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ACP offers a number of resources to help members make sense of the MOC requirements and earn points.
Understanding MOC Requirements
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Combined Internal Medicine and Pediatrics (Med-Peds) residency
programs provide concurrent, dual training in Internal Medicine and
Pediatrics and allow eligibility for board certification and
practice in both disciplines. Physicians practicing Med-Peds see
both adults and children in a variety of practice settings and
practice styles. Practice settings range from outpatient primary
care to inpatient hospitalist practice, and practice styles range
from urgent acute illness care to the longitudinal chronic illness
care of patients with congenital heart disease.
Recognizing the need for physicians with in-depth skills in the
provision of care to adults and children, the American Board of
Internal Medicine and the American Board of Pediatrics approved
combined training leading to dual board eligibility in 1967. Since
then, combined internal medicine-pediatrics residency programs have
flourished, especially since the mid-1980s. Med-Peds attracts
bright, capable physicians desiring a challenging career path
either in primary care or further subspecialty fellowship
With their in-depth knowledge of both internal medicine and
pediatrics, Med-Peds physicians can synthesize their clinical
knowledge into care for patients spanning the spectrum from birth
until death. They encounter a wide variety of patients and clinical
scenarios: well baby visits, high risk deliveries, newborn
assessments, common childhood illnesses, emergency room visits,
basic gynecology care, inpatient adult and pediatric patients,
outpatient adult and pediatric patients, adult and pediatric
intensive care. Because of their dual training, Med-Peds physicians
are uniquely qualified to care for adolescent patients,
particularly children with complex and chronic conditions as they
transition to adulthood.
Med-Peds trainees and physicians receive the same in-depth
training as their categorical pediatric and internal medicine
colleagues. Recognizing a shared knowledge base, a Med-Peds
residency is streamlined into four years of residency training.
Residents change between their internal medicine and pediatric
rotations every 3-4 months, depending on the residency program. By
the end of four years residents will have completed core
requirements for both categorical internal medicine and categorical
pediatrics, including some elective time.
A frequently asked question regards the differences between
Med-Peds and family medicine since both are trained to care for
adults and children. Med-Peds training is four years, versus three
for family medicine, and includes in-depth training in both
internal medicine and pediatrics. Med-Peds does not include
obstetrics/gynecology or surgical training like family medicine and
completion of Med-Peds training allows for dual board certification
in internal medicine and pediatrics. In practice, Med-Peds
physicians are generally more narrowly trained to care for both
healthy but also very complicated children and adults in great
depth, while family physicians are trained to attend to the broader
needs of a family in both health and sickness, with a clear focus
on the primary care of the family unit.
For the 2013-2014 academic year there are 79 accredited training
programs in Combined Internal Medicine and Pediatrics with 1,462
active residency positions. Program accreditation is granted by the
Council for Graduate Medical Education (ACGME).
At the completion of residency training in Med-Peds graduates
are board eligible for certification by the American Board of
Pediatrics and by the American Board of Internal Medicine
American Board of Internal
Med-Peds residents may choose to enter a subspecialty fellowship
in either internal medicine or pediatrics, or both. Dual board
eligibility may prove to be a competitive advantage to fellowship
directors who are reviewing fellowship candidates. Many residents
choose a fellowship where their expertise in both specialties will
be beneficial. Med-Peds trained physicians have pursued nearly
every type of fellowship training with cardiology, endocrinology
and infectious disease representing the most popular fellowships.
Combined internal medicine and pediatrics subspecialty fellowships
can be streamlined via special arrangements with the fellowship
directors and the boards.
There is a wide variety of practice settings and styles
available to a Med-Peds physician. Primary care, inpatient care,
subspecialty practice and urgent care are the most popular practice
styles. Practice settings range from solo practice to large
multi-specialty groups to academic medical centers. Some Med-Peds
physicians pursue international health careers in the U.S. or other
November 2013 Issue of IMpact
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