Ultimate Guide to Medical Shadowing in Med-Peds Residency

Medicine-Pediatrics (Med-Peds) is uniquely positioned at the intersection of adult and pediatric care. If you are considering a Med-Peds residency, your medical shadowing experience can be one of the most powerful tools to understand the specialty, strengthen your application, and clarify whether this path truly fits your interests and personality.

This guide walks you through how to plan, conduct, and leverage Med-Peds shadowing—from first email to ERAS application—with concrete examples and practical advice tailored specifically to the medicine pediatrics match.

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Understanding Med-Peds and Why Shadowing Matters

Before you start arranging shadowing hours, it helps to understand what makes Med-Peds distinct and why programs care about documented exposure to the field.

What is Medicine-Pediatrics?

Internal Medicine-Pediatrics (Med-Peds) is a 4-year combined residency that leads to board eligibility in both Internal Medicine and Pediatrics. Med-Peds physicians are trained to:

• Care for patients across the entire age spectrum, from newborns to older adults
• Manage complex chronic conditions that begin in childhood and extend into adulthood (e.g., cystic fibrosis, sickle cell disease, congenital heart disease, type 1 diabetes, childhood cancers)
• Bridge transitions of care from pediatric to adult systems
• Work in a wide range of settings: primary care, hospital medicine, subspecialties, global health, underserved care, and academic medicine

For applicants, Med-Peds can look similar to both Pediatrics and Internal Medicine. But residency program directors want evidence that you understand the combined nature of the specialty and have experienced it firsthand.

Why Med-Peds Shadowing Is So Important

Your shadowing experiences serve several purposes in the medicine pediatrics match:

1. Demonstrates genuine interest in Med-Peds

   • Shows programs you are not simply applying broadly to IM and Pediatrics as a backup.
   • Confirms that you know what Med-Peds physicians actually do day-to-day.

2. Helps you clarify your own fit

   • Do you enjoy switching between adult and pediatric cases?
   • Are you energized by longitudinal, complex care?
   • Do you like balancing inpatient and outpatient medicine?

3. Provides strong material for your personal statement and interviews

   • Memorable patient encounters and clinic experiences become anchor stories.
   • You can articulate concretely why Med-Peds and how your shadowing shaped that decision.

4. Supports letters of recommendation (LORs)

   • Faculty who see you consistently in clinical settings can write more personalized, specialty-specific letters.

5. Fills gaps if your school has limited Med-Peds exposure

   • Some medical schools have no Med-Peds residency or faculty. Shadowing becomes crucial to show programs that you actively sought out the field.

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Planning Your Med-Peds Shadowing: Strategy and Logistics

To get the most out of shadowing, you need to be deliberate about where, with whom, and how you shadow.

How Many Shadowing Hours Are Needed?

There is no official minimum number of shadowing hours needed for Med-Peds specifically, and programs rarely quote a strict cutoff. However, common patterns among strong applicants include:

• Total clinical exposure: Often 50–150+ hours across different settings and specialties
• Med-Peds–specific exposure:
  • Ideal: 20–50+ hours directly with Med-Peds physicians
  • At minimum: Multiple half-days or full days that allow you to see both adult and pediatric patients

If you cannot access Med-Peds physicians, a combination of:

• Pediatrics shadowing + Internal Medicine shadowing
• Plus meaningful mentorship or virtual experiences with Med-Peds faculty

…can still be compelling—if you clearly connect these experiences to Med-Peds in your application.

How to Find Shadowing Opportunities in Med-Peds

The question of how to find shadowing in a relatively small specialty like Med-Peds is common. Use a multi-pronged approach:

1. Start at Your Own Institution

• Check your medical school directory: Search for “Internal Medicine-Pediatrics,” “Med-Peds,” or dual-boarded faculty
• Ask clerkship directors: Especially in Pediatrics and Internal Medicine; they often know Med-Peds trained attendings in hospital medicine, primary care, or transition clinics
• Look at combined clinics: Such as transition clinics for childhood-onset chronic disease, adolescent/young adult cancer clinics, or cystic fibrosis centers. Many are staffed or co-staffed by Med-Peds physicians.

