I apologize in advance, but I have a lot of problems with your advice PalmOlive. it is never too late to apply to programs until the match list is officially submitted.
I know plenty of people who interviewed for MULTIPLE programs including Med-Peds and the categoricals.
The field of Med-Peds hospitalist has not yet seen its peak because there has not been the full appreciation of the dual trained doctor.
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Well, I never said that it was too late to apply for med-peds. I was just guesti-mating that if it takes 3-4 weeks to get in an LOR that some Med-Peds programs have filled most of their interview spots since then, i.e. getting the whole thing in around November 1st is OK. Based on my percentage guesses I am just suggesting that this person apply to maybe 30 med-peds programs to yield about 10 interviews . . . if he/she gets too many interviews no problem. My advice is pragmatic and it helps this person tackle the next step.
But for everybody else out there, I will be on the med-peds interview trail and have gotten basically 40% of programs I applied to respond back with an invite for interviewing, some with only a few interview dates. Which really surprised me!
I expect to get the remainder of my interview invites between October and early November. So, basically if applicants follow your advice then come November 1st I have basically ALL the interviews I want and some applicants would just submit their applications.
So, don't believe someone about to hit the interview trail . . .
I do totally agree that decisions should be made on what you like to do, in the end you will do it for decades likely, and basically I was trying to point out that the salary for an IM hospitalist and a Med/Peds hospitalist are probably about the same. Some people have to delay doing a fellowship to pay off loans that are really huge, that is just life. Perhaps some medical students stuck between straight IM or Peds can't afford to do Med-Peds.
Normally I wouldn't comment about the financial loops you have to jump through to do Med/Peds at all, but this OP asked about it.
In terms of "appreciation of the dually trained doctor" I think Med-Peds offer great advantages for rural health, i.e. where a doctor who can see both types of patients is needed. However, in hospital settings, i.e. hospitalist positions, it is easy for a hospital to hire an IM doc to do hospitalist work full-time and for the Peds department to hire a pediatrician to be a full-time hospitalist.
As hospitals are in need of hospitalists now there is opportunities for med/peds physicians to work in both departments as a hospitalist for children and adults. However, I do not believe that being a med/peds doctor gives you a leg up necessarily in getting a hospitalist position, especially at hospital which mainly have adult patients as you would need to negotiate with both the pediatrics and the medicine departments. Currently, for IM doctors, pediatricians and med/peds docs there is no shortage of hospitalist spots.
While I love the positives of Med/Peds such as being able to see both adults and children, I wouldn't say that Med/Peds docs have a advantage over pediatricans or internists in securing hospitalist positions as most hospitalists are either pure IM or pure Peds. I have resigned myself to having to negotiate between both Peds and Medicine departments to be able to treat patients in both the peds and adult wards, and plan to ask nicely to be able to do this as I feel I would be a slight imposition on them.
Why? Because an IM hospitalist see adults patients more in residency and initially may make a better pure IM hospitalist (likewise for Peds) so I figure I will have to go up the learing curve quickly as a Med/Peds physician if I am seeing both peds and adults on an inpatient unit. In economic terms I don't know if there is much if any advantage to hiring one IM doc hospitalist and one Peds doc hospitalist versus two med/peds doctors . . . the combination has equivalent training in terms of excellence in IM and Peds, . . . there is intellectual stimulation for the med/peds doc, but I don't think that being a Med/Peds hospitalist will ever lead to increased appreciation or recognition amoung pure IM and pure Peds hospitalist, why should it?? Every field in medicine hopes for increased recognition/appreciation at some point and many are disappointed. Actually, as far as I know the number of Med/Peds residency slots has decreased over the last decade and a lot of programs have closed, meaning that any appreciation of Med/Peds docs over IM and Peds docs has not translated into more residency positions or programs to produce more of these doctors.
I have talked with a med/peds program director that did NOT like it when applicants applied to both categorical Peds and Med/Peds at the same institution. It could make you look less dedicated to med/peds which is a fairly intensive residency compared to categorical Peds or IM. . . . Again, dfferent PDs may have different opinions on this, . . . Basically I wouldn't apply to peds and IM at every place I applied for Med/Peds but would diversify my applications to different places I would want to go. If you do apply for both Med/Peds and either Peds or IM at a single hospital they usually know about it.
I feel it is an exaggeration to say that it isn't too late to apply for med/peds until the rank list is in. Obviously your chances decrease the more you wait, and if you applied in January or February before the rank list are in, well, if you get any interviews you have a lot of tap dancing to do to show how much you want to do Med/Peds.