Correlates and trends in training satisfaction on completion of internal medicine-pediatrics residency: a 5-year study.

OBJECTIVE: To examine trends in training satisfaction in graduates of combined internal medicine-pediatrics (Med-Peds) training programs and whether curricular elements designed to enhance the integration of the two disciplines have been successful. STUDY DESIGN: We conducted a cross-sectional survey of all graduating Med-Peds residents (years 2003-2007). Responses across survey years were analyzed to identify trends. Data for all survey years was analyzed for correlations among curricular elements, perceived adequacy of training, and preparation for future activities. RESULTS: Overall, residents rated training time as just right for all areas except neonatal intensive care unit training, outpatient procedures, career planning, and office management. There was a significant upward trend in availability of board examination reviews, Med-Peds noon conferences, and mentoring. Residents' ratings of their preparation for most activities increased across the years. More residents reported being satisfied with preparation for internal medicine than pediatric primary care practice (86% versus 83%). Career planning seminars, mentoring, and board reviews correlated with the greatest increase in satisfaction. CONCLUSIONS: Med-Peds graduates report a high and increasing level of satisfaction with their preparation in multiple educational domains. Curricular elements designed to enhance integration of the two disciplines have a broad positive impact. Perceived pediatric practice preparation lags behind that of internal medicine.

The effect of dual training in internal medicine and pediatrics on the career path and job search experience of pediatric graduates.

OBJECTIVE: To compare the job search experience and career plans of medicine-pediatrics (med-peds) and pediatric residents. STUDY DESIGN: Annual surveys of graduating med-peds and pediatric residents were compared from 2003 and 2004. RESULTS: The survey response rates were 58% for med-peds residents (n = 427) and 61% for pediatric residents (n = 611). Pediatric residents were more likely to be female or an International Medical Graduate. The groups were equally satisfied with their career choice and had equivalent debt. Med-peds residents were more likely to seek and accept generalist and hospitalist positions. Pediatric residents were more likely to seek subspecialty careers and research opportunities. More than 94% of med-peds residents expected to care for pediatric patients. Among residents seeking generalist positions, med-peds residents sent half as many applications to get the same number of interviews and offers as pediatric residents, were more likely to be offered their most desired position, and were more likely to accept a position in a rural area/small town. Med-peds residents had substantially greater starting salaries as hospitalists or generalists compared with pediatric residents. CONCLUSION: Med-peds and pediatric trainees differ in their career plans, although primary care is their most popular choice. Med-peds- trained physicians have an easier job search experience and greater market valuation.

Training experiences of U.S. combined internal medicine and pediatrics residents.

PURPOSE: To investigate the demographics and training experiences of internal medicine and pediatrics (med-peds) physicians. METHOD: A cross-sectional survey addressing demographics, training experiences, and career plans of fourth-year residents graduating from combined internal medicine and pediatrics programs that were identified in the American Academy of Pediatrics database was initiated in May 2003. Questionnaires were mailed up to four times to nonresponders through August 2003. RESULTS: Valid responses were received from 212 of the 340 graduating residents (62% response rate). The majority (186/208 [89%]) reported that they would choose med-peds training again. Career planning (135/210 [64%]), office management (173/212 [82%]), and outpatient procedures (155/211 [73%]) were the only areas where the majority desired more training. Neonatal intensive care training was the only topic area that the majority of residents (142/212 [67%]) reported could have been carried out in less time. Nearly all residents (183/196 [93%]) planned to care for children and adults. Residents' self-assessment of their preparation was good to excellent for evidence-based medicine (192/210 [91%]), caring for patients with special health care needs (179/209 [86%]), and use of information technology (169/208 [81%]). Residents felt equally well prepared for postgraduate activities in internal medicine and pediatrics primary care (170/212 [80%] versus 163/211 [77%], p = .305, NS) and internal medicine and pediatric fellowships (186/207 [90%] versus 181/208 [87%], p = .058, NS). Only 112 of 209 residents (54%) felt their preparation for research was good to excellent. CONCLUSIONS: The study findings suggest that med-peds residents are satisfied with their decision to train in med-peds and with their level of preparation. They feel equally well prepared to care for adults and children, and well prepared to care for patients that may transition to adulthood with complex needs, to assess evidence, and to use information technology.