Sample email to local faculty:

Subject: MS2 Interested in Med-Peds – Request for Shadowing Opportunity

Dear Dr. [Last Name],

I am a [MS2/MS3] at [School Name] with a strong interest in Medicine-Pediatrics. I am hoping to gain more exposure to Med-Peds practice and would be grateful for the opportunity to shadow you in clinic or on the wards, if feasible.

I am particularly interested in how Med-Peds physicians manage patients across the age spectrum and navigate complex transitions of care. I am happy to work around your schedule and comply with any institutional requirements for shadowing.

Thank you for considering my request.

Best regards,
[Your Name]
[Class Year, Contact Info]

2. Reach Beyond Your Institution

If your school has limited Med-Peds presence:

• Nearby Med-Peds residency programs

  • Visit program websites and look for a “For Students” or “Contact Us” section
  • Email program coordinators or associate program directors expressing interest in medical shadowing
  • Some programs allow visiting medical students or pre-clinical students to shadow in clinic or attend didactics

• Regional academic centers

  • Children’s hospitals attached to adult hospitals often have Med-Peds faculty in hospital medicine, complex care, or primary care clinics.

• Professional organizations

  • National Med-Peds Residents’ Association (NMPRA) often lists Med-Peds contacts, mentors, and interest groups.
  • They may share virtual shadowing-like opportunities (e.g., case discussions, career panels) if in-person options are limited.

3. Be Open to Adjacent Experiences

If no explicit Med-Peds shadowing is available, seek experiences that approximate Med-Peds practice:

• Pediatric subspecialty clinics that follow patients into young adulthood
• Internal medicine clinics or hospital teams with many patients who have childhood-onset conditions
• Transition-of-care programs (e.g., congenital heart, sickle cell, CF adult care transitions)

You can then reflect on how these experiences mirror what Med-Peds physicians do and why a combined approach appeals to you.

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Making the Most of Med-Peds Shadowing: What to Observe and Ask

Shadowing is not just about “clocking hours”; the quality of your engagement matters much more than the raw number of hours logged.

Key Clinical Settings to Prioritize

Try to see Med-Peds physicians in more than one context if possible:

1. Continuity / Primary Care Clinic

   • Ideal for understanding the longitudinal nature of Med-Peds
   • You will see infants, toddlers, teens, young adults, and older adults—sometimes within the same half-day
   • Observe how the physician tailors communication styles and anticipatory guidance by age

2. Transition Clinics or Complex Care Clinics

   • Focused on patients with chronic childhood-onset disease as they move into adult care
   • Illustrates the “bridge” role that Med-Peds excels at
   • Watch how the physician coordinates multiple specialists and social resources

3. Inpatient Wards (Adult and/or Pediatric)

   • Shows how Med-Peds residents function on teams, especially in combined or “flex” roles
   • Look at how they approach differential diagnoses, handoffs, and interdisciplinary collaboration

4. Emergency Department or Urgent Care

   • Helpful to see acute presentations in both adults and children
   • Observe how management and triage differ across ages

What to Pay Attention to During Shadowing

During each shadowing session, focus on these core themes:

1. Breadth of Age Range

   • How often does the physician switch between adult and pediatric patients?
   • How do they adjust history-taking, physical exams, and counseling across age groups?

2. Complex Chronic Care

   • Notice patients with long-standing conditions (e.g., cystic fibrosis, congenital heart disease, sickle cell disease, developmental disabilities).
   • How does the physician manage continuity from childhood to adulthood?

3. Systems Navigation and Advocacy

   • Watch for moments where the physician coordinates with social workers, case managers, schools, or community agencies.
   • This is a core part of Med-Peds identity that you can discuss in your application.

4. Teaching and Team Dynamics

   • Med-Peds physicians often have strong academic and teaching roles.
   • Observe how they teach residents and students, and how they integrate into both IM and Pediatrics teams.

5. Physician Identity and Career Satisfaction

   • Ask yourself: Does this role seem sustainable and fulfilling?
   • How does the physician talk about their career choices and long-term goals?

Questions to Ask Your Med-Peds Mentor

When the timing is appropriate (between patients, at the end of clinic, or over email), consider asking:

• “What drew you to Med-Peds instead of categorical Internal Medicine or Pediatrics?”
• “How do you structure your career now—what percentage is adult vs pediatric vs administrative/teaching?”
• “What aspects of your training were most valuable in preparing you for your current role?”
• “How has being dual-trained changed the way you think about patients with childhood-onset disease?”
• “For someone interested in the medicine pediatrics match, what experiences do you think are particularly helpful during medical school?”

