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Pediatric Hospital Medicine Certification

Eligibility Criteria for Certification in Pediatric Hospital Medicine

The American Board of Pediatrics (ABP) has established a procedure for certification in pediatric hospital medicine. In addition to the specific admission requirements listed below, general eligibility criteria for all ABP subspecialties must be fulfilled to be eligible for certification. At the present time, there are two pathways to certification: Training Pathway and Practice Pathway.

Admission Requirements

Training Pathway

Physicians may apply on the basis of the completion of two years of pediatric hospital medicine training in a program supervised by a director who is certified in pediatric hospital medicine or, possesses appropriate educational qualifications. The ABP will consider only fellows who complete training in pediatric hospital medicine programs that are operated in association with general pediatrics residency programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) in the United States or the Royal College of Physicians and Surgeons of Canada (RCPSC). Physicians who have completed a two-year fellowship in general academic pediatrics fellowship may be considered if the supervised clinical training was devoted to pediatric hospital medicine. 

There will be a temporary period which includes the first three examination administrations (2019, 2021 and 2023) during which candidates who have completed two years of non-accredited pediatric hospital medicine training within the previous seven years of the examination date may apply for the examination using the Training Pathway. Those individuals accepted for the exam have seven years from the time of initial acceptance for the examination to become certified. 

Applicants for an examination scheduled during the temporary period (2019, 2021, 2023) who completed training more than seven years before the examination must apply through the practice pathway.  

Accredited Training

An application has been submitted to the Accreditation Council for Graduate Medical Education (ACGME) to request that it begin a process to accredit pediatric hospital medicine training programs. A fellow entering subspecialty training in pediatric hospital medicine before completion of the accreditation process by ACGME is advised to enter those programs in which the director or senior faculty of the program possesses appropriate educational qualifications or are certified in pediatric hospital medicine once certification is available. Only pediatric hospital medicine training programs that are operated in association with general comprehensive pediatric programs accredited by the ACGME or RCPSC will be considered.  A Verification of Competence Form must be completed by the program director(s) verifying satisfactory completion of the required training, evaluating clinical competence including professionalism. The ABP will determine and publish the date after which fellows must enter accredited training to be eligible for the certifying examination. At that time, Scholarly Activity as defined in the ABP’s General Criteria for Certification in the Pediatric Subspecialties will be required.

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

Likewise, training which qualifies a diplomate for admission to one subspecialty examination cannot be double-counted toward certification in another subspecialty.

Practice Pathway

There will be a temporary period during which candidates may apply for the certifying examination based upon practice experience in pediatric hospital medicine. This temporary period will span the first three examination cycles (2019, 2021, 2023). All practice experience must be accrued during the most recent four years prior to the examination. During this temporary period, there will be two pathways used to apply for the examination for those who can demonstrate a significant practice concentrated in the discipline of pediatric hospital medicine.  Individuals have seven years from the time of initial acceptance for the examination to become certified. 

Four-Year Practice Pathway

The most recent four years of full time practice must have consisted of at least 50% time spent engaging in professional activities (clinical care, teaching, quality improvement, research, administration, etc.) related to the care of hospitalized children. At least half of that time must be devoted to direct patient care of children, i.e., 25% of full-time professional practice. Professional activities must be of such type and quality that they are sufficient to substitute for the breadth of experience one would encounter during formal subspecialty fellowship training. Unsupervised pediatric hospital medicine practice accrued during a chief residency can be recognized if it meets the requirements above. For those graduates of internal medicine-pediatrics programs who are practicing as hospitalists caring for both adults and children, non-patient care related professional time devoted to activities related to adults may qualify. However, the time devoted to direct patient care for children must be 25%. Practice experience must be accrued in the US or Canada.

If the most recent four-year period was interrupted by personal/family leave or other circumstances, an exception may be considered at the discretion of the ABP, provided substantial prior practice experience in Pediatric Hospital Medicine can be documented.  

