In November, almost 1,500 pediatricians took the first Pediatric Hospital Medicine (PHM) certifying examination at nearly 200 testing centers across the United States and in eight other countries. The pass rate was 84.2%.
Hospital Medicine is the 15th pediatric subspecialty certification offered by the ABP. Certificates in another five subspecialties are offered in conjunction with other boards.
“Children who are hospitalized today generally have more complex medical problems or are more seriously ill than those who can be treated as outpatients,” says Suzanne Woods, MD, ABP Executive Vice President for Credentialing and Initial Certification. “This new subspecialty sets standards for training and recognizes the expertise of pediatricians working primarily in hospital settings. It also recognizes the role of hospitalists in improving hospital systems, ensuring patient safety, and striving for quality improvement.”
Establishing a new subspecialty is an involved process. Interest in PHM certification started more than seven years ago. In 2014, a group from the Joint Council on Pediatric Hospital Medicine petitioned the ABP for a subspecialty certification in their field. After it was approved by the ABP Board of Directors and then by the American Board of Medical Specialties (ABMS), the ABP appointed a PHM subboard (a committee of subspecialists in a particular field). The pediatricians on the new subboard established eligibility criteria for three pathways (practice, training, and a combination). The Accreditation Council for Graduate Medical Education (ACGME) then approved the PHM training program requirements. And finally, the PHM subboard wrote questions for the initial PHM certifying exam.
In February 2019, the ABP started accepting applications for the first PHM exam. Pediatricians certified in general pediatrics who currently work in a hospital as a general pediatric hospital medicine specialist may qualify to take the exam through a practice pathway.
After the PHM exam in 2023, however, all pediatricians taking the PHM certifying exam must meet the requirements for the training pathway, which includes completion of a fellowship in a PHM program.
Sara Horstmann, MD, who leads the pediatric hospitalist group at Atrium Health/ Levine Children’s Hospital in Charlotte, NC, was among the first to take her PHM exam, along with several of her colleagues. She says she thinks board certification will help pediatricians who work in hospitals better define what they do and be prepared for challenges unique to the setting.
“The field of hospital medicine requires skill in certain areas, including quality improvement, system administration, and leadership,” she says. “These are all areas of expertise that set our subspecialty apart. It’s important to have these skills when you are in a hospital setting, especially as an educator, researcher, or administrator.” She doesn’t think every pediatrician working in a hospital needs the PHM certification, though.
“There’s a tremendous amount of hospital medicine work that needs to be done,” she says. “You can be an excellent clinician without having hospitalist training.”