Med-Peds is a four-year program where you divide your time evenly between internal medicine and pediatrics. At the end of the four years, you are board-eligible in both fields. Although started in 1967, there were very few programs until the late 1980’s, when these programs dramatically increased in popularity, number and capacity. For the 1997 Match, there were 102 programs offering 442 positions. Almost all of these are in the Midwest (36), Northeast (29) and South (29). There are very few in the West.

Given the dual nature of med-peds, many applicants would most likely be happy doing any of the three options (med, peds, family). The question remains, are you convinced that med-peds is how you must spend the rest of your medical career? If the resounding answer is "yes," than it may be best to apply only to med-peds programs and save yourself the added hassle and confusion of looking at other types of residencies. However, know that the caliber/reputation of med-peds programs vs. straight medicine or pediatrics programs is very different (with very few exceptions). Many med-peds programs are places where either the medicine or pediatric program may not be spectacular. This means you may have to sacrifice program quality for the chance to actually do the med-peds option. Some say this doesn’t matter because place of training is irrelevant in the face of type of training. For others, it is a choice between getting top-notch training in medicine or pediatrics vs. training at a so-so institution that happens to offer med-peds. If, after much soul searching, you decide med-peds is your destiny, I suggest doing a three-tiered search - look around at the med-peds programs (Green Book is best), and then scrutinize each institution’s medicine and pediatrics residencies. Your safest bet is to give a go at both roads; it’s a lot more work and interviewing, but you will sleep better knowing you explored all of your options.

This, of course, depends on your needs and how you did in school. But, because med-peds programs are small (average number of spots is 4.3 per program), it gets tricky even for the best applicants. In general, you will need to file more applications than if you were applying for categorical programs offering 20+ positions. Be receptive to programs you have never heard of, since many are new and this isn’t necessarily bad. Be receptive to areas of the country that aren’t perfect or places you never imagined you would live. There aren’t many places with more than one med-peds program, so you will be doing a lot of traveling, making the cost of interviewing somewhat higher than other programs.

Most programs ask for recommendations from the Pediatrics Department Chair, the Medicine Department Chair, a Medicine faculty member and a Pediatrics faculty member. Plus, an extra "other" recommendation from any attending would also be very handy to have This may sound excessive, but each program asks for different combinations of the above and since you can customize your application with ERAS, it’s best to tailor them to each institution. I strongly suggest calling these offices early to avoid the last minute crunch of trying to schedule a meeting for your letter. In addition, they will often offer to read over your personal statement and give you suggestions - remember: these people read tons of statements for their own residency programs.

1. Good medicine and pediatrics departments - you can’t build a solid whole if one-half is rotten.
2. Approximately comparable medicine and pediatrics departments and thus mutual respect between the two - unfortunately, there are some places where one department looks down on the other and if you are a med-peds resident in such a place, you will experience a lot of unnecessary friction in your life.
3. Commitment to the med-peds program in the person of a director, faculty, clinic, or specific programs for the med-peds resident.
4. Good communication between departments and evidence that they will work together on your behalf.

These are in addition to the usual things you should look for: Are the residents happy? How’s the teaching? etc.

Just take a big ol’ breath, put on a suit, and forge on with a smile. If it’s any consolation, you’ll meet extremely nice and interesting people from other schools during your interview trail, and everyone is in the same boat. It ultimately becomes therapeutic to commiserate with fellow interviewees, as well as get their opinions of what they’ve seen.