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General Pediatrics Training Irregularities

To apply for certification by the American Board of Pediatrics (ABP), an individual must meet the training requirements as specified in the eligibility criteria.

Waiver of Accredited Training

The ABP has established requirements for a physician who has had at least 3 years of general comprehensive pediatric training in programs not accredited by the ACGME or RCPSC (ie, international training or training in accredited osteopathic programs in the US) who wishes to apply for a waiver of training. The interested physician, department chair or program director must write to the ABP before training begins to receive approval.

The individual must provide documentation of the successful completion of at least 3 years of general pediatric residency training that includes the actual beginning and ending dates of the training and that is signed by the residency program director. The individual must also provide a copy of his or her medical school diploma and ECFMG certificate. Upon review and confirmation by the ABP of this information, the individual may have 1 year of accredited training waived. If a waiver is granted, 24 months of general pediatrics training must be completed in a program accredited by the ACGME or RCPSC.  Beginning in 2016, the individual must enter training at the PL-1 level, but at the discretion of the program director, may be advanced to the PL-2 level based upon the program director’s assessments of competence. A full year at the PL-3 level must be completed. (The training must be completed in general pediatrics; subspecialty training may not be substituted.) Refer to Suggested Training for Individuals Who Waive Accredited Training Policy provided below.

The director of the residency program that the individual enters will decide whether the 1 year of waived training will be accepted by the program. Individuals should investigate the licensure requirements in the state in which they wish to seek permanent licensure to ensure they meet the requirements if they choose to shorten pediatric training completed in the US.

Suggested Training for Individuals Who Waive Accredited Training

The ABP Non-Accredited Training Policy allows an individual to waive up to 1 year of accredited general pediatric residency training on the basis of having successfully completed at least 3 years of non-accredited training in pediatrics. Of the remaining 2 years of required accredited training, 1 full year must be at the PL-3 level in order to be eligible to apply for the certifying exam offered by the ABP. It is at the discretion of the accredited pediatric residency program that he/she enters whether the program will accept this waiver of training. Once the individual enrolls in the program, the program director is also expected to judge the adequacy of clinical skills and acculturation to the training program in determining whether two years of training will be sufficient or if a third year will be required.

On occasion individuals who have met the requirements of the Non-Accredited Training Policy (usually International Medical Graduates) have sought permission to alternate assignments in the general pediatrics training program with those in a subspecialty fellowship training program. Although part-time training is allowed, the ABP strongly discourages fragmentation of the general pediatrics training. It is important that residents participate in a coherent educational program with continuity of patient care. Residents and program directors should communicate with the ABP regarding any proposed deviation from 2 years of training in general pediatrics prior to the start of the training program in order to ensure that the eligibility requirements for certification will be met.

Although the ABP does not prescribe the curriculum of the 2 years of accredited training, with the exception that 1 year must be at the PL-3 level, the ABP has been asked to provide suggestions for training of individuals who have received a waiver of training.

Given the diversity of training offered in non-accredited training programs, the ABP feels that an individual who wishes to be eligible for certification by the ABP should successfully complete a broad tapestry of general pediatric experiences with increasing supervisory responsibility that would prepare her/him for the competent, independent care of children. The program director may wish to perform an assessment for readiness for supervision during the first period of training.

To this end the ABP suggests the following experiences for those who have completed 3 years of non-accredited training in general pediatrics without additional subspecialty training.

Component

Educational Unit*

Emergency Medicine & Acute Illness

3 (with at least 2 in ED)

Developmental-Behavioral Pediatrics

1

Adolescent Medicine

1

Term Newborn

1

Inpatient Pediatrics (non-ICU)

5 (no maximum)

Ambulatory Experiences to include community pediatrics and child advocacy

2

NICU

2

PICU

2

**Additional Subspecialty

4 (minimum)

General Pediatric Continuity Clinic

36.5 day/week per year for the entire training period

Supervisory Responsibility

4 months

*(Educational Unit = 4 weeks or 1 month OR outpatient longitudinal experience of 32 half-day sessions OR inpatient longitudinal experience of 200 hours)

**Additional Subspecialty includes 3 units from 3 different subspecialties from the following list:

  • child abuse
  • medical genetics
  • pediatric allergy and immunology
  • pediatric cardiology
  • pediatric dermatology
  • pediatric endocrinology
  • pediatric gastroenterology
  • pediatric hematology-oncology
  • pediatric infectious diseases
  • pediatric nephrology
  • pediatric neurology
  • pediatric pulmonology
  • pediatric rheumatology

Additional 1 unit of single or combined subspecialties from the list above or below:

  • child and adolescent psychiatry
  • hospice and palliative medicine
  • neurodevelopmental disabilities
  • pediatric anesthesiology
  • pediatric dentistry
  • pediatric ophthalmology
  • pediatric orthopaedic surgery
  • pediatric otolaryngology
  • pediatric rehabilitation medicine
  • pediatric radiology
  • pediatric surgery
  • sleep medicine
  • sports medicine

Individuals who have completed subspecialty training or those who have interrupted fellowship training to complete general pediatrics requirements should not complete additional experiences in that subspecialty during the general pediatrics residency. For instance, an individual who has completed 12 months of clinical neonatology fellowship should not take more than suggested NICU experience in the table above.

  • No more than 3 months of subspecialty training may be completed in any 1 subspecialty.
  • No more than 2 months of elective experiences may be taken outside of the accredited program.
  • Leave in excess of 1 month/year must be made up.

Continuity of care experience should be emphasized for individuals who have missed accredited categorical pediatric training, allowing some leeway for program directors to determine how much additional experience is needed.

Established 6/2000
Rev. 6/2003
Edited 1/2010
Revised 2/15/2013

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Credit for Previous Training

A physician transferring to pediatric residency training from another accredited residency (eg, family medicine, internal medicine, transitional year) must contact the ABP to determine whether partial credit can be awarded for this training. Credit is usually applied to the PL-1 year of training. Requests for credit must be submitted either by the candidate or the pediatric residency program director before the candidate enters pediatric residency training. Training completed more than 24 months prior to the request requires additional review and may not be credited.

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Absences from Training

The duration of general pediatrics training is 36 months. Thirty-three months of clinical training are required. One month of absence is allowed each year for leave (eg, vacation, sick, parental leave). Absences greater than 3 months during the 3 years of residency should be made up with additional periods of training. If the program director believes that the candidate is well qualified and has met all the training requirements, the program director may submit a petition to the ABP requesting an exemption to the policy. Residents in combined training or special training pathways may not take more than 1 month of leave per year.

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Interruption in Training

Residents who experience an interruption in general pediatrics training for greater than 24 continuous months and who wish to re-enter residency training in general pediatrics 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 residency program director before the candidate re-enters residency training in general pediatrics.

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Nonaccredited Training Experience

No more than a total of 3 months of the required 3 years of residency training may be taken outside of an accredited pediatrics residency program. These elective experiences must be approved by the program director, must have goals and objectives for training and must provide an evaluation of the resident's performance.

Formal graduate or postgraduate school courses that do not carry the essential ingredient of responsibility for patient care cannot fulfill the ABP's training requirement in general pediatrics.

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Military Service

Military service, unless as a pediatric resident in a military training program that is accredited by ACGME, cannot be substituted for training requirements.

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