Dual Applying vs. Combined Residency Programs: Applying in Multiple Specialties

We are thrilled to bring you another recorded session from Elite Medical Prep’s Residency Roundtable series. This session, titled “Dual Apply for Residency – Applying in More Than One Specialty” is hosted by Dr. Brittany Glassberg and Dr. Savannah M. Alvarado. In this session, Dr. Glassberg and Dr. Alvarado share valuable insights and practical advice to help you navigate the process of dual applying and pursuing combined residency programs. For a more comprehensive understanding of this journey, explore additional resources in this series. If you’re seeking a roadmap for your ultimate residency application strategy, find our residency timeline here.

Exploring the Niche of Dual-Specialty Physicians

Combined residency programs offer unique opportunities for those interested in developing a specialized niche in patient care that spans two medical disciplines. Physicians trained in dual-specialty programs, such as internal medicine and dermatology or med/peds, meet growing demands for comprehensive care across intersecting fields.

Dual-specialty training addresses complex healthcare needs by equipping physicians with interdisciplinary skills that allow them to treat a broad spectrum of conditions. For example, med/peds specialists often care for adults with childhood-onset conditions, offering continuity of care that isn’t feasible with a single specialty focus. Similarly, dual-trained internal medicine and dermatology physicians can address systemic diseases with dermatologic manifestations, improving patient outcomes through their combined expertise.

These programs also provide a pathway for physicians to become leaders in areas that require a deep understanding of two specialties, enhancing their value in clinical, academic, and healthcare systems.

What is Dual Applying for Residency?

First and foremost, let’s define what it means to dual apply for residency. This means applying to two different specialty programs during one application cycle, with the goal of matching into just one specialty. It’s crucial to understand that this isn’t a combined program where you’ll graduate with degrees in both specialties.

The ideal candidate for dual applying varies. It could be someone who hasn’t made their final decision about their career path due to the diverse experiences in medical school. Others might consider dual applying due to geographic limitations, couples matching, or interest in competitive fields.

There are also instances where red flags in your application might make dual applying a prudent choice. In such cases, applying to a slightly less competitive backup field can keep your options open.

Should You Dual Apply for Residency? The Pros and Cons

The advantages of dual applying are significant. It increases your chances of matching and offers more opportunities. This leads to a higher likelihood of employment at the end of the cycle. Plus, it gives you more time to make your final career decision, as the application process spans several months.

However, there are cons to consider. It can be more expensive due to more application fees associated with applying to more programs. The process is more complex, requiring meticulous attention to detail. It’s also time-consuming. Moreover, there’s a potential stigma associated with dual applying, although we’ll discuss strategies to mitigate this.

How to Dual Apply for Residency

When it comes to dual applying, there are several key steps to consider. First and foremost, for your ERAS application, you have the ability to submit multiple personal statements. It’s highly recommended to craft a distinct statement for each specialty you’re applying to. This allows you to spotlight the attributes that make you an ideal candidate for that specific field and express your genuine interest. Seeking guidance from mentors can be invaluable in tailoring these statements to perfection. However, meticulous attention is essential when it comes to submitting your application, ensuring that each statement finds its way to the right program.

Moving forward, dual applying means doubling your interview load, as you’ll be focusing on one specialty at a time. This requires careful time management and strategic selection of which interviews to attend, emphasizing the need for a well-organized calendar. Learn more about the virtual interview process here.

During interviews, a common concern for dual applicants is how much applicants should divulge about their application process. While complete transparency is encouraged, there’s no obligation to proactively share this information if not prompted. If asked, it’s best to be forthright about your goals and reasons for dual applying.

Finally, when it comes to creating a rank list , the two specialties you’ve interviewed for come together. You’ll compile a single list that can include programs from both fields. Some may choose to group specialties, prioritizing one specialty’s programs before the other. Others may intermix them. The beauty of this process lies in the flexibility—you won’t need to make a final decision until it’s time to submit your rank list. Ultimately, you’ll only match with one program, and predicting in advance which specialty that will be is impossible. The outcome will be determined by the rankings you submit.

What Is a Combined Program?

Combined programs, such as the ones Dr. Alvarado and Dr. Glassberg are in, involve completing a full residency training in two distinct medical specialties. Upon completion, graduates are required to pass board examinations in both specialties. These programs offer a high degree of autonomy in choosing one’s future practice path. Examples of combined programs include an internal medicine residency and family medicine residency, internal medicine and pediatrics, internal medicine and dermatology, internal medicine and emergency department medicine, internal medicine and critical care as well as pediatric psychiatry or the triple board program.

Board Certification and Licensure in Dual Specialties

Physicians completing dual-specialty training must meet the requirements for board certification and licensure in both fields. This process ensures they are fully equipped to provide expert care across specialties.

