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Integrated Research Pathway (IRP)

Objectives

The objectives of the Integrated Research Pathway (IRP) are:

  • to attract committed young physician-scientists to pediatrics;
  • to provide mechanisms to sustain research interest, skills, knowledge, and productivity during core pediatric training;
  • to offer a means for fostering transition to a physician-scientist career;
  • to ensure that trainees accomplish the requisite training and acquire the skills to function as competent pediatricians in the unsupervised care of children.

General Requirements

Individuals may apply for this pathway either before entering an accredited pediatric residency program or during the first nine months of the PL-1 year. This pathway is open to individuals with MD/PhD degrees or others who can demonstrate equivalent evidence of research experience and commitment.

Training in pediatrics must be completed in an accredited general pediatrics residency program. It is anticipated that in most instances the research component will be completed in the same academic health center. The curricular components that constitute the pediatric residency training must be taken from those experiences that have been approved by the Review Committee for Pediatrics as part of the requirements for pediatric residency training.

Except for the following provisions, the IRP must conform to the program requirements for accreditation of a general pediatrics residency.

 

A resident may enter the IRP only at the PL-1 level. Approval for this pathway must be obtained from the ABP either before beginning residency training or during the first nine months of the PL-1 year. A resident may not transfer into this program beyond the PL-1 year or from another categorical program. Applications from program directors that provide an outline of proposed training for an individual will be reviewed; programs will not be approved.

 

The training should be the same as described in the ACGME Program Requirements for Graduate Medical Education for Pediatrics as outlined in this document with the exceptions that follow. The residency training must be of 3 years duration. There must be at least 2 years of training in clinical pediatrics and up to 1 year of research training opportunities. Vacation leave or other absences from training cannot exceed three months during these 3 years.

The curriculum must include 2 years of clinical experiences and should be organized in educational units. An educational unit should be a block (four weeks or one month) or a longitudinal experience. An outpatient educational unit should be a minimum of 32 half-day sessions and an inpatient educational unit should be a minimum of 200 hours.

The specific curricular elements are detailed in the following chart:

Requirements in General Pediatrics for

Training in Pediatrics for those in the Integrated Research Pathway

(Effective July 2013)

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)

*(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:

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

Subspecialty Experience

Educational experiences in the subspecialties must emphasize the competencies and skills needed to practice general pediatrics of high quality in the community. They should be a blend of inpatient and outpatient experiences and prepare residents to participate as team members in the care of patients with chronic and complex disorders.

Supervisory Responsibility

  1. The Resident
  2. Supervision of the Resident

    A supervisory/review committee must be established by the residency program and the research mentors to ensure that each trainee is meeting the requirements of training and is successfully completing each experience to be continued in the pathway. The general pediatrics program director must provide careful evaluation of clinical training to determine whether the resident is attaining the knowledge and experience necessary to provide unsupervised care of children. A research mentor must oversee the research experiences to ensure that the trainee is accomplishing pathway goals. The committee should meet at least every six months to evaluate and advise the resident. Meetings and evaluations must be documented.

     

  3. Core Curricular Requirements
    • 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
    • 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
  4. At least 3 educational units of supervisory responsibility must be completed during the 2 years of training.

    Continuity Clinic

    There must be a minimum of 36 half-day sessions per year of a longitudinal outpatient experience in a continuity clinic at a pediatric primary care site throughout the 3 years of general pediatrics training, including during the research experiences. The sessions must not be scheduled in fewer than 26 weeks per year. The patients should include those previously cared for in the hospital, well children of various ages, and children of various ages with special health care needs and chronic conditions. Residents must have a longitudinal general pediatrics outpatient experience in a setting that provides a medical home for the spectrum of pediatric patients and must care for a panel of patients that identify the resident as their primary care provider.

    The medical home model of care must focus on wellness and prevention, coordination of care, longitudinal management of children with special health care needs and provide a patient- and family-centered approach to care.

    Individualized Curriculum

    There is no expectation of an individualized curriculum, but it is acceptable for a resident to complete electives appropriate for their career pathway.

    Clinical and Research Assignments

    During the PL-1 year, a minimum of 10 months of clinical pediatric residency training is required. Residents in this pathway must have the opportunity to establish general pediatric skills along with the cohort of categorical pediatric residents. It is incumbent that the pediatric program director assess the progress of the resident in this pathway at nine months of the PL-1 year to determine whether the resident has developed the requisite experience and skills to continue in light of the truncated clinical training.

    During the remaining training there may be as much as 11 months of research experience, of which a minimum of five months must be in the PL-3 year. During the research experience not more than 20% of time may be spent in clinical activities, including continuity clinic.

    Evaluation

    Periodic evaluation with feedback of the educational progress of the resident should occur as outlined in the Program Requirements for Pediatrics. Included in this evaluation must be resident's knowledge, skills, attitudes, and interpersonal relationships. Similarly, the research mentor(s) must evaluate the resident's experiences and progress in their areas of supervision. These evaluations should be regularly discussed with the resident and must be kept on file and available for review. Final evaluation should include the approval of a summary progress report of the trainee's research experience by the program director or mentor. Evaluations of the pathway and faculty are required of the resident.

    Eligibility for Certification

    To meet the eligibility requirements for certification in general pediatrics, the resident must satisfactorily complete the 3 years of the IRP. The pediatric program director must verify that the resident has completed the prescribed training and verify clinical competence. An additional 1 year of pediatric clinical experience must be completed successfully to be eligible for the certifying examination in general pediatrics. This experience must be in an accredited specialty residency or subspecialty fellowship approved by the ABP. The program director of the additional clinical experience will be asked to verify clinical competence and training. The certifying examination may not be taken until all training requirements (ie, the three-year IRP and the additional one year of clinical training) have been completed.

    Interface with Research in Subspecialty Training

    Some residents who have made early commitments to subspecialty training may benefit from an integrated research experience spanning core and subspecialty training. In these cases, subspecialty program directors should join the trainee's supervisory committee.

    Residents accepted into the IRP may be eligible for subspecialty fast-tracking by virtue of having a PhD degree or sustained research achievement relative to the chosen subspecialty or career path. Petitions for subspecialty fast-tracking must be approved by the credentials committee of the relevant subboard. This petition must be made either before the beginning of subspecialty training or during the first year of training.

     

    Approved: 9/00
    Revised: 12/03
    Revised: 11/05
    Draft Revision: 12/16/2012
    Revised: 2/16/13 by the ABP Board of Directors