Medicine-Pediatrics

What Is Med-Peds and Why It Matters for PGY-0 Planning

Internal Medicine-Pediatrics (Med-Peds) is a four-year combined residency that produces physicians board-eligible in both internal medicine and pediatrics simultaneously. Graduates sit for both the ABIM and ABP certifications. The training alternates between adult and pediatric services across all four years rather than sequencing them; you are not doing two residencies back to back—you are doing one integrated program with dual attending supervision, dual continuity clinics, and dual board preparation running in parallel throughout.

That structure has real consequences for PGY-0 planning. Because both medicine and pediatrics programs are fully accredited within the same four years, you are competing with categorical IM and categorical Peds applicants for attending time, procedures, and learning opportunities—and your program is deliberately building someone who can do both. Programs are not lowering their standard for either discipline; they are raising the bar by requiring competence across both. You need to arrive at residency orientation already comfortable framing yourself that way.

The match is small. The total number of Med-Peds positions nationally is a fraction of categorical IM positions and a fraction of categorical Peds positions. Roughly 120 programs participate in any given cycle (see the current data page for the most recent count). Because the community is small, attendings at strong programs know each other, program directors communicate across institutions, and your reputation—clinical and interpersonal—travels. Early intentionality is not optional. An applicant who decides in MS4 October that they want Med-Peds and has no prior engagement with the field will be visible as a late convert in a field where many competitive applicants have been committed since MS2 or early MS3.

Why choose Med-Peds at all? The honest answer is that it is the correct choice for a narrow, specific kind of physician: someone who genuinely cannot make peace with limiting their clinical identity to one age range, who wants to see the developmental arc of disease across a human lifespan, and who accepts that the tradeoff is a longer residency, a more complex fellowship landscape, and a practice model that requires deliberate construction post-training. If that description fits you, Med-Peds is defensible and strong. If you are choosing it to hedge between two uncertain interests, that motivation is legible to every experienced interviewer in this field and will cost you.

Match Landscape: Numbers Every Applicant Must Know

The current position count, fill rate, and applicant-to-position ratio for Med-Peds change each cycle. Every figure below should be verified against the NRMP's most recent Main Residency Match data, which are published by applicant type and specialty after each Match. Do not rely on any static figure here or elsewhere—see the current data page for updated numbers.

What the longitudinal NRMP data consistently show, cycle over cycle, is the following structural pattern:

• Med-Peds fills at a high rate relative to many small specialties. Programs are not desperate for applicants. Competitive pressure is real.
• US MD seniors have historically matched at higher rates than other applicant types, consistent with nearly every specialty, but the gap to IMGs and DOs in Med-Peds is not fixed—it narrows or widens with cycle-to-cycle variation and individual application quality.
• Step score distributions at matched applicants trend above the national mean for both IM and Peds separately. This is a program perception issue as much as a hard cutoff issue: because programs are evaluating candidates against two specialty norms simultaneously, competitive applicants tend to cluster toward stronger numerical profiles.
• Rank list length matters in small specialties more than large ones. The NRMP publishes median rank list lengths for matched applicants by specialty; in a field with roughly 380 positions and 120 programs, a rank list of 10–12 programs carries meaningfully less redundancy than a rank list of the same length in a field with 800 programs. The strategic implication is discussed in the program list section below.

The single most actionable data habit for a PGY-0 Med-Peds applicant: read the NRMP Charting Outcomes in the Match report for your applicant type in the year before you apply, and read it for Med-Peds specifically. The report breaks down matches by Step scores, research experience, and number of programs ranked, and it is publicly available. That document should be on your desktop, not summarized for you by someone else.

The PGY-0 Timeline: Month-by-Month Action Plan

The timeline below assumes you are entering with your eyes open in MS2. If you are a reapplicant, a graduate applicant, or an IMG beginning this process later, compress it—the structural tasks are the same, the sequencing is tighter. See the current season timeline page for application-year-specific dates.

MS2: Summer Before Dedicated Study

• Identify two or three Med-Peds attendings or senior residents at your institution and have one substantive conversation with each. Ask what they wish they had known before applying. Ask what distinguished the applicants who matched at their program.
• Find the Med-Peds Society of North America (MPSNA) and familiarize yourself with its structure. Its annual meeting is the single best networking venue for this specialty at the student level.
• If your school has a Med-Peds interest group, join it and take on a role. If it does not, founding one is a low-cost, high-visibility scholarly activity for your application.

