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General Criteria for Subspecialty Certification

In addition to the training requirements, which are specific to each of the pediatric subspecialties, the following are required of candidates seeking certification in the pediatric subspecialties of adolescent medicine, cardiology, child abuse pediatrics, critical care medicine, developmental-behavioral pediatrics, emergency medicine, endocrinology, gastroenterology, hematology-oncology, infectious diseases, neonatal-perinatal medicine, nephrology, pulmonology, and rheumatology. Each candidate must be familiar with specific subspecialty training requirements as well current rules and regulations in A Guide to Board Certification – Booklet of Information.

CERTIFICATION BY THE AMERICAN BOARD OF PEDIATRICS (ABP)

A candidate for subspecialty certification must have achieved initial certification in general pediatrics and continue to maintain general pediatrics certification in order to take a subspecialty examination. No exceptions to this policy will be granted. The requirements for Maintenance of Certification (MOC) can be found on the ABP website. All candidates are urged to ensure that the requirements for maintenance of certification will be met in sufficient time to allow acceptance to the subspecialty certifying examination.  Under certain circumstances, individuals registered for the general pediatrics certifying examination may apply for a pediatric subspecialty examination pending notification of the general pediatrics examination results. Before making application, contact the ABP for information.

LICENSURE 

An applicant must hold a valid, unrestricted allopathic and/or osteopathic medical license in at least one jurisdiction in the United States, its territories, or Canada. If licenses are held in more than one jurisdiction, all licenses held by a physician should meet this requirement. Temporary or training licenses are not acceptable.

Individuals practicing exclusively abroad, ie, who are not practicing in the United States or Canada, and who do not hold a United States or Canadian license, must provide proof of licensure in the country in which they practice. Applicants for initial certification who intend to practice abroad exclusively must submit a letter stating this fact. In addition, they must submit proof of licensure in the country in which they intend to practice.

VERIFICATION OF TRAINING

Applicants are required to complete training in programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) in the United States or by the Royal College of Physicians and Surgeons of Canada. Those completing training in the United States must have been formally enrolled in the training program and reported annually as a fellow to ACGME and the ABP. An applicant will be asked to list the program(s) where fellowship training occurred as well as the name(s) of the program director(s). The ABP will provide a Verification of Competence Form to the program director(s) for completion. (Note: For new subspecialties, alternatives to the usual training requirements, such as practice experience, will be acceptable as criteria for admission to the examination. Refer to the specific subspecialty eligibility criteria for details.)  The role of the program director in the certification process is to verify training, evaluate clinical competence including professionalism, and provide evidence of the trainee’s scholarly activity/research.

The ABP will provide no credit for a year in which clinical competence has been rated as unsatisfactory and will require a repeat year of training. A marginal evaluation in clinical competence indicates the need for remediation of certain portions of clinical training. A trainee may be advanced to a higher level of training under these circumstances as remediation is provided. 

It is expected that the next year of training will result in a satisfactory evaluation for clinical competence in order for full credit to be provided for the marginal year of training. Two consecutive marginal evaluations require a repeat year of training.

An applicant must have the verification form(s) on file at the ABP in order to be admitted to the subspecialty examination. If an applicant’s training is not verified or if the applicant receives an unsatisfactory evaluation in any of the competencies (with the exception of professionalism alone), the applicant will be required to complete an additional period of subspecialty fellowship training before reapplying. The director of the program where the additional training occurred must complete a separate Verification of Competence Form. If the unsatisfactory evaluation is in professionalism only, the applicant will be required to complete an additional period of fellowship training or, at the program director’s recommendation and at the ABP’s discretion, a period of observation may be required in lieu of additional training. A plan for remediation must be submitted for review and approval by the ABP.

Appeals Process:  Applicants who wish to appeal evaluations must proceed through institutional due process mechanisms. The ABP is not in a position to reexamine the facts and circumstances of an individual’s performance.

An applicant must satisfactorily complete all subspecialty training one month before the scheduled administration of the examination. An applicant whose contracted training period does not expire before the first day of the month of the examination will not be eligible for that examination, even if all formal training has been completed earlier and the remaining time is used only for leave.

No credit will be given for subspecialty training during the core general pediatrics residency or a chief residency.

An applicant seeking certification in another pediatric subspecialty or a non‑ABP specialty (eg, allergy/immunology) on the basis of practice and/or training may not apply the same period of time toward fulfillment of these requirements.

SCHOLARLY ACTIVITY

The ABP requires scholarly activity during fellowship training. The requirement accommodates a wide variety of academic scholarly activities. The scholarly activity training requirements apply to all fellows beginning subspecialty training July 1, 2004, and thereafter. Those fellows who began training prior to this date must meet the requirement for meaningful accomplishment in research, which was in place at the time they entered training. Contact the ABP for more information.