To achieve board certification in the United States, dual-specialty physicians must complete the residency training requirements for each specialty and pass separate board exams. For example, a physician in a combined internal medicine and dermatology program would need to pass the certification exams for the American Board of Internal Medicine (ABIM) and the American Board of Dermatology (ABD). These exams rigorously test the knowledge and skills specific to each field, requiring significant preparation. Many combined programs offer tailored resources to help residents meet these dual demands.

Maintaining Licensure and Continuing Education

Maintaining licensure in dual specialties involves ongoing continuing medical education (CME). Most states require a minimum number of CME hours, and dual-specialized physicians must fulfill CME requirements for both fields. Interdisciplinary CME opportunities often address overlapping areas, simplifying the process. Additionally, board certifications require periodic recertification through Maintenance of Certification (MOC) programs, which include exams, practice improvement modules, and skill updates.

With the guidance of program directors, associate program directors, and robust graduate medical education frameworks, dual-specialized physicians excel in their fields. Meeting state licensure requirements, fulfilling CME obligations, and pursuing public health-oriented training ensure physicians provide exceptional care while advancing their careers.

Dr. Alvarado’s Path: Combined Internal Medicine and Dermatology Path

To provide an example of a combined path, we will discuss Dr. Alvarado’s experience with a combined internal medicine and dermatology program. To provide some context, we’ll outline the path for both a traditional Medicine applicant and a standard Dermatology applicant.

During the first year (PGY1) as a prospective Dermatology applicant, you embark on an intern year. This initial phase mirrors the experience of a Medicine applicant, except for those opting for a preliminary year in either Transitional Pediatrics or Surgery programs.

Moving on to the second year (PGY2) in Dr. Alvarado’s combined program, the focus shifts entirely to Dermatology. It’s during this period that Dr. Alvarado immersed herself in the intricacies of dermatological practice.

In PGY3, PGY4, and PGY5, the program will transition back and forth between Internal Medicine and Dermatology. This contrast is striking when compared to the traditional Internal Medicine route, which spans three years before entering a fellowship program or beginning work as an attending physician. Conversely, in Dermatology, a preliminary year precedes three specialized training years, leading to a fellowship or attending position. If Dr. Alvarado was to dual apply to these two residency specialties, she would have had to choose just one. This combined path offers a unique blend of specialized training in both fields.

Dr. Glassberg’s Path: Combined Internal Medicine and Pediatrics (Med/Peds) Path

In the Combined Internal Medicine and Pediatrics (Med/Peds) program, the PGY-1 year involves alternating between the Pediatric and Internal Medicine hospitals. Categorical residents in either field also complete an intern year, but exclusively in their respective specialties.

In the PGY-2 year, Med/Peds residents continue this rotation every six weeks to two months, mirroring the experience of their categorical peers. However, categorical residents focus solely on their chosen specialty.

The divergence becomes more apparent in the PGY-3 year. As a Med/Peds PGY-3 resident, Dr. Glassberg remains a junior resident, engaging in rotations that differ slightly from those of senior residents in categorical programs.

In the PGY-4 year, Dr. Glassberg will advance to the role of Med/Peds senior resident, while her categorical peers move on to fellowships or work as attending physicians. Opting for a combined program does extend training beyond the individual categorical programs. Nonetheless, it is still a shorter duration compared to pursuing both specialties separately. For instance, Med/Peds encompasses a total of four years for both internal medicine and pediatric certification. Pursuing each program individually would have entailed six years in total—three years for each specialty.

The Ideal Candidate for Combined Residency Programs

To thrive in a combined program, the ideal candidate should possess specific qualities and attributes. First and foremost, commitment is paramount. You must be fully dedicated to completing the entire residency training in each specialty independently. These programs often have smaller cohorts, demanding a proactive and independent approach. Given the less established structure, you’ll need to pave your own path and ensure your priorities are met within the program. Confidence is another key trait. You’ll need to explain your decision to complete two residency programs to peers and colleagues. Having a clear long-term career goal that utilizes both specialty training programs is essential. For instance, Med/Peds residents often aim to care for patients with conditions that span both specialties, such as adults with childhood-onset conditions or adolescents transitioning into adult care.

Pros and Cons of a Combined Residency Program

There are several advantages to combined residency programs. Firstly, you can develop a niche that combines both specialties, allowing you to offer unique and comprehensive patient care. These programs also foster a sense of community among like-minded peers who share thoughtful career goals. Additionally, you gain a unique perspective on medicine by learning two different approaches and can contribute to your peers’ learning as well. This interdisciplinary experience ultimately enhances your patient care skills.