MS2: Academic Year

• Identify a research project in either medicine or pediatrics—ideally one with dual relevance. Health disparities work, adolescent medicine, underserved populations, and global health topics all carry natural cross-disciplinary resonance. This is not a requirement, but a submitted abstract or manuscript by application opens increases your application's density.
• Begin Step 1 preparation with timeline awareness. Your Step 1 score (pass/fail for most MD students under the current system, numeric for many DO and IMG applicants) and your Step 2 CK score are the primary numerical anchors reviewers use. Step 2 CK timing is critical—see the benchmarks section.

MS3: Clerkships

• Your IM and Peds clerkships are your audition tapes for two different attending populations simultaneously. Do not treat either as a secondary priority. You need strong evaluations from both services.
• Identify attendings in both clerkships who could write a letter that speaks credibly to your dual commitment. Do not ask yet—build the relationship.
• If your school allows an MS3 elective in a Med-Peds continuity clinic or ambulatory block, take it. Demonstrating early exposure to the combined training model strengthens your narrative.

MS3: Late Spring / Early Summer

• Take Step 2 CK as early as your school's policies allow, ideally before application opens. Programs use CK scores in screening and in interview decisions. Scores that arrive after your application is reviewed carry less weight than scores submitted at the open.
• Finalize your research project timeline. If publication is not realistic, a submitted abstract or poster presented at MPSNA or AAP/ACP is documentable.
• Draft a rough personal statement. Do not submit this draft anywhere. Use it to test whether you have a genuine narrative or a hedged one.

MS4: Summer Before Application Opens

• Away rotations (see clinical experiences section) should be scheduled and confirmed. Most away rotations require applications months before the rotation date; plan backward from the away rotation, not forward from when you remember to apply.
• Request letters of recommendation from your identified attendings. The timing and content of that ask are detailed in the LOR section.
• Finalize program list. Use the MPSNA program directory and FREIDA. Build your list before application opens, not during.

MS4: Application Open Through Interview Season

• Application opens in ERAS. Submit on the first day or within the first week. Small-field programs with limited interview slots fill their review queues quickly.
• Interview invitations typically begin arriving within weeks of application open. Accept promptly; Med-Peds interview slots are limited by program size.
• Track program-specific signals and follow-up communications. Document everything.

MS4: Post-Interview Through Match

• Rank list submission opens and closes on a published NRMP schedule. See the current season timeline.
• Post-interview communications with programs vary in norms by institution; follow the guidance in the signaling section below.
• Match Day and SOAP planning are addressed in the final section.

Building Your Med-Peds Identity Early

The single question every Med-Peds interviewer will probe, in some form, is: why both? Not why medicine. Not why pediatrics. Why the specific intellectual and clinical commitment to both, across a four-year training and a career. The applicants who answer this question fluently are the ones who built the answer through actual experience rather than reverse-engineered it in their personal statement.

A coherent Med-Peds identity has three visible components by the time your application is submitted:

Clinical Exposure to Both Disciplines Across Multiple Settings

A strong application shows not just clerkship evaluations in IM and Peds, but engagement with the intersection: adolescent medicine, transition medicine (moving pediatric patients with chronic disease into adult care), underserved primary care spanning age groups, or global health work that required both skill sets. If your clinical experience is deep in one discipline and thin in the other, your narrative will feel asymmetric and programs will read it accurately as a hedge.

Scholarly Work With Dual-Discipline Relevance

You do not need a publication. You do need something that demonstrates sustained intellectual engagement with a question that Med-Peds training is particularly well positioned to answer. Quality improvement projects in continuity clinics that serve both adult and pediatric populations, health disparities work in mixed-age communities, or transition care research are the categories of scholarship that read as genuinely Med-Peds rather than opportunistically combined.

Mentorship and Visibility in the Community

Med-Peds is small enough that a senior resident or attending at your target programs may know your letter writers by name. This is not a system to game—it is a reality to plan for. Seek out Med-Peds attendings, not just IM or Peds attendings separately. Go to MPSNA. Be visible in the national student community early enough that your name is not appearing for the first time on a rank list.

Clinical Experiences That Strengthen Your Application

Away Rotations

Away rotations in Med-Peds carry a different function than in other specialties. Because programs are small and cohesion within a residency class matters disproportionately, an away rotation is an extended mutual evaluation. Programs want to see how you perform on both their medicine and their pediatrics services—not just one. Aim for programs on your target list, not prestige-name programs where you have no realistic match probability. A strong away performance at a program where you genuinely want to train, and where your face is now known, is worth more than a mediocre away at a program you ranked as a reach.