Taking brief notes after these conversations will help you later when you craft your personal statement and interview responses.

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Documenting and Reflecting: Turning Shadowing Into Application Strength

Simply completing shadowing is not enough—you need to capture and translate these experiences effectively for ERAS and interviews.

How to Log and Organize Your Shadowing Hours

Create a simple tracking document (spreadsheet or note) with:

• Physician name, credentials, and specialty (e.g., “Dr. Smith, MD – Med-Peds, Primary Care”)
• Institution and clinic type (adult primary care, combined continuity clinic, transition clinic, inpatient wards)
• Dates and approximate number of hours
• Key cases or themes you observed (1–3 bullet points)
• Memorable quotes, teaching pearls, or reflections

This will help you later when asked:

• “Tell me about your exposure to Med-Peds.”
• “What did you learn from shadowing that influenced your decision to pursue this specialty?”

Integrating Shadowing into Your Personal Statement

Strong Med-Peds personal statements often:

1. Start with a concrete clinical vignette from shadowing or rotations
2. Use that story to illustrate the unique appeal of Med-Peds
3. Connect the experience to your values and career goals

Example angle:

“In a single afternoon in Dr. Lopez’s Med-Peds clinic, I watched a 3-month-old with feeding difficulties, a 17-year-old with sickle cell disease preparing to transition to adult care, and a 45-year-old with congenital heart disease whose medical history stretched back to pediatric surgery notes. Shadowing in this setting crystallized for me how Med-Peds physicians serve as both continuity and translation across the lifespan…”

Even if your most meaningful stories come from non–Med-Peds shadowing, you can still:

• Highlight combined themes (longitudinal care, transitions, dual perspectives)
• Explicitly state why Med-Peds, rather than only IM or only Pediatrics, feels like the best fit

Using Shadowing to Guide Your Program Preferences

Reflect on:

• Did you prefer outpatient continuity vs inpatient hospital medicine?
• Were you most inspired by transition clinics, global health, underserved care, or complex chronic disease?
• Did you gravitate more to adult patients, pediatric patients, or truly enjoy both?

Use these insights to assess:

• Programs with strong transition-of-care tracks
• Med-Peds residencies with high inpatient vs outpatient emphasis
• Institutions known for global health, academic careers, or primary care

You can then ask focused questions on interview day that signal you have done real reflection and research.

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Common Pitfalls and How to Avoid Them

Even well-intentioned students can undermine the value of shadowing if they approach it passively or without preparation.

Pitfall 1: Treating Shadowing as a Box to Check

Programs can tell when applicants have “collected” experiences rather than learned from them. Avoid:

• Attending a single half-day clinic and citing it as proof of deep commitment
• Listing shadowing on ERAS without being able to discuss specific takeaways
• Using generic statements like “I enjoy caring for patients of all ages” without examples

Solution:
Commit to multiple encounters with the same physician or clinic when possible. Focus on reflection and ask yourself after each session:

• What surprised me today?
• What did this show me about the identity of a Med-Peds physician?
• How does this align (or not) with my strengths and interests?

Pitfall 2: Being Passive or Invisible

Standing quietly in the background and never engaging can limit what you gain from the experience.

Solution:

• Introduce yourself clearly to the team and, when appropriate, to patients as a medical student observing.
• Ask brief, focused questions between patient encounters.
• Offer to help with small tasks within your scope (e.g., looking up guidelines, printing patient instructions, organizing charts), if appropriate and permitted.

Remember: You are still an observer; never perform clinical tasks without explicit permission and supervision. But thoughtful engagement shows initiative and curiosity.

Pitfall 3: Not Aligning Shadowing with Broader Career Exploration

Some students accumulate hours indiscriminately—shadowing broadly in specialties they know they will not pursue—without using that time to sharpen their thinking.

Solution:

• Be intentional about how shadowing in IM, Pediatrics, and Med-Peds compares for you.
• After each experience, ask:
  • What aspects of this specialty energize me?
  • What aspects drain me?
  • How might Med-Peds incorporate the best of both worlds for me?

Articulating this comparison is especially helpful in interviews when programs ask why you chose Med-Peds instead of categorical paths.

