Subspecialty Choices Among Medicine-Pediatrics Graduates: Results From a Four-Year National Program Director Survey.

Background and objectives Dual-trained medicine-pediatrics physicians (med-peds) play an important role in the healthcare ecosystem. Little is known about the subspecialty choices of med-peds residency graduates. This study aims to characterize the subspecialty choices of med-peds residency graduates. Methods The Medicine-Pediatrics Program Directors Association (MPPDA) administers an annual survey to the program directors of all med-peds residency programs accredited by the Accreditation Council for Graduate Medical Education (ACGME). This project represents aggregate survey data from 2020-2023. Results The number of program directors responding to the survey ranged from 80.8% (63/78) to 85.7% (66/77; mean response rate: 82.8%). About 465 of 1,245 (37%) graduates over the four years chose fellowship training, across 51 unique subspecialties. The top five selected pathways were: adult pulmonary and critical care 54 (11.6%), allergy and immunology 37 (7.9%), adult infectious diseases 30 (6.5%), adult cardiology 30 (6.5%), and pediatric cardiology 30 (6.5%). Conclusions Med-Peds residents pursue a diversity of subspecialty training and represent an important contribution to the subspecialty workforce. Improving combined subspecialty opportunities may increase participation by med-peds graduates and, in particular, may support the increasing need for pediatric subspecialists.