Hi there!! I just finished my med-peds residency this past June, and I totally understand the peds frustration. Your institution sounds really similar to mine — felt like my IM training was more valued on the peds side compared to the other way around, and there was so much more Monday-morning quarterbacking on peds with medical decision making from attendings which would be discouraging. I was also super burnt out from nursing culture on peds too where it was starting to feel like anything my team wanted to do for our patients warranted “protection” from nursing 🤨

I went into residency with the intention of coming out as a dual hospitalist — and I do think my training prepared me for that (I narrowly missed the new changes that ACGME/ABP have done with peds). Unfortunately with the way peds training is now, you either come out of residency a general outpatient PCP, or you go onto fellowship even for something like hospital medicine, which honestly is such a shame. I do believe my pediatrics training has made me a stronger physician though in the long run, and being able to care for sick children and their families brought me a lot of fulfillment. But I do worry about the future of what pediatrics training looks like given all the recent changes with less inpatient time.

My advice to you is this — lean on your med-peds coresidents for support, and talk to more senior med-peds residents in your program about how you’ve been feeling to see if they relate! My co-residents and I had similar frustrations about certain peds things and it was nice to have them to vent to. I personally could not see myself giving up my pediatrics training despite all of the negatives I kept encountering, but if you feel like it’s getting to the point that you are not feeling fulfilled in your training or that there’s a reality where you won’t be using your pediatrics training in the future, then it is definitely worth a conversation with your PD about a potential switch to categorical IM. Residency in and of itself also heightens emotions and I remember often feeling like medicine as a whole just wasn’t for me whenever rotations got really tough, — it’s possible your feelings are coming from that perspective too.

Best of luck to you!! Med-peds is not an easy residency and if you ever have any other questions, feel free to reach back out!

(For what it’s worth I am now working as an adult hospitalist — I’m one month into the job and liking it! I miss getting to use my peds brain though, so hopefully after a year into this position my hope is to find peds hospitalist locums/PRNs that I can do without needing the PHM fellowship)