American Academy of Pediatrics

Pediatrics 101

Pediatricians:• Focus on the physical,

emotional, and social health of infants, children, adolescents, and young adults from birth to 21 years.

• Focus on prevention, detection, and management of physical, behavioral, developmental, and social problems that affect children.

• Treat infections, injuries, and many types of organic disease and dysfunction.

• Work towards reducing infant and child mortality, foster healthy lifestyles, and ease the day-to-day difficulties of those with chronic conditions.

General Pediatrician’s Responsibilities Include:• Management of serious and life-threatening

illnesses• Referral of more complex conditions as

needed• Consultative partnerships with other care

providers• Health supervision• Anticipatory guidance• Monitoring physical and psychosocial

growth and development• Age-appropriate screening• Diagnosis and treatment of

acute and chronic disorders• Community-based activities in

sports medicine, school health, and public health

Pediatrics• You have to do what will make you

happy!• No other physician group can match

pediatricians on career satisfaction96% of current graduating pediatric

residents who are in the general practice job market report that if they did their residency over, they would choose pediatrics again

Pediatricians report higher satisfaction than internists on key satisfaction indicators including job, career, and specialty satisfaction

2003 AAP Third-Year Resident Survey, unpublished data

Pediatrics• The opportunities for graduates of

pediatric residencies are diverse and numerous80% of residents seeking a

general practice position report obtaining their most desired position

Many pediatric subspecialties are currently experiencing workforce shortages

Pediatric training and job market trends: results from the American Academy of Pediatrics Third-Year Resident Survey, 1997-2002. Pediatrics. 2003;112:787-792

Pediatrics• Flexible jobs are more common in

pediatrics than any other specialty26% of pediatricians versus 14% of

all physicians have worked part-time at some point in their careers

Pediatrics offers a broad spectrum of rewarding career options (variety of practice settings and styles)

There are many medically underserved communities seeking pediatricians

American Academy of Pediatrics Division of Health Policy Research. Pediatrics leads specialists in number of part-time physicians. AAP News. 2002,21:126

Pediatrics• Employment settings

Group practice: 45.3%Solo/2-physician

practice: 15%Hospital or clinic: 14.5%Medical school: 12%Other: 9.9%Health maintenance

organization: 3.3%

Source: American Academy of Pediatrics. Socioeconomic survey of pediatricians. #57-60, 2004.

• Practice LocationSuburbs: 40%Urban practice

(non-inner city): 28.2%

Urban practice (inner city): 20.5%

Rural: 11.3%

Medical School• Best resource on medical

specialties is the American Board of Medical Specialties (ABMS) at www.abms.org

• Most medical schools now have a pediatric special interest group. If there isn’t an interest group, speak to your clerkship director about starting one.

• Get involved: summer externships, volunteering, physician shadowing

Choosing a Residency Program

• Resources for looking at pediatric residency programs:Accreditation Council for Graduate

Medical Education (ACGME) at www.acgme.org

Graduate Medical Education Directory from the American Medical Association (AMA) at www.ama-assn.org

FREIDA Online (Fellowship and Residency Electronic Interactive Database) from the AMA at www.ama-assn.org

• When evaluating residency programs consider the following:Diversity and complexity of

patientsNumber of locations in which

rotations are conductedAvailability of facultyResident cadre

(size and personality)Etc.…

Choosing a Residency Program

• Other things to consider:Big city or rural settingAre there cultural activities

availableExtracurricular activitiesGood distance from family/friendsEtc.…

Choosing a Residency Program

• The application process:Electronic Residency Application

Service (ERAS) – a services that transmits applications to residency programs over the Internet

Interviews – ask about strength and weaknesses of the program, program flexibility, call schedules, policies on leave, medical liability, insurance benefits, etc.

The Match – National Resident Matching Program (NRMP) which offers uniform dates of appointment to residency program sin the US

Choosing a Residency Program

Residency Training• Consists of a 3-year program of core

pediatric experiences and elective rotations

• All programs must provide experiences in: Inpatient pediatric care Emergency and acute illness care Continuity care Normal/term baby care Subspecialty care

• Residents also participate in: Regular scheduled teaching Attending rounds and conferences Procedural skills Scholarly experiences (journal club,

research, etc.)

Combined Training Programs

• Internal medicine-pediatrics (4 years)

• Pediatrics/dermatology (5 years)• Pediatrics/emergency medicine (5

years)• Pediatrics/medical genetics (5 years)• Pediatrics/physical medicine and

rehabilitation (5 years)• Pediatrics/psychiatry/child and

adolescent psychiatry (5 years)• More information: American Board

of Pediatrics (ABP) at www.abp.org

Licensure and Board Certification

• Medical license – 3-part examination during medical school and residency Pass all 3 parts and eligible to apply for medical license Links to individual state boards can be found on the

AMA web site at www.ama-assn.org

• Board certification requirements (renewed every 7 years) Graduate from an accredited medical school Complete 3 year residency training program Verify satisfactory completion of residency training Acquire a valid, unrestricted state license to practice

medicine Pass the 2-day written examination for certification

• Fellow of the American Academy of Pediatrics (FAAP)

Post-residency Training• A pediatric subspecialist is an individual

who, as a result of training and experience, is qualified to provide patient care and education and to conduct research in a defined or organ-specific area of medical or surgical care

• Currently most pediatric subspecialists practice within academic medical systems

• Most pediatric subspecialists are board-certified general pediatricians who are subspecialty boarded through the American Board of Pediatrics (ABP)

• Most post-residency training is 3 years in length

Post-residency Training• Current list of pediatric

specialties include: Adolescent medicine Cardiology Child abuse Critical care medicine Dermatology Developmental/behavioral Emergency medicine Endocrinology Gastroenterology Hematology/oncology Hospice and palliative medicine

Infectious diseaseMedical toxicologyNeonatal-perinatal medicineNephrologyNeurodevelopmental disabilitiesPulmonologyRheumatologySleep medicineSports medicineTransplant hepatology

Fellowship opportunities in the Journal of Pediatrics at www.mosby.com/jpeds

Pediatric Subspecialties• Most pediatric subspecialties have

a “section” of their own with in the AAP that provides a forum for education and dialogueInclude both medical and surgical

subspecialtieswww.aap.org/sections

Resources from the AAP• Medical student membership: $16/year• YoungPeds Network at

www.aap.org/ypn• National Conference & Exhibition

(NCE) FREE to medical studentsOctober 11-14, 2008 in Boston, MA

• NCE Clinical Case Program – submit abstract on interesting cases from medical school (due April of each year)

• Residents as Teachers Handbook – PDF only at www.aap.org/ypn/ms