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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.  

To be eligible, an individual must:

  • Hold a current ABP certification in general pediatrics.
  • Satisfactorily meet either the training pathway requirements for pediatric hospital medicine or the practice pathway requirements or the combined pathway requirements.  If applying through the practice pathway, practice experience must be accrued by June 30th of the year of application.
  • Possess a current (active), unrestricted medical license in the US or Canada. 

The first administration of the exam will occur on November 12 and November 13, 2019.  The exam is 4.5 hours of actual testing time and will be offered throughout the day, allowing for morning or afternoon testing slots. Applicants may register for the exam on the ABP website from February - April 2019.  Subspecialty examinations are given in alternate years; therefore, the exam is expected to be administered in odd years in the fall (e.g. fall 2021, fall 2023, etc.). 

Admission Requirements

Training Pathway

Physicians may apply on the basis of the completion of 2 years of pediatric hospital medicine training in a program supervised by a director who is certified in pediatric hospital medicine or, who 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 2-year fellowship in general academic pediatrics fellowship may be considered if the clinical training during the fellowship focused on the care of hospitalized children and provided the depth and breadth of clinical training experiences, supervised by qualified hospitalists, comparable to that offered in a pediatric hospital medicine fellowship training program.

Training in global health, patient safety research fellowships, and clinical informatics does not qualify toward the training pathway.  No credit will be given for training completed during the core general pediatrics residency or a chief residency.  Training which qualifies a diplomate for admission to one subspecialty examination cannot be double-counted toward certification in another subspecialty.  Training may be completed on a part-time basis if the required two years of fellowship is completed over no more than a four-year period.  

There will be a temporary period which includes the first three examination administrations (2019, 2021 and 2023) during which candidates who have completed 2 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 7 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.

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.  Many of these individuals helped to “establish” 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.  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 7 years from the time of initial acceptance for the examination to become certified. Residents graduating in 2019 may be able to accrue the 4 years of practice by 2023 if they start their practice experience in July 2019. The final year to use the practice pathway as a means of eligibility will be 2023.  

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, patient safety, 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.  In general, for purposes of practice, full time is considered to be at least 40 hours per week.  Therefore, an applicant’s direct care of patients should average no less than 10 hours per week, or 450-500 hours per year over the most recent four years.  To qualify, the clinical time must average at least 10 hours per week directly caring for children whose diagnoses encompass the breadth of the discipline, including children from birth to 21 years of age and include the full spectrum of general pediatric inpatient medicine including but not limited to newborns, children with complex chronic diseases, surgical care and co-management, sedation, palliative care, and common procedures related to the practice of pediatric hospital medicine.  Practice experience must be accrued in the US or Canada.

Between 900-1000 hours per year over the most recent four years should be spent overall in the practice of pediatric hospital medicine when accounting for the overall requirement of spending at least 50% time in professional activities related to the care of hospitalized children. If your clinical practice is at least 50% of your full time professional activity and is spent in the care of hospitalized children (from birth to 21 years of age) in a general pediatrics setting, then you do not have to engage in other non-clinical activities related to the care of hospitalized children.  If you do not engage clinically as described for at least 50% time, but do meet the requirement for 25% clinical time, then you need to engage in other hospital medicine activities for an additional 25% of your time. These activities can focus on administrative, quality improvement, patient safety, research, or teaching activities related to the care of hospitalized children.  Examples of activities that are not applicable include administrative time as a residency or fellowship program director executing the routine activities of that position that do not directly relate to the care of hospitalized children. 

Individuals who are graduates of internal medicine-pediatrics programs who are practicing as hospitalists caring for both adults and children may qualify.  A Med - Peds physician must spend at least 25% of their full-time, professional activity in the direct clinical care of hospitalized children.  The additional required activities may consist of patient care of hospitalized children beyond 25%, however the clinical care of hospitalized adults cannot be counted toward the requirements.  If less than 50% of practice activity is devoted to the clinical care of hospitalized children as described above, the additional, required 25% of professional activity must include administrative, quality improvement, patient safety, research, or teaching activities related to the care of hospitalized children and/or adults. 

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 at least 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, patient safety, etc.).  A physician working less than half-time (i.e., < 20 hours per week) is unable to qualify through the practice pathway.   

For individuals who have interrupted practice during the most recent four years for family leave or other such circumstances, an exception may be considered 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 possible 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. 

