The role of the med-peds physician in a changing medical world.

The characteristic site-specific reactivation phenotypes of HSV-1 and HSV-2 depend upon the latency-associated transcript region. Increasing proportion of herpes simplex virus type 1 as a cause of genital herpes infection in college students. episodes of genital herpes in a Swedish STD population: a study of epidemiology and transmission by the use of herpes simplex virus (HSV) typing and specific serology. et al. The epidemiology of infection with the human herpesviruses in Navajo children. Risk of human immunodeficiency virus infection in herpes simplex virus type 2-seropositive persons: a meta-analysis.jape RS, et al. Recent herpes simplex virus type 2 infection and the risk of human immunodeficiency virus type 1 acquisition in India. Effect of maternal herpes simplex virus (HSV) serostatus and HSV type on risk of neonatal herpes. T he combined internal medicine-pediatrics (med-peds) residency program celebrates its 40th birthday in 2007. With the growth in med-peds programs over the years, almost 1 of every 8 pediatricians currently in training is completing a med-peds residency program. 1 The past several years also have seen increased attention to the evaluation of med-peds training and outcomes. 2-5 With the recent declining interest in primary care, what options do med-peds graduates have for their careers? What is the nature of their job search after completing training? Chamberlain et al try to answer those questions in this issue of The Journal. 6 The authors found that med-peds graduates had less difficulty than categorical pediatric graduates finding a position and had significantly higher starting salaries. In addition, although neither group of graduates was particularly likely to accept a position in a rural area (2%-3% in each group), med-peds graduates were more likely to select a position in a small town (population Ͻ50,000). Two findings from this study warrant further reflection. First, although the number of med-peds graduates who choose subspecialty careers is less than graduates from categorical pediatric programs (18% versus 31%), there is a significant shift in career plans during residency. As the authors point out, the number of med-peds graduates who planned a primary care career was 55%, in contrast to the 70% who anticipated entering primary care at the start of residency. In contrast, the number of pediatric graduates who took a primary care position was 50%, with 51% anticipating this career at the start of residency. Why was there such a large shift for med-peds residents? Is there something about the residency training …