For an individual utilizing the practice pathway, an Evaluation Form(s) will be required from the pediatric hospital medicine program director (if there is a subspecialty training program), or the pediatric hospital medicine division director, the pediatric department chair, the chief of pediatrics or chief of staff in the hospital(s) where the applicant is now or has been practicing pediatric hospital medicine.

Combination Fellowship and Practice 

An individual completing less than two years of fellowship may qualify with an additional two years of practice experience that meets the requirements stated above. The two years of practice experience may be completed at anytime either before or after training within the four years prior to the examination. 

For an individual utilizing the combination training and practice pathway, a Verification Form will be required from the director of the applicant's pediatric hospital medicine training program, and an Evaluation Form will be required from the pediatric hospital medicine program director (if there is a subspecialty training program), the pediatric hospital medicine division director, the pediatric department chair, the chief of pediatrics or chief of staff in the hospital(s) where the applicant is now or has been practicing pediatric hospital medicine.

More About Practice

Part-Time Practice

The expectation is that an applicant who has completed part-time practice must meet the same minimal requirements outlined above. To qualify, a part-time practitioner’s engagement in pediatric hospital medicine must be equivalent to full-time practitioners, i.e., 50% of a full-time equivalent (FTE). A practitioner working less than half-time (i.e., < 20 hours per week) is unable to qualify through the practice pathway.    

Accrual Deadlines for the Practice Pathway

The specific deadline for each examination is noted below:

Exam Year Deadline to Accrue Practice
2019 June 30, 2019
2021 June 30, 2021
2023 June 30, 2023

An applicant qualifying for the examination via either the four-year practice pathway or the combination training and practice pathway must complete an application and receive approval to take the examination no later than 2023.

Notice: The American Board of Pediatrics (ABP) reserves the right to make changes in its policies and procedures at any time and will make every effort to give advance notice when such changes are made. It is the applicant’s responsibility to be aware of and to meet all requirements and deadlines.

Approved by the Board of Directors June 2017

Frequently-Asked Questions

General

Who is eligible for an exam?

  • To be eligible, an individual must:
    • Hold a current certification in general pediatrics
    • Satisfactorily meet either the training pathway requirements for pediatric hospital medicine or the practice pathway requirements.  If applying through practice pathway, accrue practice experience by June 30 of the year of application
    • Possess a current, unrestricted medical license  

When will the examination be given?

  • The first exam will be given on a single day in November 2019. Applicants may access the application on the ABP website from February - April 2019. The exact day of the examination and the dates of registration will be established in the spring 2018. 
  • Subspecialty examinations are given on alternate years; therefore, the exam is expected to be administered on odd years in the fall.  

Training Pathway

What are the requirements for the Training Pathway?

  • Individuals must have completed at least two years of pediatric hospital medicine training in a pediatric hospital medicine program in the US or Canada associated with an accredited general pediatrics training program. For first-time applicants, the training must have been completed within the previous seven years. 

I completed a two-year General Academic Pediatrics Fellowship. May I qualify?

  • You may qualify if your clinical training focused on the care of the hospitalized child and provided the depth and breadth of clinical training experiences, supervised by qualified hospitalists, comparable to that offered in a pediatric hospital medicine training program. A description of your training must be submitted by your program director during the application process. For first-time applicants, the training must be completed within the previous seven years.

When will the ABP require training to be completed in an accredited training program?

  • An application has been submitted to the Accreditation Council for Graduate Medical Education(ACGME) to initiate the accreditation process. When the timetable for accreditation of programs is known, the ABP will establish a date by which fellows who enter training must enter an accredited pediatric hospital medicine program. Trainees who enter fellowship training in nonaccredited training programs before this date may complete training in the nonaccredited program and apply for certification if the training was completed within the previous seven years.

When will the ABP require that fellows in pediatric hospital medicine meet the requirements for Scholarly Activity?  