Schedule away rotations through VSAS according to each program's individual requirements. Confirm early—popular programs fill visiting student spots months in advance.

Sub-Internship Selection

Competitive applicants typically complete sub-internships on both an internal medicine service and a pediatrics service before rank lists are submitted. A MICU or PICU rotation adds procedural and acuity credibility that clerkship-level evaluations cannot provide. If your school's curriculum allows only one Sub-I, choose the discipline where your application is weaker—the stronger discipline is already evidenced by your clerkship record.

Continuity Clinic

Ambulatory continuity experience is weighted heavily in Med-Peds because the specialty's post-training practice is predominantly outpatient or mixed. Time in a continuity clinic—especially one serving across age groups or underserved populations—gives you both talking points and authentic clinical material for your personal statement and interviews. Do not treat continuity clinic as a necessary inconvenience between inpatient blocks.

Global Health and Underserved Settings

These experiences resonate specifically in Med-Peds because they test exactly the skillset the specialty develops: managing complex, resource-limited patients across age groups without subspecialty backup. They also align with the scholarly themes that read well in this field. They are not required, and a poorly supervised or short-duration international trip that you cannot speak to in depth will not help you. Quality and reflective depth matter more than geography.

Research and Scholarly Activity in Med-Peds

Med-Peds programs do not uniformly require research. This is verifiable: the NRMP Charting Outcomes data show that a meaningful proportion of matched applicants have no publications. However, the same data show that matched applicants at more competitive programs tend to have higher rates of research experience. The honest framing is that research strengthens an application that is already competitive on clinical and exam grounds—it rarely compensates for weakness elsewhere, and absence of research does not disqualify an otherwise strong applicant.

What matters more than publication count is the type of project and your ability to speak to it coherently in an interview. Projects that read as genuinely Med-Peds—rather than as IM or Peds work you are rebranding—include:

• Health disparities research in populations that span age groups: uninsured adults and children in the same catchment area, immigrant families across generations, rural communities with limited subspecialty access.
• Transition medicine: the evidence base for moving adolescents with chronic conditions (congenital heart disease, type 1 diabetes, sickle cell, cystic fibrosis) into adult care systems is still being built, and it is a field where Med-Peds physicians have a structural advantage in designing and studying interventions.
• Quality improvement projects in ambulatory settings: care coordination, vaccination equity, chronic disease management in primary care. These are publishable as QI projects and directly relevant to what Med-Peds graduates do.
• Medical education research in combined training programs: if your institution has a Med-Peds program, an education research project with a Med-Peds faculty mentor is both accessible and high-signal.

Frame any scholarly work in terms of what you learned to do, what question you were trying to answer, and what the answer was. Do not list it as a credential; describe it as an intellectual experience. That distinction is audible in interviews.

Letters of Recommendation: Who to Ask and When

The Ideal Portfolio

Most Med-Peds programs expect three letters and will accept four. The strongest portfolio for this specialty contains:

• One letter from an internal medicine attending who can speak to your clinical performance on an inpatient or sub-I level, not just an outpatient preceptor relationship.
• One letter from a pediatrics attending with equivalent depth of evaluation.
• One letter from a Med-Peds attending or program director who can explicitly speak to your suitability for combined training—why you, specifically, are someone this particular training model is built for.
• A fourth optional letter: research mentor, global health supervisor, or a second Med-Peds attending if the third letter writer cannot address your clinical performance directly.

The third letter—from someone inside the Med-Peds world—is the differentiating one. It requires that you have cultivated a relationship with a Med-Peds physician early enough to have generated a genuine impression. This is why MS2 networking is not optional.

When to Ask

Ask for letters at least eight weeks before you need them uploaded. The realistic ask for MS4 application season is late spring or early summer of MS4 year, after your relevant clerkship or sub-I performance is complete and visible. Do not ask before the attending has enough data to write substantively. Do not wait until July of application year if your rotation ended in April.

How to Coach Your Writers

Writers who are not Med-Peds physicians may not know how to frame a letter for combined-specialty training. Give each writer a one-page document that includes: a summary of your Med-Peds-specific experiences and scholarly work, the core narrative of your personal statement (the "why both" argument), and one or two specific clinical moments from your time with them that you would like them to include if they remember them positively. You are not writing their letter; you are giving them the context to write a strong one. Most experienced attending writers appreciate this. Anyone who finds it presumptuous is not the right letter writer for this application.