The program director is responsible for notifying all fellows of the scholarly activity requirements necessary for certification upon entry to the subspecialty training program. Furthermore, in the description of the candidate’s scholarly activity performance on the Verification of Competence Form, the program director must provide a description of the experiences on which the acceptable evidence of scholarly activity is based.

PRINCIPLES REGARDING THE ASSESSMENT OF SCHOLARLY ACTIVITY 

All fellows must participate in a core curriculum in scholarly activities. This curriculum should provide skills that lead to an in-depth understanding of biostatistics, clinical and laboratory research methodology, study design, preparation of applications for funding and/or approval of clinical or research protocols, critical literature review, principles of evidence based medicine, ethical principles involving clinical research, and the achievement of proficiency in teaching. In addition to participating in a core curriculum in scholarly activities, all fellows will be expected to engage in projects in which they develop hypotheses or in projects of substantive scholarly exploration and analysis that require critical thinking. Areas in which scholarly activity may be pursued include, but are not limited to:  basic, clinical, or translational biomedicine; health services; quality improvement; bioethics; education; and public policy.

In addition to biomedical research, examples of acceptable activities might include a critical meta-analysis of the literature, a systematic review of clinical practice, a critical analysis of public policy, or a curriculum development project with an assessment component. Involvement in scholarly activities must result in the generation of a specific written “work product.”

Examples of work products include, but are not limited to:

  • A peer-reviewed publication in which a fellow played a substantial role
  • An in-depth manuscript describing a completed project
  • A thesis or dissertation written in connection with the pursuit of an advanced degree
  • An extramural grant application that has either been accepted or favorably reviewed
  • A progress report for projects of exceptional complexity, such as a multi-year clinical trial

Review of scholarly activity and the written work product will occur at the local level, with each fellow having a Scholarship Oversight Committee responsible for overseeing and assessing the progress of each fellow and verifying to the ABP that the requirement has been met. The Scholarship Oversight Committee should consist of three or more individuals, at least one of whom is based outside the subspecialty discipline; the fellowship program director may serve as a trainee’s mentor and participate in the activities of the oversight committee, but should not be a standing (ie, voting) member.

Upon completion of training, the ABP will require:

  • Verification from the training program director that the clinical and scholarly skills requirements have been met
  • A comprehensive document (ie, personal statement), written by the fellow, describing the scholarly activity that includes a description of his/her role in each aspect of the activity and how the scholarly activity relates to the trainee’s own career development plan. The fellow’s personal statement, ie, a comprehensive document written by the fellow, is integral to the requirement for scholarly activity. This document should be several pages in length and comment on the fellow’s intended career path upon entering fellowship and reasons for choosing a specific area of scholarly activity. It should describe the scholarly activity and the fellow’s role in each aspect of the activity, as well as any preparation beyond the core fellowship curriculum needed to ensure successful completion of the project. The personal statement should describe how the scholarly activity furthers the fellow’s career development plan, and should reflect upon the educational value of the pursuit of the project
  • The actual work product of the scholarly activity as described above
  • Signature of the fellow, program director, and members of the Scholarship Oversight Committee on both the personal statement and work product of the fellow as described above

Details of the scholarly activity requirement have been published by the ABP in a document entitled Training Requirements for Subspecialty Certification (January 2004), which is downloadable directly from the ABP’s website.

MISCELLANEOUS POLICIES/ISSUES RELATED TO CERTIFICATION AND TRAINING 

Transfer of Fellowship Training

While not encouraged for continuity purposes, if a fellow must transfer, the program directors of the current program and the proposed program must communicate to ensure that the fellow who transfers will meet all requirements if he or she desires to apply for a certifying examination in the subspecialty. A Fellow Transfer Information (FT11) form should be completed by the current program director and submitted to the ABP with a copy to the proposed new program. Fellow evaluations should be submitted to the proposed program as well. Months of credit for clinical experience and scholarly activity/research completed must be clearly communicated to the fellow, the new program director, and the ABP. The ABP must be informed of the plan to ensure continued appropriate mentoring for scholarly activity upon transfer, including the role of the Scholarship Oversight Committee. The ABP will send summary evaluations to a new training program if a fellow transfers.

Interruption of Training

Fellows who interrupt fellowship training for greater than 12 continuous months and who wish to re-enter training in fellowship must petition the ABP to determine whether credit may be awarded for prior training. The request for credit must be submitted by the candidate or the fellowship program director before the candidate re-enters fellowship.

