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Time-Limited Eligibility: Plan for Supervised Practice - General Pediatrics

Time-Limited Eligibility – Plan for Supervised Practice and Assessment of Competence in General Pediatrics in the Accredited Training Program

Overview:

The purpose of the requirement is to provide the ABP with an independent assessment of the individual’s contemporary competence to practice pediatrics without supervision through a supervised practice experience of at least 6 months.

  • The supervised practice must involve direct patient care, with hands-on experience, in the environment of an ACGME (in the US) or an RCPSC (in Canada) accredited training program that offers a breadth of general pediatrics experience. 
  • The supervised practice must extend over a minimum of 6 months, but the required experiences as detailed below could be spread out over a longer period of time to accommodate personal needs. If a part-time plan is proposed, it must ensure consistency of supervision and continuity of experience.   
  • This experience must be under the consistent supervision of attending physicians as well as more senior residents if appropriate with a goal of providing sufficient exposure time per assessor in order to provide a valid assessment of the individual’s contemporary competence to practice pediatrics unsupervised. There must be a multifaceted method for the objective evaluation and documentation of clinical competence such as a multi-source evaluation (360 degree assessments) in which faculty, residents, fellows, nursing staff, patients, and families provide input.
  • The Program Director of the accredited general pediatrics training program must submit the specifics of the planned experiences to the ABP for approval prior to initiation and then verify the individual’s clinical competence at the conclusion of the supervised practice. 

Specific Requirements:

  • Inpatient care experience: This experience in an ACGME or RCPSC approved program must consist of blocks of no less than two weeks, five days a week and may or may not require night and weekend call, for at least 8 weeks in aggregate. The experience must consist of at least four weeks caring for general pediatrics patients or mixed non-intensive care subspecialty patients.  The remaining time could include up to four weeks of intensive care in the PICU or NICU, or up to four weeks caring for patients in a single subspecialty.
  • Emergency Department experience: This experience in an ACGME or RCPSC approved program must consist of blocks of no less than one week for at least four weeks in aggregate, working five days a week, with one 8-hour shift daily.
  • Newborn care experience: This experience in an ACGME or RCPSC approved program must be of at least four weeks duration, with a minimum of two-week blocks. Two of the four weeks could be spent in the NICU or Level II nursery rather than the well-baby nursery if such an experience provides a greater opportunity for demonstrating skills in resuscitation.  Time spent in the NICU or Level II nursery cannot be double-counted with the inpatient care experience.
  • Outpatient practice experience:  A supervised care experience in general pediatrics in an ACGME or RCPSC approved program must be completed. 

    This requirement may be fulfilled by:

    • A block of at least 4 weeks duration that will count as one of the 6 months of supervised experience or
    • One half-day of ambulatory general pediatrics experience once per week for at least 6 months or 
    • A full-day experience once per week for at least 3 months.

      If completed as a half-day or full-day longitudinal experience, it cannot be double-counted as one of the 6 months.

  • Stabilization of the sick newborn or child: This experience can be gained by the documented management of seriously ill children while working in the setting of the Emergency Room or the intensive care units (see above).
  • Additional Experience Relevant to Current Practice: For those in general pediatrics practice, 1 month of the 6 month requirement may include detailed assessment of clinical competence in the candidate’s usual site of practice if agreed to by the program director. This must include review of 10 de-identified case records by the Program Director and 360 degree assessments by at least 2 physicians and 2 nurses in the practice and 10 patients/families submitted to the Program Director for review.  Alternatively, an experience within the accredited residency training program is at the discretion of the Program Director and the candidate.  It may address areas of interest or deficiency. 

Outcome:

  • At the time the candidate applies for certification, the Program Director must submit documentation that clinical competency was assessed and verified based on evaluations from faculty and from practice site observers, if applicable, after the completion of a minimum of 6 months of supervised practice.  Evaluations should be made available to the ABP if requested.  If competence is not verified by the program director, the individual must enter an accredited general pediatrics residency and complete 3 years of training in order to regain eligibility.
  • Following the satisfactory completion of the 6 months of supervised practice, the candidate will have 7 years to become certified.  When applying or re-applying for certification, the applicant must meet the requirements for acceptance in effect at that time.
  •  If unsuccessful in becoming certified during the additional 7 years of eligibility, the candidate must enter an accredited general pediatrics residency program and complete 3 years of training in order to regain eligibility.

 

11/7/14
10/14/15
Edited 5/26/16