USMLE/COMLEX Benchmarks for Competitive Applicants

Step scores in Med-Peds function as initial screening tools at many programs. Because the applicant pool is small and programs review applications manually to a greater degree than large specialties, scores below a program's informal threshold are more likely to result in a quiet non-invitation than in a follow-up request for context. Know your score position relative to the matched-applicant distribution before you build your program list.

Current benchmarks by applicant type are on the data page. The structural observations that hold across cycles:

• Step 2 CK is weighted as heavily as Step 1 by most Med-Peds programs, and some programs explicitly state they weight it more heavily because it better predicts clinical performance. Taking CK early—before application opens—maximizes the window for programs to see your score during their initial review.
• For DO applicants: COMLEX scores are accepted, but many Med-Peds programs also expect or strongly prefer USMLE scores. This is program-specific. Review each program's stated requirements and do not assume your COMLEX score alone is equivalent in reviewer utility to a USMLE score at a program that has historically trained MD graduates.
• For IMG applicants: both Step 1 and Step 2 CK are numeric and visible. Scores above the matched-applicant median for IMG applicants in Med-Peds substantially improve your probability of interview invitation. Scores below the median do not disqualify you, but they shift the burden of proof to other application elements. There is no honest way to say otherwise.
• Attempt history is reviewed. A score achieved on a second or third attempt, transparently disclosed and paired with strong clinical evaluations and upward trajectory, is a manageable narrative. A score achieved on a second attempt that the applicant has not addressed anywhere in their application is not—reviewers notice the attempt count on the transcript and will ask.

If you have a Step score that sits below a program's visible or inferred threshold, the decision framework is: can I credibly argue that my clinical performance, research, letters, and narrative make a holistic case that my score does not capture? If yes, apply to programs where holistic review is documented and expected. If no, the most efficient path is to retake CK before submitting rather than submitting with a score you are not prepared to defend.

Program Tiers and How to Build a Balanced List

The Landscape

Med-Peds programs vary across several dimensions that matter for your career trajectory, not just your match probability:

• Academic vs. community focus: Academic programs are embedded in medical schools with research infrastructure, subspecialty depth, and fellow co-training. Community-affiliated programs often provide higher clinical volume, earlier autonomy, and training in resource-limited environments. Neither is categorically superior; the right choice depends on your post-residency plan.
• Fellowship training record: If you anticipate subspecializing after Med-Peds, the program's track record of placing graduates into competitive fellowships—in both medicine and pediatrics subspecialties—is the single most important program-level variable. Programs with established fellowship pipelines have existing relationships with fellowship directors. Programs without them are asking you to build that pipeline yourself.
• Geographic density: Med-Peds programs cluster in specific regions. Certain cities and academic medical centers have multiple programs within reasonable distance; others are isolated. Geographic constraints—family, partner employment, state licensing preferences—interact with the small total program count in ways that can compress your effective list significantly. Map this early.
• Continuity clinic model: Because Med-Peds graduates predominantly practice in outpatient or mixed settings, the quality, structure, and patient population of a program's continuity clinic predicts your ambulatory training depth. Ask directly: how many half-days per week of continuity clinic across all four years? What is the payer mix? Is there a Med-Peds-specific continuity panel or are you splitting a general medicine panel?

List Size and Construction

With approximately 120 programs nationally, a target list of 20–30 programs is appropriate for most applicants. The list should be stratified into three tiers:

• Reach programs: Your Step scores and clinical record fall below their evident matched-applicant median, but the program has characteristics—geographic, research, fellowship pipeline—that make them worth pursuing. Limit reach programs to a minority of your list.
• Target programs: Your profile aligns with their matched-applicant distribution. You have a realistic probability of interview invitation and match if interviewed. This tier should form the core of your list.
• Likely programs: Programs where your profile is above their evident threshold and the program would represent a strong match for your training goals even if not your first preference. Do not neglect this tier—it is insurance against an unexpectedly compressed interview season.

Do not add programs solely to inflate your list. An application to a program you would not rank tells that program nothing useful and takes your application fee. More consequentially, if you interview there and convey disinterest, you consume a slot that another applicant needed.

