Combined training in Pediatrics and Emergency Medicine is offered at four institutions: University of Maryland, University of Arizona, Indiana University, and Louisiana State University. Arizona has three spots, the remaining programs have two per year, though there is talk of increasing the number of programs and spots throughout the country. Graduates are board-eligible in both Pediatrics and Emergency Medicine after their five years of residency. Residents split their time each year between the two departments so they never spend too much time away from either program.
While there are a limited number of graduates, often they practice in Emergency medicine, but are increasingly choosing to practice both specialties in some capacity. Recently they surveyed the graduates from all the programs regarding where they wind up practicing and this can be found online. It is very important to remember that this residency currently does not take the place of an EM-Peds fellowship, which is typically desired when one chooses to practice in a Pediatric Emergency Department in major academic centers or standalone children’s hospital. These fellowships vary between 2-3 years depending on the location and the discipline in charge of the fellowship (EM sponsored are 2 years, Peds are 3, boarded EM physicians are able to participate in either, while Pediatricians may only do 3 year fellowships). There are people working to allow combined trained physicians to sit for the Pediatric-Emergency Medicine fellowship exam, but this has been unsuccessful thus far. This is crucial information to understand before selecting this career path as well as prior to interviews, so it is important to have a good understanding of your 10-20 year plan and what you wish to do with this unique training down the road so you look prepared.
Each of the programs are located in vastly different settings throughout the country, making the selection of the best program challenging. Consider the amount of time you will spend with each department. Ask residents if they feel integrated into both departments. Also, be sure to look into how much attention is paid (read: money is given) to each program within the hospital, this can help gauge how much the programs are valued within the hospital as a whole. Some of the programs are run as a unique combined program with a dedicated program director, some are managed by the two individual departments program directors with good collaboration. As with every program, find out how they are viewed and how they get along with other residencies. Often the program itself improves EM resident and Peds resident relations and wishes the combined residents to be ambassadors to both departments.
As there are currently a total of 9 (an increase from 7!) spots in the country, you must select a back-up, be it Peds, EM, or both. Even the best candidates have to be left behind with so few spots. Coming from Maryland is an advantage, as we have a program and you should talk with the current Peds/EM residents to get a good grasp of their experience before applying. Interestingly, this combined specialty has not been considered as competitive historically due in part to few people knowing about the programs (total applications are usually in the 30s), and selection of candidates based more on fit with the program than scores and grades, so do not be discouraged if your board scores were not as highly competitive. This trend is changing however as more people apply to this program each year. I strongly encourage you to speak with the residents and faculty involved with the program(s) early on so you can make a well-informed decision, and they can get to know you sooner.
Application is through ERAS and the traditional match process. Getting all applications in as soon as possible is ideal since there are limited interview slots. Interviews at Maryland and Arizona are offered in 2 day blocks, so plan for at least a 3 day travel for those programs. LSU and Indiana have a 1-day interview process. These training programs take a great deal of dedication, so think about it before you apply. If you do not like working with adults or dislike continuity of care, this is not the program for you. However, if you love Pediatrics and Emergency Medicine and could see yourself completely happy in either specialty, you have selected the right residency for you!
Last Revision: March 13, 2018