Med-Peds

What are some important statistics around the specialty?

Combined Internal Medicine-Pediatrics (Med-Peds) is a 4-year dual training residency that results in board eligibility for both internal medicine and pediatrics. It is a relatively small specialty, offering around 80 programs and 400 positions per year.

• Most applicants also apply to categorical IM and/or pediatrics programs
• Applicants who matched had a mean of 11 contiguous ranks, compared to 3 for those who didn’t
• Step scores for matched applicants were approximately 20 points higher than those who didn’t match, and were around the median for IM and Peds separately
• There is a >90% chance of matching when ranking at least 7 programs, and a >98% chance when ranking 12 or more

Sources:

• https://www.nrmp.org/wp-content/uploads/2025/03/Advance_Data_Tables_2025.pdf
• https://freida.ama-assn.org/
• https://medpeds.org/

What general advice do you have for someone choosing this specialty?

Med-Peds is ideal for students who are equally passionate about internal medicine and pediatrics and want to care for patients across the entire age spectrum. It offers incredible breadth and flexibility, allowing graduates to pursue careers in primary care, hospital medicine, academic medicine, global health, policy, or subspecialty training. Physicians often gravitate toward transitional care, complex chronic conditions, and underserved populations. If you truly cannot choose between IM and Peds and are excited to train rigorously in both, Med-Peds is likely a great fit.

What are the top three areas that students can focus on to help prepare themselves for a successful residency application and a successful transition to residency?

1. Clinical Excellence: Honors or strong performance in both IM and Peds clerkships, ideally with Sub-Is in both
2. Professionalism and Communication: Strong interpersonal skills, team orientation, and flexibility
3. Genuine Dual Interest: Demonstrated interest in both fields equally, including electives or service work

What resources would you share with a student who is just starting to research their interest in this specialty?

• National Med-Peds Residents' Association: https://medpeds.org
• FREIDA Program Search: https://freida.ama-assn.org/
• Podcasts:
  • NMPRA Med-Peds Podcast
  • The Cribsiders (Peds)
  • The Curbsiders (IM)
• Local Med-Peds interest group and faculty mentors

What subspecialties exist with this specialty?
 

Med-Peds graduates can pursue any internal medicine or pediatrics fellowship, including:

• Pediatric or adult Cardiology, Infectious Disease, Endocrinology, Hematology/Oncology, GI, Nephrology, Rheumatology, Pulmonology, and more
• Combined training pathways in transitional care or global health also exist

What does a typical workday or work week look like?
 

Typical schedules vary by role:

• Outpatient primary care: 8a–5p weekdays, all ages
• Inpatient hospitalist: 8–12 hour shifts, block schedules
• Subspecialty: Clinic, consult, or procedure-based

Work is often team-based, and Med-Peds physicians may split their time between IM and Peds.

What are the important traits, qualities, and/or considerations recommended for physicians in this specialty?
 

Adaptability, intellectual curiosity, compassion, and resilience. The best Med-Peds physicians are committed to lifelong learning, enjoy working with diverse populations, and thrive in complex or transitional care scenarios.

How does the specialty work differ in various settings?

• Academic: Teaching, subspecialty care, research, transitional programs
• Community: Broad primary care, hospitalist roles
• Private Practice: Primary care or urgent care for all ages

What does training for this specialty look like?

Med-Peds residency is a 4-year categorical program:

• 2 years IM + 2 years Peds
• Training may be block-based or integrated
• Graduates are board-eligible in both specialties

What types of experiences might strengthen my future residency application?

• Sub-Is in both IM and Peds
• Med-Peds electives, ICU/PICU/NICU exposure
• Advocacy or service work with transitional or underserved care
• Involvement in Med-Peds Interest Group, AAP, ACP, or NMPRA

Is there a specialty interest group?

Yes. Most schools have a Med-Peds Interest Group. Students should also consider:

• Joining NMPRA (https://medpeds.org)
• Attending national Med-Peds events and conferences
• Connecting with local Med-Peds faculty for mentorship

What advice would you offer MS1s and MS2s who are interested in this specialty?

• Shadow both internists and pediatricians
• Attend Med-Peds Interest Group meetings
• Explore continuity of care and chronic illness management
• Keep an open mind and build a balanced experience in both fields

How and where can I find other mentors for this specialty?

• Local Med-Peds faculty and residents
• National Med-Peds Residents' Association (mentorship directory)
• Attend Med-Peds conferences and workshops
• Contact Specialty or House Advisors at your institution

Is there anything else that could aid my future application now that Step 1 is P/F?

• Strong Step 2 CK score (often 245+ for competitive programs)
• Strong clinical performance and letters
• Consistent and clear interest in both fields

Which memberships might strengthen my application?

• AOA or GHHS if eligible
• NMPRA (student member)
• AAP (Peds) or ACP (IM)
• Local Med-Peds interest group leadership or involvement

How important are Step 2 scores?

Important. Many programs use Step 2 CK as a screening tool. A score above 245 is generally competitive.

Are publications important?

Helpful, but not required. Research in IM, Peds, or related areas is a bonus, particularly for academic programs. One or two posters or abstracts are sufficient.

Are there any special considerations when applying for residency?

Med-Peds is not a backup; programs want applicants who are committed to dual training. Be prepared to answer: “Why Med-Peds and not just IM or Peds?” or “Why not Family Medicine?”

What is a general recommendation for how many programs to apply to?

Ranking 7+ programs yields >90% match probability; ranking 12+ increases it to >98%. It’s impossible to predict how many interviews you’ll get based on the number of programs you apply to, but plan to apply to 16-20 programs if you are a competitive applicant, more if you are less competitive.

What letters of recommendation are recommended?

• Each program has its own requirements, so please look at each interested program well in advance to secure these
• One from a Med-Peds physician is always recommended
• One from the Chair of IM and/or Peds is recommended or even required, depending on the program
• One from Peds and/or IM is strongly recommended

Are there specific specialties you would recommend for LoR writers?

If a Med-Peds letter is not possible, choose someone who knows you well and can speak to your performance and commitment to both fields. Strong letters matter more than the writer’s specialty.

How competitive are the residency programs in this specialty?

Med-Peds is moderately competitive with a small number of positions. Applicants with balanced interests, strong Step 2 scores, and good clinical evaluations are usually successful. Competitive programs include those affiliated with large academic centers (e.g., Michigan, Baylor, Brown, UNC).

When do programs typically offer interviews?

Interview invitations usually go out in September and October, with interviews held from October through January.

What is UA COM-P’s history with matching in this specialty?

UA COM-P has a successful history of matching students in Med-Peds, including into top programs. Mentorship and networking with Med-Peds faculty are key.

Are away rotations required?

Not required, but may be helpful:

• If you are targeting a specific Med-Peds program
• If your home institution lacks Med-Peds-trained faculty
• Should be completed before ERAS submission, ideally after completing Sub-Is

Key Links

• National Med-Peds Residents’ Association: https://medpeds.org
• FREIDA Med-Peds Listings: https://freida.ama-assn.org/
• AAP Careers: https://www.aap.org
• ACP Membership: https://www.acponline.org/