Signaling and Early Communication with Programs

AAMC Program Signals

AAMC's program signaling mechanism allows applicants to indicate specific interest in programs beyond the act of applying. Signal availability, count, and timing change by cycle—verify the current cycle's rules on the AAMC's official pages before application opens. The strategic principle that holds across cycles: use signals for programs where you have a specific, articulable reason for interest beyond ranking and geography. A signal that cannot be supported by your application content and interview conversation is not useful signal.

Pre-Interview Communication

The norm in Med-Peds is restrained. Unsolicited emails to program directors before receiving an interview invitation are generally not productive and can read as pressuring in a small community where everyone is visible. Exceptions: if you have a direct professional relationship with a faculty member at that program, a brief, substantive email referencing that relationship and your application is appropriate. "I applied and I'm very interested" is not substantive.

Conference Networking

Three conferences are high-yield for Med-Peds applicants:

• Med-Peds Society of North America Annual Meeting: The most concentrated gathering of Med-Peds program directors, attendings, and residents in the country. Attending as a medical student—presenting a poster if possible—is the single highest-signal voluntary act available to a pre-application student.
• AAP National Conference: Large, visible, and attended by pediatric faculty from programs on your list. Student and trainee sessions are accessible and worth attending.
• ACP Internal Medicine Meeting: Equivalent value on the medicine side. Abstract and poster presentation opportunities exist for students.

Networking at conferences is not about collecting business cards. It is about having conversations substantive enough that the person you spoke with would recognize your name on an application. That requires knowing the field, having an opinion about something in it, and being able to ask a question that demonstrates you have thought about more than your own match probability.

Personal Statement Craft for Med-Peds

The Med-Peds personal statement has one non-negotiable structural demand that other specialty statements do not: it must answer the question "why both" in a way that is specific, earned, and forward-looking. Every other craft consideration is secondary to this.

The Three-Act Structure

Act One: The origin story. Not "I have always loved working with children and adults." That sentence is inert. The origin story needs to be a specific moment or pattern that made the dual commitment feel not just possible but logically necessary—a clinical encounter, a research observation, a patient you saw across a care transition, a community you served that required both skill sets. The more specific, the more credible. Vague formulations ("I realized I couldn't choose") read as indecision; specific formulations ("the care discontinuity I watched happen when my adolescent patient with lupus aged out of her pediatrician's panel and entered an adult system that had no record of her history") read as insight.

Act Two: The proof point spanning both fields. This is where your clinical experience, scholarly work, or mentorship demonstrates that you have already tested the commitment. You are not promising you will learn both disciplines—you are showing that you already started. One to two examples, each containing a specific observation or result, not a summary of activities. The goal is to give the reader evidence, not assertions.

Act Three: The vision for practice. Where are you going after Med-Peds training? This does not need to be a five-year plan with a specific institution named. It needs to demonstrate that you have thought about what Med-Peds physicians actually do after training—primary care across the lifespan, transition medicine, academic general medicine and pediatrics, global health leadership—and that your training goals connect logically to a real post-residency role. Applicants who have no answer to this question in their statement, or who give a generic answer, suggest that they chose the specialty without fully thinking through what it produces.

Common Pitfalls

• The false dilemma construction: "I loved medicine but I also loved pediatrics and couldn't choose." This positions Med-Peds as the result of indecision rather than intention. Reframe: you identified a specific clinical problem or population that required both, and Med-Peds training is the tool that equips you to address it.
• Separate paragraphs for medicine and for pediatrics with no integration: If your statement reads like two separate specialty statements stitched together, that is what reviewers will hear. The integration is the point.
• Absence of specificity about post-training practice: "I want to serve underserved communities" is not a practice model. Name a care delivery structure: a federally qualified health center, an academic primary care practice with a teaching mission, a global health program with a specific disease burden focus.
• Exceeding the ERAS character limit while using fewer than half of them for actual content: Padding is legible. Every sentence should add a fact, a claim, or a narrative beat that was not present in the sentence before it.

Interview Season: Logistics and Preparation

The Med-Peds Interview Format

Most Med-Peds interviews involve conversations with program directors, chief residents, faculty from both medicine and pediatrics services, and often current residents. The day structure varies by program. Virtual formats have become more common post-pandemic; some programs have returned to in-person only, others offer hybrid options. Confirm format before you prepare—virtual and in-person require different logistical and presentation preparation.

The Central Interview Question and How to Handle It

Every Med-Peds interview, in some phrasing, will arrive at: Why not just internal medicine? Why not just pediatrics?