  • Once the timetable for accreditation of training programs is established, the ABP will set a date by which fellows will be required to meet the requirements for Scholarly Activity, including the requirement for a Scholarship Oversight Committee to be established for each fellow at the start of training and for a written scholarly work product to be provided to the ABP. 

I am completing training part-time. May I qualify?

  • The required two years of fellowship may be completed on a part-time basis over no more than a four-year period.   

When will the Subspecialty In-Training Examination (SITE) be available for trainees? 

  • ABP will announce when SITE for Pediatric Hospital Medicine will be available once training programs become accredited.  

Practice Pathway

What is the purpose of the Practice Pathway?

  • When there is a new subspecialty certification, the ABP allows those individuals who are expert subspecialists and already practicing the discipline (often for many years) to have access to the examination without having to go back and complete formal fellowship training. In fact, they may even be the individuals who “established” the subspecialty and direct the non-accredited fellowship programs that already exist. This practice pathway is not meant to offer a means to informally train in the discipline or to serve as an apprentice outside of a formal fellowship program. For individuals who are in residency, one way to assure eligibility for certification is to enter a fellowship training program and complete the required training. However, the ABP will accept those who qualify for the practice pathway as defined in the eligibility criteria. Residents graduating in 2019 may be able to accrue the four years of practice by 2023, the final year the practice pathway will be offered.

What are the requirements for the Practice Pathway?

Details may be found in the Eligibility Criteria.

  • To meet the practice pathway requirements, the most recent four years of full-time practice must have consisted of at least 50% time spent in engaging in professional activities (clinical care, teaching, quality improvement, research, administration, etc.) related to the care of hospitalized children.  At least 25% of full-time professional practice must be devoted to the direct patient care of children.  In general, full-time is considered at least 40 hours per week.  Therefore, an applicant’s direct care of patients should average 10 hours per week, or 450-500 hours per year over the most recent four years.  Between 900-1000 hours per year over the most recent four years should be spent overall in the practice of pediatric hospital medicine.

I am a Medicine-Pediatrics hospitalist. May I qualify for the Practice Pathway?

  • Individuals who are practicing as hospitalists caring for both adults and children may use non-patient care related professional time toward the requirements, but must spend at least 25% of their full-time professional activity in the direct care of hospitalized children. The additional required time may consist of patient care of hospitalized children or non-patient care, professional activities related to adults.  

I practice pediatric hospital medicine part-time. May I qualify?

  • Individuals who practice part-time may qualify for the practice pathway if the minimum requirements are met. The part-time practice must be equivalent to 50% of full-time professional activity, with half of that time spent in the direct care of hospitalized children.  In general, full-time is considered at least 40 hours per week.  Therefore, an applicant’s direct care of patients should average 10 hours per week, or 450-500 hours per year over the most recent four years.  Between 900-1000 hours per year over the most recent four years should be spent in the overall practice of pediatric hospital medicine (clinical care, teaching, quality improvement, research, administration, etc).

How will the ABP verify my hospital medicine practice?

  • The ABP will ask that you provide information that describes your practice experience, including the scope of your practice and your practice environment as part of your application for certification.  
  • Also, an Evaluation Form must be completed by:
    • the pediatric program director of the pediatric hospital medicine training program at the institution, if applicable, OR
    • the pediatric hospital medicine division director, OR
    • the pediatric department chair, OR
    • the chief of pediatrics or chief of staff

The Evaluation Form will also seek specific information about the nature of your practice and the practice environment and the evaluator will be asked to attest to your practice as a pediatric hospitalist and verify that you have met the time requirements. 

I have practiced hospital medicine for more than four years. Should I include a description of all my practice experience in my application? 

  • You should only include information on your application that describes the most recent four years of your practice experience. 

How long will the Practice Pathway be available? How long is an applicant eligible once approved?

