Med-Peds a great choice for those in medical school who can’t decide what they want to do.  Whether one chooses Med-Peds for any of these options is not critical: they chose it for their own reason, and that is what matters most.
What I have the privilege of doing within Med-Peds is being an educator.  At Indiana University School of Medicine, I oversee a Med-Peds residency program (the largest one in the country), and love the opportunity to train future physicians, no matter what their interests.  Niches within Med-Peds include transitional care (caring for patients as they transition from being a child to being an adult) and global health.  However, it is important to realize that Med-Peds alone as a specialty cannot be solely responsible for transitioning every child with a chronic condition to adulthood, and that other physicians need to be comfortable in thinking about this transition.  One of my Indiana University colleagues and mentors, Dr. Mary Ciccarelli, was involved in writing a document about transitional care, which was recently published, and has been passionate about furthering the concept of transitional care.
Explaining Med-Peds to physicians not familiar with it is difficult enough explaining it to patients is even harder (hence the reason for this post).  Med-Peds is not necessarily an “alternative” to family medicine (for the record, I do not “bash” family medicine as a specialty); the training is very different, yet many in both end up practicing similarly, in a primary care arena.
If you are a medical student, I encourage you to think about Med-Peds as a specialty.  If you are a patient, I encourage you to consider a Med-Peds doctor as your primary care physician.  Here are some quick facts about Med-Peds:
The training is four years total: two in pediatrics and two in internal medicine.
The training allows opportunity to pursue further training in either pediatrics, or internal medicine, or both.
A wonderful organization which promotes Med-Peds is called NMPRA (National Med-Peds Residents’ Association).  This website provides the best explanation of Med-Peds that I have seen.
A wonderful organization which promotes the education of Med-Peds trainees is called MPPDA (Medicine-Pediatrics Program Directors’ Association).  I was honored to serve as the president of this organization from 2010-2011.
Med-Peds is the only “combined” residency which is accredited by the Accreditation Council for Graduate Medical Education (ACGME).
There are currently 77 residency programs in Med-Peds accepting residents in the National Residency Match Program (the “Match”).  We would like to see Med-Peds grow as a field and have more accredited programs.
A blogger who has the same Med-Peds training as myself (and completed his training just as I was beginning mine at Indiana) is Dr. Rob Lamberts.  Here is his current website.
The Med-Peds Section of the American Academy of Pediatrics is the second largest section in the entire Academy.
I would love to hear your comments about the field of Med-Peds.  It is a wonderful specialty, and I am honored to call myself a Med-Peds doctor!

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