This question is not hostile—it is the most important diagnostic the interviewer has. What they are evaluating is not whether you have a polished answer but whether your reasoning is coherent, specific, and stable under light follow-up. An annotated model of how to approach this:

Opening move: Anchor to a specific clinical or scholarly experience that required both disciplines. Not a feeling, an experience.

Why this works: It immediately moves the conversation from assertion to evidence, and it gives the interviewer something concrete to engage with rather than a philosophical statement they cannot probe.

Middle move: Name what you would lose by choosing only one. Be precise: "If I trained only in internal medicine, I would not have the early-life disease context to manage the adult complications I want to work with. If I trained only in pediatrics, I would not be equipped to follow those patients through the transition that I think is where the most care is lost."

Why this works: It demonstrates that you have thought about the tradeoff from both directions, not just argued for the intersection from one side. Interviewers who have spent years in this specialty know the costs as well as the benefits; applicants who acknowledge the tradeoff are more credible than those who present only the upside.

Closing move: Connect to your post-training vision. One sentence. "That's the practice model I'm building toward, and I don't think either categorical training alone produces it."

Why this works: It signals that you have thought past residency, which programs need to believe to feel confident you will complete all four years and not transfer out to a categorical program after year two—a real risk that program directors think about when reading your application.

Program Evaluation During the Interview Day

You are gathering specific data during the interview, not just performing. Questions worth prioritizing:

• What is the call structure across both medicine and pediatrics services, and how does it change across the four years?
• How many of your recent graduates have pursued fellowships, in which disciplines, and at what programs?
• What is the continuity clinic structure—how many half-days per week, what patient population, how is the panel constructed?
• What do Med-Peds graduates at this program typically do in practice five years out? (This question reveals both the program's self-awareness and its alumni network depth.)

Second-Look Visits

Second-look visits (post-interview, pre-rank-list) are offered by some programs and not others. If offered, they are worth attending for your top one or two programs—they signal genuine interest in a community where signals matter, and they give you data about program culture that the structured interview day cannot provide. Do not attend a second look at a program you will not rank highly; it wastes their time and yours, and in a small community, that impression persists.

Rank List Strategy and Post-Match Planning

Constructing the Rank List

Rank your programs in the true order of your preference if you could guarantee acceptance to each. Do not attempt to game the NRMP algorithm—it is designed such that honest ranking is the dominant strategy, and it has been proven so mathematically. The only strategic question is whether your list is long enough to give you a realistic match probability given your interview count.

In a specialty with roughly 120 programs and 380 positions, an applicant who interviewed at 12 programs and ranks all 12 honestly has a different probability profile than an applicant who interviewed at 12 and ranks 6. The NRMP's own guidance is to rank every program where you would accept a position. Follow it.

Rank list length recommendations relative to interview count for Med-Peds are available in the NRMP's published resources by specialty. Use them. Do not reconstruct this calculation from anecdote.

SOAP: If You Do Not Match

The Supplemental Offer and Acceptance Program (SOAP) runs immediately after Match Week's early results. Med-Peds positions do enter SOAP in some cycles, though not consistently or in large numbers. If you do not match:

• Have your ERAS application updated and your letters of recommendation current before Match Week begins. You will not have time to make changes during SOAP.
• Be prepared to apply to both Med-Peds positions in SOAP and to categorical IM or categorical Peds positions if Med-Peds SOAP positions are sparse or filled before you reach them. Know in advance which categorical specialty you would accept—this is not a decision to make under time pressure at 6 AM on SOAP morning.
• Identify two faculty advocates who can make calls on your behalf during SOAP. In a small specialty, a call from a known attending to a program director carries weight. Identify these people before Match Week.

Immediate Post-Match Steps

When you match:

• Contact your program coordinator within 48 hours with any documentation they request. Credentialing timelines are compressed and programs begin that process immediately.
• Begin Step 3 planning. Many residency programs expect Step 3 completed by the end of PGY-1 or early PGY-2. Med-Peds residents are preparing for two separate board examinations (ABIM and ABP) simultaneously across four years. Know the timeline for both, and confirm your program's expectations at orientation.
• If you are an IMG, your visa and ECFMG certification processes must be complete before your start date. Begin follow-up immediately. Verify current requirements directly with ECFMG/Intealth and official sources for your application year.
• Connect with your incoming co-residents before orientation. In a small residency class—Med-Peds classes are typically four to eight residents per year—the relationships you build before Day 1 matter structurally for the four years ahead.