Program Requirements for Residency Education in the Subspecialties of Pediatrics

Program Requirements for Residency Education in the subspecialties of pediatrics are approved by the Accreditation Council for Graduate Medical Education (ACGME) or by the Royal College of Physicians and Surgeons of Canada (RCPSC). Program Requirements and a listing of accredited programs may be found on the ACGME website or the RCPSC website.

TRAINING LEADING TO DUAL PEDIATRIC SUBSPECIALTY CERTIFICATION

Sequential Dual Training

If an individual has completed 3 years of training in one subspecialty and the program director has verified both clinical competence and satisfactory completion of scholarly activity, he or she can become eligible to take an examination in a second subspecialty after 2 years of additional training, of which at least 1 year must be broad‑based clinical training. The requirement for scholarly activity in the second subspecialty is waived. Individuals approved for subspecialty fast-tracking in the first subspecialty are also eligible for this pathway. This dual training option does not require preapproval by the ABP.

Integrated Dual Training

An individual and his or her program director(s) may petition the Credentials Committees of two pediatric subspecialties with a proposal for a 4- or 5-year integrated training program that would meet the eligibility requirements for certification in both subspecialties.  Petitions for this option must be approved before subspecialty training begins or early in the first year of subspecialty training.

Guidelines for dual subspecialty training may be obtained from the ABP or can be found on the ABP website.

TRAINING LEADING TO ELIGIBILITY FOR COMBINED (INTERNAL MEDICINE-PEDIATRICS) SUBSPECIALTY CERTIFICAITON

An individual who has completed internal medicine-pediatrics training should contact the American Board of Internal Medicine and the American Board of Pediatrics regarding opportunities for combined training (ie, training in both the adult and pediatric subspecialties). Combined training petitions must be submitted prospectively either before training begins or in the first 3 to 6 months of fellowship training and must be approved by both boards. All training in the internal medicine and pediatric subspecialty must be completed in order for an applicant to take a pediatric subspecialty certifying examination. Guidelines for Combined training may be obtained from the ABP or can be found on the ABP Web site.

Subspecialty "Fast-Tracking"

A subspecialty fellow who is believed to have demonstrated accomplishment in research, either before or during residency, may have a part of the training requirement waived. Evidence of such accomplishment might include a PhD degree in a discipline relevant to the subspecialty or career path of the fellow, or sustained research achievement relevant to the subspecialty or career path of the fellow. The subspecialty program director may petition the Subboard to waive the requirement for scholarly activity, and to reduce the length of subspecialty training by as much as 1 year. This petition must be made either before the beginning of training or during the first year of training.

A candidate for this pathway must have satisfactorily completed 3 core years of pediatrics or approved combined pediatrics and other specialty training in an accredited program in the US or Canada. This pathway is also available to candidates who have satisfactorily completed at least 3 years of non-accredited general pediatrics training (eg, overseas) and qualified for a waiver of 1 year of general pediatrics training through the Policy Regarding Individuals with Non-Accredited Training. An individual who enters subspecialty training via the Accelerated Research Pathway would not be eligible for subspecialty fast-tracking.

A subspecialty fellow who receives a waiver by the Subboard must complete at least 2 years of training in the subspecialty with at least 1 year of broad-based clinical training. In order for an individual to be eligible for subspecialty certification, all requirements for general pediatrics certification must be fulfilled. 

TIME-LIMITED ELIGIBILITY FOR INITIAL CERTIFICATION EXAMINATIONS

Beginning with the examinations administered in 2014, the American Board of Pediatrics will require that applicants have completed the training required for initial certification in the pediatric subspecialties within the previous 7 years (eg, 200710 or later for examinations administered in 2017). If the required training was not successfully completed within the previous 7 years, the applicant must complete an additional period of supervised practice in order to apply for certification. The subspecialty examinations are offered every other year. Therefore, please note that the pediatric subspecialty examination may not be offered in the year the acceptance expires. The full policy can be found on the ABP website.

CLOSURE OF PRACTICE PATHWAY FOR SUBSPECIALTY CERTIFICATION​

The ABP has established a policy for a closure date for the practice pathway for all subspecialties in which a certificate is offered. The certifying examinations for 2010 were the last examinations for which an individual could apply for certification using practice experience accrued by the deadline stated in the original eligibility criteria when the subspecialty was established. A candidate qualifying for the child abuse pediatrics examination via the practice pathway had until 2013 to apply for certification.

It should be noted that these criteria and conditions are subject to change without notice. All applicants should be familiar with the current Booklet of Information. Applicants are advised to contact the ABP to ascertain whether the information they have is current. 

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