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Linking Shadowing to the Medicine-Pediatrics Match Strategy

Finally, connect your shadowing plan to your overall match strategy so your experiences work cohesively in your favor.

Building a Coherent Med-Peds Narrative

Over the course of medical school, aim for a combination of:

• Formal clinical rotations in Internal Medicine and Pediatrics
• Shadowing experiences with at least one Med-Peds physician or team
• Additional exposure (e.g., Med-Peds interest group, NMPRA events, quality improvement projects related to transitions of care or complex chronic disease)

This allows you to present a narrative like:

“Through my internal medicine and pediatrics clerkships, I found myself consistently drawn to patients whose care crossed developmental stages. Shadowing Dr. X in Med-Peds clinic, where I saw [specific example], clarified that I wanted a career explicitly built around that continuity and complexity…”

The goal is to show:

• Long-standing interest, not last-minute decision
• Specific understanding of Med-Peds roles
• Active steps taken to explore and confirm your fit

Using Shadowing to Prepare for Interviews

When interviewers ask about your Med-Peds interest, they want more than abstract enthusiasm. Use shadowing to prepare specific responses:

• “What Med-Peds experiences have you had?”

  • Describe one or two key shadowing experiences (with settings and patient types)
  • Highlight what you learned about Med-Peds scope and identity

• “Tell me about a patient who influenced your career choice.”

  • Choose a patient whose story reflects lifecycle continuity, transitions of care, or complex chronic disease across ages.
  • Explain how your Med-Peds mentor approached the case and what you took away.

• “How do you imagine using your Med-Peds training in the future?”

  • Use themes from your shadowing (transition care, primary care, hospital medicine) to frame your preliminary career goals.

Even if your precise subspecialty or practice setting is undecided, demonstrating that your goals align with what Med-Peds actually offers reassures programs.

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FAQs: Medical Shadowing in Medicine-Pediatrics

1. Do I absolutely need Med-Peds–specific shadowing to match into a Med-Peds residency?

No, there is no universal requirement that you must have Med-Peds–specific shadowing to match. However, most competitive applicants:

• Have at least some direct exposure to Med-Peds physicians or clinics, or
• Compensate with strong Internal Medicine + Pediatrics experiences plus clear, explicit reasoning about why dual training is right for them.

If your school lacks Med-Peds faculty, make this clear in your application, and emphasize how you sought alternative ways to explore Med-Peds (e.g., NMPRA, virtual meetings, mentors, relevant projects).

2. How many shadowing hours needed are ideal before applying Med-Peds?

There is no fixed “ideal” number, but a reasonable target is:

• 20–50 hours directly with Med-Peds (if available), plus
• Additional Internal Medicine and Pediatrics clinical experience from clerkships and electives.

That said, programs value depth and reflection over raw hours. A few well-chosen, thoughtfully reflected-on experiences are more valuable than 100 unfocused hours.

3. Can preclinical students or premeds shadow in Med-Peds, or is it only for clinical students?

Preclinical medical students and even premeds can often shadow in Med-Peds, depending on institutional policies. If you are early in your training:

• Clarify your level (premed, MS1, MS2) when you reach out
• Ask about any onboarding, HIPAA training, or documentation needed
• Focus on observation, professionalism, and learning rather than trying to perform clinical tasks

Getting early exposure can help you decide whether to pursue Med-Peds–oriented opportunities later, such as research, electives, or sub-internships.

4. How should I list shadowing experiences on ERAS for Med-Peds?

ERAS does not have a dedicated “shadowing” section, but you can:

• Include substantial, ongoing shadowing in the Experience section as “Clinical Observer,” “Medical Student Observer,” or similar
• Mention Med-Peds shadowing in your personal statement and, if appropriate, in letters of recommendation requests
• Be prepared to describe details (setting, physician specialty, what you observed) if asked during interviews

When in doubt, prioritize experiences that had real educational impact or that clearly shaped your decision to pursue the medicine pediatrics match.

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Thoughtful, well-planned medical shadowing in Medicine-Pediatrics can transform your understanding of this unique specialty and significantly strengthen your residency application. By approaching shadowing strategically—choosing settings carefully, engaging actively, and reflecting deeply—you will be well prepared to articulate not just what Med-Peds is, but why it is where you belong.