However, there are drawbacks to consider. The most significant is the extended time commitment compared to categorical programs. Combined programs have fewer available spots, which can make admission highly competitive. Some individuals may find the structure less defined, as you transition between different specialties, so it’s crucial to find a program that aligns with your preferences in this regard. Lastly, you might encounter advice suggesting that it’s challenging to integrate into a specific field after completing a combined program, potentially pressuring you to choose one specialty. Nevertheless, if you believe there’s a specific niche where you can utilize your talents from both specialties, we encourage you to seriously consider these programs.

These pros and cons should be taken into consideration if you are stuck between dual applying or combined residency programs.

How to Apply to a Combined Residency Program

When applying to a combined program, it’s important to recognize that the process differs from dual applying to residency. Mentors play a crucial role in any residency application. This is especially true for combined programs. While finding a mentor who has undergone the same training as the combined program you’re pursuing may be relatively unlikely, it’s essential to seek out mentors in each respective field who are genuinely interested in your aspirations and willing to advocate on your behalf.

If your school offers a combined program, be sure to reach out for guidance. If such a program isn’t available, don’t hesitate to contact programs at other institutions or hospitals to connect with current residents or faculty members who might be open to discussing your interests. Given the small size of these programs, personal introductions carry significant weight. This is particularly true amidst the multitude of applicants vying for positions.

During the ERAS process, keep in mind that you’ll be interviewing for these programs as a single unit. For instance, instead of dual applying separately to internal medicine and dermatology residency at a specific institution, you’ll apply to the combined internal medicine and dermatology program. Consequently, you’ll have a unified interview experience and submit just one application.

With this in mind, it’s advisable to present a letter of recommendation and personal statement that both specifically address the combined program. If you’re fortunate enough to have mentors who are willing to compose a tailored letter discussing your status as a dual or combined applicant. This letter of recommendation can significantly enhance your application as it highlights the thought you have put into going down that route and provides a third party’s objective opinion as to why that pathway is a good fit for you and why they perceive you would excel. Additionally, crafting a personal statement that distinctly outlines your interest and commitment to a combined program is of paramount importance. This demonstrates your dedication and enthusiasm for this unique pathway in medicine.

Should I Apply to Combined Programs vs. Dual Apply?

When considering whether to apply to combined programs or pursue dual applications for multiple residency programs, there are important factors to weigh.

Opt for a combined program if you hold a genuine passion for both fields and envision a specific niche where you can make a significant impact with the combined training from both residencies. Recognize that this path entails extended training and may require a more self-directed approach compared to the more conventional categorical program.

On the other hand, dual applying is a fitting option for individuals with diverse interests who can envision themselves in either field, but don’t necessarily require both for their future career. This approach is also worth considering if you face constraints in your application process. For instance, geographic restrictions, couples matching, or other factors that may pose challenges to your match.

Remember, you don’t necessarily have to make an exclusive choice between the two. Those interested in combined internal medicine and pediatrics often apply to both combined and categorical programs nationwide. This broadens their opportunities and helps ensure a successful match.

The Impact of Dual Specialization on Career Development

Combined residency programs significantly enhance career prospects. Dual-specialized physicians are uniquely positioned for leadership roles in clinical and academic settings. Their interdisciplinary training makes them attractive candidates for fellowship programs, advanced roles in specialized care, and leadership positions in healthcare organizations.

For example, med/peds physicians are often sought after for administrative roles in hospitals that require cross-disciplinary insights. Similarly, internal medicine and dermatology physicians can pursue advanced opportunities in treating complex conditions, making them invaluable to research initiatives and academic institutions.

By broadening career trajectories and providing advanced expertise, dual-specialty training sets physicians apart in competitive healthcare environments.

Future Trends in Medical Education and Combined Programs

As the landscape of healthcare evolves, so do the structures and methodologies of medical education. Combined residency programs are adapting to meet the changing demands of healthcare delivery. The integration of telemedicine and online learning tools into residency programs is shaping the future of dual-specialty training. These innovations allow residents to gain exposure to cutting-edge techniques and technologies, enhancing their ability to deliver high-quality care across specialties.

As healthcare systems face growing demands for interdisciplinary care, combined residency programs are poised to address workforce development challenges. These programs will continue to expand, offering tailored solutions to meet the complex healthcare needs of diverse populations. Dual-specialty training provides long-term career benefits by equipping physicians with unparalleled expertise and flexibility. As the healthcare field increasingly values interdisciplinary care, dual-specialized physicians will remain at the forefront of innovation and patient care.

Good luck with your applications this year! If you have any questions, feel free to reach out to the team at Elite Medical Prep. We’re here to help you achieve your residency dreams!