Dual residency or combined programs offer a lot of benefits to residents as they get to experience and adapt to changing and volatile circumstances. They learn perspectives involving patient care, outpatient settings, professional development, and leadership roles. Moreover, after completing the program successfully, residents apply for dual board certification. There are many combined programs within internal medicine and emergency medicine. These offer greater fellowship opportunities with intellectual development for trainees.

Dual programs have the potential to shape future career goals with an exclusive opportunity for residents. These have a lot of advantages over single specialties as applicants have broader career options with longitudinal niche development in a wider spectrum of specialties. Prospective applicants can pursue dual residencies in a wide range of specialty programs like Combined Family Med-Preventive. Combined Im with other specialties (Geriatrics, Pediatrics, Emergency Medicine, and many others) is quite common. EM also hosts many options for future doctors to explore as dual-boarded physicians. This is not an exhaustive list and new programs are added every few years.

How Competitive are Dual-Accredited Programs?

Dual accredited residency programs are equally competitive as compared with solo programs. There are hundreds of available positions for combined residency programs like Med-Peds which offered over 380 positions in the 2021 NRMP Match. In total, there are more than 5,000 PGY-1 programs listed by the NRMP with over 170 dual or triple programs. Both American medical graduates (AMGs) and international medical graduates (IMGs) can apply for a combined residency program as hundreds of applications pour in before each program application deadline.

To increase the chances for interview offers, one should complete the application well in advance, complete medical rotations at respective clerkships, send their respective transcripts from their medical school, and may need to complete additional requirements. Selected applicants receive increased exposure to advanced medical care in both specialties, participate in physician national leadership programs, become acquainted with medical care, and gain eligibility for multiple board exams.

For example, most of the combined training programs are offered within the field of internal medicine. Residents can train in IM with anesthesiology, for example. This allows exposure in anesthesia clinics as well as other IM subspecialties. Basic internal medicine training may also be combined with disciplines that offer a broader perspective and skillsets.

The most competitive disciplines (based on application rates and average academic performance requirements) are dermatology, EM, and neurology. It is generally considered less competitive to apply for peds, FM, and PM&R. However, the competitiveness depends on many factors and varies from program to program.

Overall, such programs allow the residents to get acquainted with medical services, procedures, and technologies they likely would not come across in a single-board specialty. Many participate in care continuity clinics, learn hospitalist training, and participate in the critical care of patients amid the COVID19 pandemic. It is difficult work, but combined programs open up many doors to later career aspirations.

How do I Apply for Dual-Residency Programs?

Dual or combined programs can be applied through the Electronic Residency Application Service (ERAS) wherein prospective applicants can create their profiles and choose their preferred program. The combined residency programs usually appear with a slash like Emergency Medicine/Internal Medicine/Critical Care. Interested applicants are also advised to educate themselves by visiting each program website.

Also, prospective candidates should submit their completed applications as soon as possible. This helps to avoid any complications that may arise due to the volume of applications submitted to each program. Plan for interviews to begin as early as October, though some programs may not interview until much later in the year. The AMA FREIDA website is quite helpful in comparing various programs as it showcases expected working hours, benefits, vacation time, additional coursework, training schedule, and residency leadership programs.

Candidates are selected from the applicant pool based upon many factors. Having experience rotating in hospitals affiliated with their program of choice is usually a great benefit. Rotating students may be expected to complete certain program requirements as mentioned on the ERAS (Electronic Residency Application Service) application at National Resident Matching Program (NRMP) website. 

Like any residency Match, applicants are also expected to submit at least 3 letters of recommendation along with their school documents like the Medical Student Performance Evaluation (MSPE), licensing exam transcripts, personal statement, and medical school transcripts.

Students can also explore the Association of American Medical Colleges (AAMC) website for more information on how to apply for a combined medical residency. These resources guide rotating students with pre-requisite information, along with program name, location, and other details about their preferred program.

Why Should I Consider Being Double (or Triple) Board Certified?

Dual accredited programs offered in the NRMP Residency Match offer many options and increase career prospects later in life. These programs can lead to dual- or triple-boarded physicians with vast opportunities for fellowships. The unique training offered to combined residents at various programs such as palliative medicine, primary care specialties, PM&R, and emergency medicine experience offer various career options and exclusive opportunities.

More opportunities mean more lifestyle choices and better preparation for future career goals. A residency leadership program can shape a new professional into an engaged physician. Residents who complete the program successfully are better trained in various fields of medicine especially in categorical programs like sleep medicine, the ICU, or a preoperative anesthesia clinic. For example, residents training in IM/EM combined programs manage a panel of patients as specialty-trained physicians in a wide variety of settings. Overall, they receive hybrid training and are equipped to work and handle patients in any volatile circumstance.

The duration of residency for combined programs varies. For certain programs like Combined Family Medicine-Preventive Medicine Residency, time frames are shorter compared to others. Residents can sit for their respective boards after the successful completion of their programs. Such programs teach through innovation as it trains medical residents in various categorical specialties, handling high-risk patients, especially during the ongoing COVID19 pandemic.

Also, consider the Medical Student Guide to Clinical Rotations & Clerkships for all your Clerkship needs!

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