For individuals who practice exclusively in a niche area such as neonatal-perinatal medicine, pediatric emergency medicine, pediatric critical care, bone marrow transplant or well-baby nursery, such a niche practice limited to one population of hospitalized children will not qualify one for the practice pathway as that is not the intention of the hospital medicine certificate.

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 2 years of fellowship may qualify with an additional 2 years of practice experience that meets the requirements stated above. The 2 years of practice experience may be completed at any time 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

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

Training Pathway

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

  • An application has been submitted to the Accreditation Council for Graduate Medical Education (ACGME) to initiate the accreditation process.  When the timeline for accreditation of pediatric hospital medicine programs is known, the ABP will establish a date by which fellows who enter training must enter an accredited pediatric hospital medicine fellowship training program.

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

  • Once the timeline 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.

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

  • The ABP will announce when the SITE for Pediatric Hospital Medicine will be available once hospital medicine fellowship training programs become ACGME accredited.

Practice Pathway

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, a Verification of Subspecialty Practice Experience Form must be completed by:
    • the pediatric program director of the pediatric hospital medicine fellowship training program at one’s training 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 Verification of Subspecialty Practice 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.  You will be prompted to list the individual(s) responsible for verification when completing an application. A verification form will be sent to the email address(s) you provide for your supervisor(s) on the application.

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; in 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 (July 2015 - June 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.

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 four year practice 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.

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 clinical 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, patient safety, research, administration, etc.) related to the care of hospitalized children. Your direct care of hospitalized patients should average at least 10 hours per week, or 450-500 hours over the chief year and activity counted toward the practice requirements must be independent practice.

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

  • Individuals applying through the practice pathway must accrue at least four years of time spent at 50% FTE minimum 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 pathway and must complete the requirements for the training pathway.

May I moonlight and receive credit toward the practice requirements?

  • Yes. Your cumulative clinical practice time devoted to the care of hospitalized children along the breadth and age spectrum of the specialty of pediatric hospital medicine must average at least 10 hours/week each year of the four years prior to applying for the exam.

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 in pediatric hospital medicine must have completed the training in a program in the US or Canada that is associated with an accredited general pediatrics residency training program AND fulfill the requirements for two years of practice in pediatric hospital medicine.
  • The practice experience must have been completed in the past four years and training must have been completed within the most recent seven 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 in a pediatric hospital medicine fellowship training program. 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 July 2019 through June 2023 and be eligible for the 2023 exam.  Graduating trainees who start practice after July 2019 will 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 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.

What happens if my application is disapproved?  May I appeal?

  • When candidates apply through the practice pathway, the application is reviewed against the criteria established by the ABP. 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. If an application is disapproved or the applicant cancels by 10/10/2019, the exam fee ($2150) is refunded. The processing fee ($750) is non-refundable. Any late fees accrued are non-refundable.

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 ABP 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, known as MOCA-Peds, went live in January 2019.

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.

Applications & Acceptance

What is the earliest date to accrue practice?

  • For the 2019 exam, the dates of practice accrual must be 7/1/2015 - 6/30/2019.

I am applying for the exam during the first registration period (February 2019 - April 2019).  How should I enter the dates of my practice?

  • If you plan to continue practice through 6/30/19, enter your practice end date as 6/30/19, despite it being a future date.

How do I enter practice dates if I have practiced at multiple locations at the same time?

  • Provide each location, indicating the date range at this location, regardless of whether it overlaps with practice at another location.  If you cannot attest to 25% time at a single location, provide the number of hours you accrued within the date range, indicate your responsibilities, and describe your practice in detail at this location in the comment section.  Your supervisor should provide similar detailed comments that help us understand your practice at this location during the acceptable date range.

What information do I need handy to provide regarding my practice when I apply? 

  • The month and year of your practice at each institution/hospital, the website address of each practice location, the name, title and email address of your supervisor at each location, your medical license information including its expiration date and credit card information.

What information do I need handy to provide if I apply through the training pathway?

  • The dates of your training, the name of your training institution, name and contact information of the program director, your medical license information, including the expiration date and credit card information.  The ABP will contact the fellowship training program director to request verification of your training and clinical competence.

When are acceptances for the exam announced?

  • Acceptances will be posted to the applicant’s portfolio on the ABP website in late summer 2019.

If my application is accepted, but I find that I wish to cancel the exam, is there a deadline?

  • The deadline to cancel the exam with a partial refund is 10/10/2019.  The exam fee ($2150) is refunded. The processing fee ($750) is non-refundable and any late fees accrued are non-refundable.