Every day in the life of an internist and pediatrician, clinical questions arise. For HM practitioners, treating patients with chronic illnesses who are also on the cusp of adulthood presents a new set of challenges.
That’s when physicians trained in both internal medicine and pediatrics (med-peds) can lend their expertise. Once a physician successfully completes a four-year combined med-peds residency program, he or she may take the board certification exams in both internal medicine and pediatrics. Med-peds programs are now accredited by the Accreditation Council for Graduate Medical Education (ACGME) as a combined program instead of separate accreditation in internal medicine and pediatrics.
“The best solution would be to have more med-peds specialists as hospitalists,” says Moises Auron, MD, an assistant professor of medicine and pediatrics at Cleveland Clinic. They “can facilitate the transition by identifying these patients and providing an increased sensibility to the pediatric provider to ‘let the patient go’ and to open new insights to the adult providers to welcome those patients,” he says.
—Moises Auron, MD, assistant professor of medicine and pediatrics, Cleveland Clinic
A med-peds physician can care for people of all ages—from newborns to geriatric patients. He or she is prepared for the demands of private practice, academic medicine, hospitalist programs, and fellowships, according to the National Med-Peds Residents’ Association.
While med-peds residency offers exceptional training for primary care, it also leaves open the option of pursuing a subspecialty in either internal medicine or pediatrics, or both. Subspecialties include cardiology, infectious disease, pulmonary/critical care, women’s health, and sports medicine.
Med-peds celebrated its 40th anniversary as a formal training option in 2007. There are currently about 1,400 med-peds residents in training and about 6,300 med-peds physicians in practice, according to the American Academy of Pediatrics’ section on med-peds.
This broad-based training helps ensure smoother transitions of care. “It’s incumbent upon adult physicians to make the pediatric physicians aware of what services they offer, and also for the pediatricians to reach out with specific patients and refer them to adult physicians,” says W. Benjamin Rothwell, MD, associate program director of the med-peds residency at Tulane University School of Medicine in New Orleans.
Susan Kreimer is a freelance medical writer based in New York.