Pediatric & Combined specialty
Internal Medicine–Pediatrics (Med-Peds): Salary, Residency & Career Guide
Combined adult and pediatric care with dual board-eligibility pathways.
Typical Training
4 years
Four-year combined internal medicine and pediatrics residency.
Attending Compensation
$319,995
Average Total Compensation
Employment outlook
Not isolated
Projected Job Growth
Relative Competitiveness Index
61 / 100
Competitive
Start in Medical School
M1 to M4 Preparation
Practical experience, projects and rotation planning.
See the Medical School RoadmapAttending Compensation and State Wages
U.S. Attending Compensation
$319,995
Average Total Compensation
BLS does not publish a separately matched state wage series for this specialty.
Resident Pay by Institution
Four-year combined internal medicine and pediatrics residency..
2026–27 salaries, five published training-institution examples.
Selected institution
University of Michigan, Ann Arbor, MI
$77,049/ year
Pay varies by institution and postgraduate year.
Schedules and Work Setting
Schedule and Call
Residents move between adult and pediatric services. A future Med-Peds physician may run a dual-age clinic, hospitalist blocks or transition-care practice; staying board-certified in two disciplines affects the workload.
Practice Settings
Primary care, transitional care, adult or pediatric inpatient services and specialty clinics.
Procedures and Clinical Work
- Adult chronic disease care
- Pediatric preventive care
- Hospital medicine
- Transition care for adolescents with complex disease
Fellowship Training
Fellowship Expectation Index
3 / 5
Fellowship Options
Common Fellowship Duration: 1–3 year(s) beyond residency. Eligible graduates may enter adult or pediatric subspecialty fellowship tracks.
Med-Peds is a complete combined generalist training pathway. Further training becomes important if you pursue a particular adult or pediatric subspecialty.
Direct Practice
Combined adult/pediatric primary care and some hospitalist or transitional care roles.
Specialized Practice
Cardiology, GI, critical care and many pediatric subspecialties require approved additional fellowships.
Choosing a Path
If you expect to treat both children and adults, verify whether a fellowship preserves that scope.
Potential Fellowship Pathways
- Adult medicine subspecialties
- Pediatric subspecialties
- Hospice and palliative medicine
- Adolescent medicine
Fellowship Careers From This Residency
Choose a subspecialty to see its training requirements, clinical work and preparation pathway.
Preparing in M1 Through M4
Follow an adolescent with congenital heart disease or type 1 diabetes into adult care. Transition medicine reveals why combined training differs from two separate generalist careers.
Research or QI
A sickle-cell transition program, young-adult chronic-disease pathway, or adolescent vaccination project gives an authentic Med-Peds research focus.
Common Mistake
Applying because you cannot choose between adults and children without exploring the full four-year combined structure and actual dual-board careers.
Preparation by Year
- 1Shadow a Med-Peds continuity clinic and compare it with categorical IM and pediatrics services.
- 2Talk to a Med-Peds physician about what proportion of adult and pediatric patients they see after graduation.
Ask a resident this: Do graduates maintain meaningful practice with both adult and pediatric patients, or drift toward one group?
MD vs DO Match Outcomes
337 of 392 matched to their preferred specialty
29 of 45 matched to their preferred specialty
MD vs DO difference: 21.6 percentage points
Applicant Considerations
The DO sample in 2024 Med-Peds preferred-specialty data was modest. Small differences can shift markedly from one Match cycle to another.
DO Application Strategy
Prioritize a combined-residency advisor, review programs with DO trainees and ask how their dual-department faculty assess COMLEX and USMLE. Demonstrate understanding of combined training.
Job Outlook
N/A
Projected Employment Growth
2025 to 2035, BLS occupational projection
No distinct employment forecast is published for this exact specialty.
AI and the Specialty
Potential Workflow Changes
Documentation and preventive outreach may improve; transitions between pediatric and adult care require coordination.
Sources & Data Notes
Reviewed . National attending compensation uses Doximity's 2026 specialty survey (2025 pay) where available, then verified specialty-specific Medscape, Marit or Salary.com estimates. Doximity, Medscape and Marit report total compensation; Salary.com models base salary. Survey averages, modeled salaries and BLS wage medians measure different populations and must not be interpreted as identical metrics. BLS May 2025 state wages are shown separately and exclude self-employed physicians. The ophthalmology BLS category excludes pediatric ophthalmologists. State figures may be missing, top-coded, or suppressed. Job outlook uses BLS 2025–2035 occupational projections; it is not a local vacancy forecast. Resident stipend examples reflect published institutional scales for 2026 to 2027, by postgraduate year, not specialty. Stanford includes housing in its reported base salary; other institutions handle allowances differently.
The Relative Competitiveness Index uses a fixed score of 25 plus 1.75 times the 2024 U.S. MD preferred-specialty unmatched percentage, rounded, then applies the same 1.225 multiplier to every specialty. Neurological Surgery is 98/100; the score is not the applicant's chance of matching. It is not a 2026 estimate or DO-specific score. The MD and DO percentages compare different unadjusted applicant cohorts who ranked that specialty first. They do not account for application strategy, program selection, scores, or geography. Ophthalmology and urology have separate specialty match processes; other pathways may lack suitable NRMP cohorts.
The 1–5 Fellowship Expectation Index is an editorial assessment of customary career paths, not a measured participation rate or requirement. For residency profiles, compact training labels put specialty years before the clinical base or preliminary year; e.g. 3+1 means three specialty years and one clinical base year, even though the clinical year comes first. Fellowship-defined careers are presented in the separate fellowship explorer. Schedules, procedural scope, preparation suggestions, and potential AI effects depend on the program and practice setting; they are qualitative descriptions, not guaranteed outcomes or forecasts of physician replacement.
For Internal Medicine–Pediatrics (Med-Peds): Doximity 2026, Average Total Compensation, reported under “Medicine/Pediatrics.” The national estimate must not be treated as a state-specific compensation figure.
Internal Medicine–Pediatrics (Med-Peds): Editorial estimate of how fellowship shapes a career path. No observed fellowship uptake percentage is implied. Specialty-specific roadmaps describe illustrative activities, not mandatory publication, shadowing-hour, rotation, or skill requirements. Common fellowship routes: Eligible graduates may enter adult or pediatric subspecialty fellowship tracks.