Internal Medicine-Pediatrics Pathway

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Detailed Pathway Website

Length of training: 4 years

Setting: University Hospitals Cleveland Medical Center, University Hospitals Rainbow Babies & Children’s Hospital, Louis Stokes Cleveland Veteran Affairs Medical Center

Description and defining characteristics: The Internal Medicine-Pediatrics (Med-Peds) pathways aims to provide a comprehensive training experience to residents interested in the care of patients across the age spectrum. Residents alternate every three to four months between internal medicine and pediatrics rotations. The timeline of the switches is coordinated to allow for exposure to the seasonal variability of diseases in both areas. In addition, the residents train at a wide variety of ambulatory settings, including an option of working with a Med-Peds clinician in the community. There are daily categorical conferences on patient management issues and core curricular material. There are also weekly Med-Peds conferences that focus on Med-Peds topics such as the transition of care for children with chronic health problems, as well as journal clubs and case conferences. There is a Mentoring Committee consisting of Med-Peds trained faculty that meet with residents throughout the year to help provide guidance on real world issues of practicing in a Med-Peds career.

Educational retreats and seminars throughout training also provide in-depth education on topics such as career planning, life-long learning, communication skills, performance improvement, team leadership and teaching skills.

Schedule: Click here to view a sample schedule

Medicine-Pediatrics Experience by Paul Shaniuk, MD

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How did you originally become interested in Medicine-Pediatrics pathway?
From the moment I wanted to become a physician, I knew that caring for patients of all ages was important to me. I was naturally led to Med-Peds by this, plus the fact that my goal was to care for medically complex patients. Med-Peds physicians consider themselves to be “specialists for adults and specialists for children,” and in medical school, I was fortunate to work with many outstanding Med-Peds doctors. The residents seemed to be prepared for anything and comfortable no matter the setting or the severity of the patient’s illness. Meanwhile, the attendings all seemed to be either doing some sort of cutting edge research in areas like medical education, health care policy or quality improvement or alternatively, carving a creative niche career for themselves such as comprehensive care of medically complex young adults and children. I decided that this was the career path for me, and the program at UH and Rainbow provides the opportunity for me get outstanding training as I grow into this type of versatile, academic physician.

Why did you think you would be a good fit for it?
Med-Peds distills six years of medical training into four. As a result, the curriculum is fairly standardized throughout the country, and naturally, I noticed a lot of similarities at the various programs where I interviewed. However, what set UH apart was both the quality of the residents and the camaraderie that they shared. They were academically bright and motivated, yet they knew how to laugh at themselves and have fun both at work and outside of work. I knew that I would thrive in this type of environment, and I was thrilled to be accepted here on Match Day!

What is the single most gratifying thing about training in the pathway?
Probably the support and camaraderie shared by the Med-Peds residents across all training years. Our residents fit seamlessly into each categorical program and are treated the same way as categorical residents. This is a great feature of the program, but despite this, training for two different medical specialties can be a daunting task at times. It would be so much more challenging without the support and assistance of my resident colleagues, especially within Med-Peds. The commitment to excellence is there as is the commitment to support each other as a program. It’s great to work in such a collegial environment.

How has your experience been up until now?
It’s been an amazing three years so far! I’ve seen myself grow in my abilities as a physician and in my academic successes as well. And I would be remiss not to mention the added joy of welcoming two children into my family during residency! I’ve had experiences with great mentors who have helped me get involved in developing quality improvement projects through the Quality Center at UH and mentorship to assist me in presenting some Case Reports at National Hospital Medicine conferences. I hope to use this training to become an academic general med-peds physician and remain involved in patient care, quality improvement and education of residents and medical students.

Can you give an example of the most inspiring thing you witnessed while training in the pathway?
I’m always inspired by my Med-Peds colleagues: by the care and drive of my fellow residents, of their clinical ability in the hospital and of their adaptability to various clinical scenarios. And to steal a second answer to this, I’m also inspired by the physicians who care with vulnerable populations, such as young adults with chronic disabilities. Early in my third year, I did an elective in Comprehensive Care that involved rotating at a nursing home for children and young adults with chronic disabilities. I was so impressed by the physicians and nurse practitioners there and how they interacted with these children and young adults in a loving way, as an integrated person. I will never forget the smiles of these patients that they had for their providers, not to mention witnessing the art studio for children with cerebral palsy. With the assistance of art and physical therapists, these patients were able to exhibit their creativity and expression and created some amazing works of art!

Why would you recommend joining Medicine-Pediatrics pathway? What sets it apart?
Med-Peds residents are known for their versatility and for their comfort in caring for the sickest patients. If you are looking for broad training to become comfortable in a variety of settings, then Med-Peds may be for you! No matter if you decide to specialize or go into primary care or general medicine or pediatrics, the broad training of Med-Peds at UH & Rainbow Babies will serve you well in your career as a physician.

More information about the pathway, including FAQs, is available in Medicine-Pediatrics section.