Ferrari ND.  Letter to the editor: “Hybridization of the primary care disciplines.”  JAMA 1986;256:2345.  Pub Med ID: 3773139  DOWNLOAD PDF

Letter to the editor commenting on an article which proposed combined FP-IM residency as a training option.  It weighs MP and FP with emphasis on more pediatric training in MP

Greganti MA; Schuster BL.  “Two combined residency programs in internal medicine and pediatrics.”  J Med Educ. 1986;61:883-92.  Pub Med ID: 3772964  DOWNLOAD PDF

The paper discusses the history of development of two of the earliest combined programs in Internal Medicine and Pediatrics. It documents the program curriculum and the career choices of the early graduates. At the time of publication, it presented the outcomes of the greatest number of resident completers of combined programs.

Peterson SE, Goldenberg K.  “A combined internal medicine and pediatrics residency program.”  J Med Educ 1986;61:688-90.  Pub Med ID: 3735374  DOWNLOAD PDF

An article describing the initiation of a MedPeds residency at Wright State University.

Peterson SE, Goldenberg K.  “Survey of combined residency programs in internal medicine and pediatrics on curricula.”  J Med Educ 1987;62:732-37.  Pub Med ID: 3625737  DOWNLOAD PDF

This survey of 83% of the nation’s med/peds programs in 1986 reviewed differences in curricula amongst the different programs. Outpatient clinics were a majority of the curriculum, with only 26% having a combined clinic at that time. The authors felt that a separate med/peds RRC, a combined med/peds clinic, and more resident exposure to the administrative aspects of practice (billing, insurance-claims processing, etc.) would be beneficial to med/peds training.

Schumway JM, Ferrari ND.  “Survey of medicine/pediatrics residency training programs.”  J Gen Intern Med 1987;2:377-80.  Pub Med ID: 3694296

This survey of 57 program directors of med/peds training programs found that most programs at that time had residents switch departments every 6 months, and residents were rated by the categorical program directors to be equal or above the competency level of the categorical medicine and pediatrics residents.  40 out of 45 graduates passed the medicine boards, and 48 out of 49 passed the pediatrics boards, which were written and oral at that time.  Follow-up as to what some of the graduates were practicing is also reported in the article.

Friedman AD, Rolfe UT.  “Letters to the editor: Medicine-pediatrics programs.”  J Med Educ 1987;62:1014.  Pub Med ID: 3681933 DOWNLOAD PDF

Letter to the editor summarizing a survey sent to MedPeds PD’s in 1986-7 about attrition from MP programs.  It had a 76% response rate.  Results were that 2/3 of graduates entered primary care, 1/3 entered fellowship.  There was an overall 1/3 attrition rate, with the residents opting for IM or Peds.

Graettinger JS.  Editorial. “The 1988 national resident matching program.”  Ann Intern Med 1988;108:761-62.  Pub Med ID: 3358577  DOWNLOAD PDF

This is a review of the 1988 resident match numbers in categorical internal medicine, med-peds, primary care tracks, and preliminary positions.  As a whole, the absolute number of fourth year medical students matching in internal medicine careers increased, but this increase came from only the primary care and preliminary positions. The percentage of students matching in all IM residency programs decreased overall (67.6 to 66.6%).  Compared to 1987, Internal Medicine-Pediatric programs increased in number from 70 to 76 (spots from 206 to 232) with a concomitant decrease in filling by US medical students from 73% to 62%.  Including all who matched that year, 69% of med-peds spots filled, down from 81% in 1987.

Martin TJ.  “Attrition rates in internal medicine-pediatric residency programs.”  J Med Educ 1988; 63:925.  DOWNLOAD PDF

Survey of the 75 Med-Peds programs at the time in 1987-8.  55 responded.  Documents the climb in program numbers and intern positions in the 1980’s.  It also documents a 20% attrition rate from the programs, 31% going to IM, 40% to Peds, and 6% to another Med-Peds program.

Siegel DM, Parker RM, Gillman MW, et al.  “Demographic features and attitudes of program directors of combined internal medicine and pediatrics residencies.”  AJDC 1988; 142:1104-08.  Pub Med ID: 3177308  DOWNLOAD PDF

Survey of the 55 program directors at the time.  Documented a primary affiliation with IM in 60% of the programs and some demographics of the program directors.  85% male, mean age 44, average time in job 2.5 years, 58% fellowship trained.  Also asked why med students chose med-peds and why Med-Peds had become so popular.  Main answers from the PD perspective were 1) alternative to FM, 2) In-Depth training 3) Care for patients of all ages.  Also asked if they saw a need for concrete guidelines for MP curricula, 75% said yes, 25% said no.

Ferrari ND, Shumway JM.  “Combined internal medicine/pediatric residency training programs”  Pediatrics 1989;84:94-7.  Pub Med ID: 2740182  DOWNLOAD PDF

Mailed survey to MP PD’s of the 80 programs in 1987-8.  84% response rate.  Main outcomes were the anatomy, attrition, board passage rates, and curricular structure of the programs.  There was a wide range of structures found in this pre-ABIM/ABP guideline era survey.

Goldenberg K, Barnes HV, Kogut MD, et al.  “A combined primary care residency in internal medicine and pediatrics.”  Academic Med.1989;64:519-24.  Pub Med ID: 2765063  DOWNLOAD PDF

This report reviews the development and evaluation of the Wright State University primary care residency program in internal medicine and pediatrics.  Traditional internal medicine and pediatric programs were often used as a standard of comparison.  The overall goals of the combined program including “emphasizing experiences in outpatient versus inpatient care, developing an ambulatory practice to help support resident salaries, adequately preparing residents to take the board examination in both disciplines, and providing a comprehensive primary care curriculum”.  At the time of publication, the program had graduated one resident and had eight current residents enrolled.

Middelkamp JN.  “Commentaries: Combined medicine/pediatrics training programs.”  Pediatrics 1989;84:181-2.  Pub Med ID: 2740172  DOWNLOAD PDF

Med-peds residency programs have greatly expanded since the first program in 1967.  In fact they have expanded from 8 positions in 1980 to 232 positions in 1988.   With the significant increase in training programs, the American Board of Pediatrics and the American Board of Internal Medicine decided it was important to establish educational guidelines to help assist the local faculty of individual programs in maintaining a well rounded residency experience.   These guidelines are published in this issue of Pediatrics.  The Boards of Pediatrics and Internal Medicine are now becoming interested in following the graduates from med-peds residency programs to see the ultimate careers that they choose.   Some especially intriguing data to seek would include the percentage of med-peds physicians who entered private practice vs. academic medicine and the percentage entering primary care vs. subspecialties.  It would also be valuable to see how many med-peds trained physicians ultimately choose to limit their scope of practice to only pediatrics or only medicine.   The boards will continue to support this research and report on the data as it becomes available.