Med-Peds

Med-Peds or "Combined Internal Medicine & Pediatrics" is a medical specialty which trains its doctors to be board certified in both Internal Medicine and Pediatrics. After medical school, doctors typically train for four years dividing time equally between the two specialties making Med-Peds physicians able to take care of patients of all ages.

History
Combined internal medicine-pediatrics (Med-Peds) residency programs have existed since 1967, with its origins beginning as early as 1949 in the form of a two-year rotating internship. The specialty was initially established to provide broad-based training in primary care, but programs now offer a curriculum that prepares residents for primary care, hospital medicine, or education in the subspecialties.

Training
Internal Medicine physicians, or internists, train three additional years after medical school leading to Board Certification in Internal Medicine. Pediatricians train three additional years after medical school to board-certify in Pediatrics. Med-Peds physicians train for four years and can be "double-boarded" for both these specialties. Since there is frequent crossover of disease and treatment between children and adults, Med-Peds training enjoys the consolidation of these two specialties into four years. The performance of Med-Peds physicians on the two national board exams is equal to their one-specialty (specific internist or pediatrician) counterparts.

Med-Peds physicians are heavily trained for primary care. A recent study on post-residency training showed that 61% of Med-Peds physicians pursue primary care as a career, 18% enter subspecialties, and 17% pursue hospital medicine. Many subspecialties are available to the Med-Peds physician, with the current most popular being Infectious Disease, Critical Care, Allergy/Immunology, and Endocrinology.

Philosophy
Many people question the differences between the specialties of Med-Peds and Family Practice. A physician trained in Med-Peds can care for the newborn to the geriatric patients. Med-Peds prepares a physician well for private practice, academic medicine, hospitalist programs, and fellowships. Family practitioners typically receive formal obstetrical, gynecologic, psychiatric, and surgical training, while Med-Peds doctors do not. Family Practice residents train for three years, while Med-Peds residents train for four. This extra year is thought to make Med-Peds physicians more proficient at treating and diagnosing more complex diseases, including more emphasis on critical care medicine. Med-peds physicians also receive equal training in adults and pediatrics (24 months of each) while family medicine physicians spend a larger percentage of their training working with mostly adults; most family physicians only spend a few months dedicated just to pediatrics. A trend also seen is that an increasing percentage of Med-Peds physicians treat inpatients (patients in the hospital) as opposed to an outpatient clinic setting.