With a desire to raise the level of care for hospitalized children and better define the field, pediatric hospital medicine (PHM) has officially become the newest subspecialty. It will offer a two-year fellowship program, possibly lending a solution to the pediatric workforce shortage.
The American Board of Medical Specialties (ABMS) officially granted recognition of the American Board of Pediatrics (ABP)-sponsored application last October. Now it’s up to the ABP to move forward with establishing training assessment criteria and manage the award certification for the steadily growing field. ABMS also announced that it is reviewing eligibility requirements and an initial pathway for PHM certification before Accreditation Council for Graduate Medical Education can be awarded to programs.
Pediatric hospitalists won’t see any immediate changes in their practice requirements. But once the certifying examination has been created, those currently in practice will have eight years to follow the initial pathway to sit for the board-certification examination. After the initial pathway opportunity closes, only fellowship-trained individuals will be eligible to sit for the examination.
“If you’re in school, it’s likely that you’ll need to be fellowship trained to be able to sit for the test to be board-certified,” said Daniel A. Rauch, M.D., FAAP, chair of the Joint Council of Pediatric Hospital Medicine, which aligns pediatric hospitalists affiliated with the Academy, the Academic Pediatric Association and the Society of Hospital Medicine.
The Academy has been a strong supporter of PHM and submitted a letter in 2015 to request that the ABP sponsor the PHM subspecialty application to the ABMS.
“The hospitalists are eager for a standardized definition of the term itself, so that there is trust among the public and referring pediatricians that the title ‘hospitalist’ has meaning and value,” 2015 AAP President Sandra G. Hassink, M.D., FAAP, wrote.
The AAP Section on Hospital Medicine started with 417 members in 2005 and now has nearly 2,000. “We’ve exploded in growth probably to a degree that no other section at the AAP has exploded over the last 10 years,” said Brian K. Alverson, M.D., FAAP, section chair.
PHM is the first subspecialty with ABP approval to offer a two-year fellowship, straying from the traditional three-year fellowship programs. “The research we’re doing is related to direct patient care; it’s related to quality improvement, which is part and parcel of the everyday work,” explained Dr. Rauch. “The experience you have delivering patient care and participating in the processes of the hospital should be able to serve double duty as your research time.”
The Academy and section already provide tools for hospitalists to improve patient care: the monthly journal Hospital Pediatrics (http://hosppeds.aappublications.org/), the Caring for the Hospitalized Child handbook (http://bit.ly/2fWEADm), a webinar series (http://bit.ly/2gNgzgA), the Advancing Pediatric Educator eXcellence Teaching Program (www.aap.org/apexteachingprogram), topic-specific subcommittees, an online resource library and clinical courses (http://shop.aap.org/hospital-medicine/).
To encourage young members, the section offers a variety of resident scholarships and two international scholarships. Members also benefit from calls for action and other information through the section email list. Any AAP member with an interest and involvement in general inpatient pediatrics can join the section (see resources).
“The efforts to make sure non-fellowship people are appropriately trained and appropriately paid attention to so that they can continue to grow as professionals and providers is a real commitment of the section and the Academy,” said Dr. Rauch.
