Integration in Medicine-Pediatrics Residency Programs: A Mixed-Methods Study

Background  There are a variety of combined residency training programs, including an increasing number of medicine-pediatrics (Med-Peds) residency programs. Successful integration of these residents into the learning environments of both departments is important to train competent, successful physicians. Little is known about the factors that contribute to successful integration. Objective  To assess Med-Peds integration and explore factors essential for the successful integration of combined residents into their host departments. Methods  To further elaborate on findings from a national survey, a convenience sample of 33 Med-Peds program leaders participated in focus groups of 3-5 participants to explore factors associated with successful integration of Med-Peds programs into their host departments. Data were collected in March 2025 during the national meeting of the Med-Peds Program Directors Association (MPPDA). Focus group transcripts were analyzed using inductive qualitative analysis. Results  One hundred percent of programs that participated in focus groups (33/33) were either "somewhat well-integrated" or "well-integrated" into their medicine department, and 30/33 (91%) were "somewhat well-integrated" or "well-integrated" into their pediatrics department. There was no clear statistical difference between the medicine and pediatrics departments (p = 0.054). The focus groups identified four factors associated with successful integration of Med-Peds programs: residents' involvement in cross-program activities, the development of personal relationships across departments, the program's administrative inclusion, and its cultivation of programmatic identity. Conclusions  Med-Peds programs are well integrated into their host departments, according to program leaders. Fostering these qualities of integration is critical for successful combined programs.