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Pediatric Subspecialty Fellowship Clinical Training Project: Current Fellows

Gary L. Freed, Kelly M. Dunham, Lauren M. Moran, Laura Spera, Gail A. McGuinness, David K. Stevenson on behalf of The Research Advisory Committee of the American Board of Pediatrics

The American Board of Pediatrics certifies physicians in general pediatrics and 14 pediatric subspecialties. Historically, all subspecialties have a standard pathway of training that is 3 years in duration to ensure time for both clinical and scholarly training and experience. In 2004, the American Board of Pediatrics expanded the scope for scholarly activity in fellowship training to include the assignment of each fellow to a Scholarship Oversight Committee and the completion of a scholarly activities core curriculum across subspecialties.

We conducted a national survey of all current fellows in 13 pediatric subspecialties who took the subspecialty in-training examination (N = 3551). Overall, 86% of all pediatric fellows in the United States sit for the examination.

The majority (65%; N = 2178) believe the minimum 12-month expectation for clinical training is appropriate for their specific subspecialty. The majority of fellows (59%; N = 1984) do not agree that the amount of scholarly activity should be the same for all fellows in their respective subspecialties regardless of career path (ie, primarily clinical versus primarily research). Half (50%; N = 1661) posited that the required duration of training, regardless of career path, should remain at 3 years.

Balancing the components of subspecialty training is an important and probably never-ending quest. As changes in the health care system and care delivery organization continue, what we expect and need from our subspecialists, from the perspectives of the profession, the health care delivery system, and the public, will probably vary over time.