Career Advisor's Background and Career Information

Background

Clinical Interests/Duties:
I largely work as an inpatient doctor (hospitalist) with several months a year acting as ward attending at Moffitt Long Hospital on the general internal medicine and pediatrics services. Resident and medical student teaching and supervision are prominent duties during these months. I also continue to staff pediatric urgent care sessions (like pedi ED), which allows me to come into contact with many residents and medical students through the year for additional precepting

Research Interests/Duties:
medical student education, transitions of care from hospital to home, home visits to patients, transitions of care from pediatric to adult medicine.

Personal Notes or Comments:
One of my favorite duties/activities over the years has been to sit and casually chat with medical students making career decisions. I welcome any questions about the combined training that is available for medicine/pediatrics or the comparison of the two categorical programs in both residency traning and as an attending.

1. What can students do in the 1st and 2nd years to explore and/or prepare for this career?
I would first stress that it is important to not feel pressured to make a decision too soon. There are always students who change their minds many times through medical school. I would suggest paying close attention to interests groups and attending some gatherings to get to know more about the culture and lifestyle of different physicians in different fields. There are plenty of informal get-togethers with residents present--who are your best resources to get the nitty-gritty of training. Shadow attendings when possible (don't be shy!) in given fields of interest to get an idea of daily life.

2. What common variations exist in length/content of residency programs for this career?
All Medicine/Pediatrics programs are four years in length. They vary with respect to intervals at which a resident switches back and forth between medicine in pediatrics, though most have a four month block (this can vary from 3-6 months, however). Because you are meeting requirements to sit for boards in BOTH specialties, you have a limited time to do so in four years. This makes the variability amongst programs much less than in categorical programs. The amount of elective time is largely truncated in all programs because of the time-crunch, but there are some institutions with a more creative approach to classifying "elective" time that can allow you latitude in internation travel or other endeavors

3. What common variations exist in this career after training?
There are SEVERAL. Roughly half of residents graduating in the past few years have entered primary care--in medicine/pediatrics, family practice, internal medicine, or pediatrics clinics. Several graduates (~33%) have subspecialized in one area or the other (pediatrics or adult medicine) and a few have entered new fellowships which train in their given subspecialty in BOTH fields. Other possible areas for your career include hospitalist medicine in the community and teaching/academic medicine. Contrary to what many believe, most med/peds trained doctors still care for both adults and children.

4. What is the "culture" of this career?
Very dual-fold, as you might imagine. There are aspects of both categorical medicine and pediatrics cultures--depending on which field you are working in at the time. There is not much of a med/peds presence on the West Coast to have an actual "culture," but during training you will find that it is a field that attracts very diverse, independent, adaptable, and bright young doctors.

5. How compatible is this career with raising a family? How is this different for men and women?
Academic medicine is both rigorous and flexible, with rewarding properties of teaching to keep a person interested in what otherwise could be a grind-a-day job. UCSF is a largely family-friendly institution and many people have carved out careers in special ways to suit their home needs.

6. How important are each of the following for admission to a competative program:
Extra-curricular / volunteer work: 5
Research/publications: 4
Honors in the third year: 5
AOA: 4
A sub-internship: 5
An externship: 3

7. What are the most important qualities or character traits for a person in this field?
Adaptability, independence. There are many times when you feel 'out of the loop' with respect to your categorical colleagues, and need to fall back on some internal strength to get through residency and know all will equalize on the other end of training.

8. How competitive are the residency programs in this field?
Small numbers of residents each year means very competitive programs.

9. How competitive is the job market after residency?
Given the breadth of the possibilities for your career, job opportunities are plentiful.

10. What programs would you consider to be in the 1st tier, 2nd tier and 3rd tier?
Programs are really clustered on the East Coast and in the Mid-West. Well-known and highly thought of programs (in both categorical and med/peds) include Harvard, UNC-CH, Penn (new program), Duke, Michigan, Yale, Brown. Lesser-known from a categorical perspective, but highly thought of from a med/peds perspective include: Rochester, Baystate, Case-Western, and UCSD.

11. What resources (web, books, etc besides the AMA and AAMC sites) would you recommend for students interested in learning more about this field?
http://www.medpeds.org/
http://www.aap.org/sections/med-peds/