Recently, the American Board of Pediatrics sponsored three conferences for consideration of specific issues relative to the training and practice of pediatricians. Two of these, to be described briefly, served as background for the third, which will be reported in detail.

The first meeting was held in San Antonio, TX, in January 1984, for the principal purpose of discussing the training and practice of subspecialists in pediatrics. The discussion was precipitated by a petition from the Sub-Board of Pediatric Hematology-Oncology to extend the period of training in hematology-oncology from 2 to 3 years. Dr David Nathan spoke on the certification of subspecialists. He questioned the concept, in general, and the specification of an exact period of time for training, in particular. He suggested that the length of training might be variable for the individual and occur at some time during the faculty appointment. Dr Charles Abildgaard presented the justification for extending training on behalf of the Sub-Board. The thrust of the argument was that the discipline has become so complex that 3 years are required to acquire clinical proficiency; the research component was also emphasized. His presentation precipitated general discussion of some questions related to practice: Should subspecialists function in community hospitals or only in academic medical centers? Should the Board certify only clinical competence or should there be certification of competence to do research? What will be the impact of the large number of graduating students and of the increasing number of women studying medicine and entering pediatrics?

At this meeting Dr Robert Brownlee proposed some changes in the pattern of certification.

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