  • The Practice Pathway will be available for first-time applicants for the first three exam cycles:  2019, 2021, 2023.  First-time applicants must have completed the requirements for the practice pathway in the most recent four years. For example, a first-time applicant using the practice pathway in 2019 must meet the practice requirements over the most recent four years (2015-2019).         
  • Once an application is accepted for the first time, the applicant has seven years to become certified. See the Time-Limited Eligibility section for more detailed information regarding eligibility.

May I qualify if I interrupted practice during the recent four years for family leave or other such circumstances?

  • An exception may be considered for an individual who does not meet the requirement if there is substantial prior experience in pediatric hospital medicine. For example, if an individual interrupted practice for family leave or other such circumstances, but the previous practice experience amply fulfilled the requirements, it is likely that the ABP would approve the applicant. Such exceptions are made at the discretion of the ABP and will be considered on a case-by-case basis.  

I have a research grant that limits my clinical practice time to 20% of a FTE. May I qualify?

  • An exception may be considered for an individual who does not meet the requirement if there is a substantial prior experience in pediatric hospital medicine. Such exceptions are made at the discretion of the ABP and will be considered on a case-by-case basis.

Will those who practice exclusively in a niche area such as neonatal-perinatal medicine, pediatric emergency medicine, bone marrow transplant or well-baby nursery qualify?

  • The certificate in pediatric hospital medicine is intended for those whose practice encompasses the delivery of comprehensive medical care to hospitalized patients including those with acute serious complications of common problems, those more complicated patients with multiple co-morbidities and/or injuries, complex chronic diseases, special healthcare needs, technology dependency and those needing palliative care. Therefore, a niche practice limited to one population of hospitalized children would not qualify one for the practice pathway.  

While a chief resident, I practiced pediatric hospital medicine for a year. May I use this time toward the requirements for the practice pathway?

  • Your chief residency experience may qualify toward the accrual of practice if your experience meets the practice requirements.  At least 50% time during this year must be spent engaged in unsupervised professional activities (clinical care, teaching, quality improvement, research, administration, etc.) related to the care of hospitalized children.  Your direct care of hospitalized patients should average 10 hours per week, or 450-500 hours over the chief year.

I have practiced pediatric hospital medicine at 100% professional effort, but for only two years. May I qualify?

  • Not unless you also have one year of pediatric hospital medicine training. Individuals applying through the practice pathway must accrue at least four years of time spent at least 50% FTE before they may be accepted for the exam. Those who have less than four years of qualifying practice at the time of the exam given in 2019 must accrue additional practice time before applying for an exam in 2021 or 2023. Individuals who will not accrue four years of qualifying practice in time for the exam given in 2023 will be unable to apply using the practice route and must complete the requirements for training.  

What are the practice accrual deadlines for the Practice Pathway?

  • For each exam and application period, practice must be accrued by a specific deadline for the ABP to have adequate time to review and approve the application. See the table in the eligibility criteria for deadlines.  

What happens if my application through the practice pathway is disapproved because I missed the accrual deadline?  May I appeal?

  • When candidates apply through the practice pathway, the application is reviewed against the criteria and if an individual is denied entry to the examination, there is an opportunity to appeal.  For example, if an individual is short several weeks and substantial prior practice experience has been verified, an exception may be considered.  More detailed information may be required of such applicants.  Decisions are made on a case-by-case basis at the time of application and not prospectively.   

Combination Training & Practice

I have completed a one-year training program in pediatric hospital medicine. May I qualify?

  • Individuals who have completed a one-year fellowship must have completed the training in a program in the US or Canada that is associated with an accredited general pediatrics training program AND fulfill the requirements for two years of practice in pediatric hospital medicine.
  • The practice experience and training must be completed within the most recent four years.

Time-Limited Eligibility

I am applying through the training pathway. When does my eligibility end?

