Preparation for practice: A survey of med-peds graduates

Background: Although combined internal medicine/pediatrics programs (med-peds) are increasing in popularity, little is known of the eventual practice patterns of med-peds graduates, and how well the med-peds curriculum prepares them for practice. Purpose: To characterize current practices of the med-peds graduates of 2 programs, and assess how well residency prepared them for practice. Method: Thirty-four graduates (81% response) of 2 med-peds residencies were surveyed regarding their current medical practices. These graduates were also asked to rate 23 procedure and 17 practice skills as to the importance the skills hold in their current practices, as well as their level of preparation from residency for each. Results: Most graduates (78%) practiced in an urban/suburban setting. Most (61%) provided primary care to adults and children. Respondents reported being overprepared for skills specific to an intensive care setting (i.e. neonatal and pediatric intensive care, delivery room resuscitation, Swan-Ganz catheter insertion, etc.), and underprepared for skills needed in an ambulatory setting (i.e. pelvic examination business/administrative skills, addressing the psychosocial problems of adults and children, etc.). Conclusions: Med-peds graduates most frequently report practicing adult and pediatric primary care. They report a discrepancy between skills emphasized in training and those important for practice. These findings have implications for curriculum development.