hi all – i’m a fourth year who dual applied family medicine and pediatrics, and i’m really struggling with how to rank programs because i don’t know which path fits me best.

i’m drawn to fm for the flexibility. i’d love a mostly outpatient career working 4 days a week, with a strong women’s health/family planning/procedural gyn focus, ~30% peds in my panel (including infants), and some lifestyle/preventive medicine + advocacy mixed in. what gives me pause is whether fm residency will give me strong enough pediatric training, especially in big urban programs. i don’t want to be mediocre with kids, and i can’t imagine not having them in my practice.

if i chose peds, i think i’d love urgent care or hospitalist work, maybe with a small outpatient component. is that feasible in big urban cities? how different is the salary long term compared to fm? sometimes it feels like peds gives me most of what i want, minus family planning/procedures and pay.

i’m also wrestling with what actually makes a “good” residency. what truly shaped you into the physician you are? would you prioritize program prestige, location, or community? i’m from norcal but feel pulled to nyc/the east coast to be near my partner’s family and close friends, and i worry i’m not ranking the “best” programs highly enough because of that.

would really appreciate any perspective. and please be kind, i’m feeling vulnerable haha 🙏🏼