For the first three examinations, a first-time applicant must have completed training within the previous seven years. This means that if you apply for the 2019 exam, your training must have been completed no earlier than 2012. Once approved as a first-time applicant, you have seven years of eligibility to pass the exam. For example, if you are approved for the 2019 exam, you will have seven years (2026) to become certified in pediatric hospital medicine. However, because the examination is given in odd years, the last exam you could take would be the one offered in 2025 before your eligibility expired. If you are unsuccessful or do not take the exam, the “time clock” for eligibility does not reset. See below:

Exam/Approval Year Training Completed No Later Than Last Available Exam Eligibility End Date
2019 2012 2025 2026
2021 2014 2027 2028
2023 2016 2029 2030

If your training was completed prior to 2012, you must apply through the practice pathway.

I am applying through the practice pathway. When does my eligibility end?

The practice pathway is open to first-time applicants for three exam cycles (2019, 2021, 2023). A first-time applicant must demonstrate that the most recent four years of practice experience met the requirements for practice. Once approved as a first-time applicant, you will have seven years to pass the exam. If you are unsuccessful or do not take the exam, the “time clock” for eligibility does not reset.  

Exam/Approval Year Last Available Exam Eligibility End Date
2019 2025 2026
2021 2027 2028
2023 2029 2030

What happens if I do not become certified before my eligibility expires?

Other Questions

Does the ABP advise an individual planning a career in pediatric hospital medicine to complete training requirements or accrue experience to apply under the practice pathway?

  • For an individual just beginning a career, the ABP advises the completion of training requirements. The practice pathway is not intended to be a prospective pathway leading to certification. It is intended to allow leaders in the field, those who established the subspecialty discipline before training programs were established, and those who are currently practicing the discipline to access the certifying examination without completing training. Once a discipline is approved for certification, the ABP advises graduating residents to complete the training requirements. Following the announcement of a new subspecialty certification, the next step is to establish accredited training programs and to set a deadline by which all future trainees must enter accredited training programs.

I am currently a resident and will be entering practice as a pediatric hospitalist. What is the last graduating year I may qualify by the practice pathway to sit for the pediatric hospital medicine exam?

  • 2019. A trainee graduating 6/30/2019 could accrue time from 7/1/2019 – 6/30/2023 and be eligible for the 2023 exam. Trainees graduating after 2019 would not be able to meet the four-year pediatric hospital medicine practice criteria to qualify for the practice pathway by the 2023 board exam.

I am currently a resident and will be entering a one-year pediatric hospital medicine fellowship. What is the last graduating year I may qualify by the practice pathway to sit for the exam?

  • It is not possible to provide an answer at this time because the timeline of program accreditation is unknown. The ABP has not established a date by which trainees must enter training in an accredited program.

I am an osteopathic pediatrician and have not completed ACGME accredited general pediatrics residency. Am I eligible for certification by either the training or practice pathway?

  • No, an individual must be certified by the ABP in general pediatrics to take a certifying examination in any pediatric subspecialty. Individuals who have completed ALL general pediatrics training in a program accredited by ACGME and AOA should contact the ABP for more information.

Certification & MOC

I am a permanent certificate holder in general pediatrics. Must I participate in MOC to be eligible for Pediatric Hospital Medicine certification?

  • As a General Pediatrics permanent certificate holder, participation in MOC is voluntary. Once you become certified in pediatric hospital medicine you must meet MOC requirements in pediatric hospital medicine to remain certified in the subspecialty.

I have a lapsed general pediatrics certificate. What must I do to take the Pediatric Hospital Medicine exam?

  • To become certified in Pediatric Hospital Medicine, you must first regain your certification in General Pediatrics. You must enroll in MOC, have a valid, unrestricted medical license, earn a combined total of 100 MOC points of approved Part 2 and Part 4 activities and must have passed the General Pediatrics MOC examination within the last 10 years. An alternative to the MOC secure examination called MOCA-Peds is currently being piloted.

Must I maintain my general pediatrics certificate after I become certified in Pediatric Hospital Medicine?

  • No. The ABP allows diplomates to maintain subspecialty certification without simultaneously maintaining certification in General Pediatrics.