Following completion of general pediatrics residency, some physicians choose to continue their medical education with subspecialty training. A medical subspecialty is an identifiable component of a specialty to which a practicing physician may devote a significant proportion of time. Board-certified subspecialists complete additional training and qualifying examinations beyond those required for board certification in general pediatrics.
A pediatric subspecialist is an individual with the training and experience to provide patient care and education and to conduct research in a defined or organ-specific area of medical care. This definition recognizes that pediatric subspecialists function in a wide variety of roles, including direct patient services, research, and education. Currently, many pediatric subspecialists practice within academic medical systems. The wide range of pediatric subspecialties includes age-specific generalists (neonatologists and adolescent medicine specialists), acute care specialists (critical care and emergency medicine), organ-specific specialists (cardiologists, nephrologists), and non-organ-specific specialists (endocrinologists, oncologists, infectious disease physicians). Some choose a subspecialty for the specific clinical discipline; others seek an academic career path marked by teaching, writing, and/or research.
Pediatric medical subspecialists and pediatric surgical specialists are either board-certified general pediatricians who are subspecialty boarded through the American Board of Pediatrics (ABP) or physicians who are initially board certified in another discipline who then seek pediatric training to apply their skills in the care of children and adolescents. A list of board-certified subspecialties, along with the passing rates for first-time examinees over the past 5 years, is posted on the ABP Web site.
Pediatric subspecialties that are certified by the ABP, including 5 (indicated by an asterisk) that are certified by the ABP in conjunction with another board, are:
- Adolescent Medicine
- Pediatric Cardiology
- Child Abuse Pediatrics
- Pediatric Critical Care Medicine
- Developmental-Behavioral Pediatrics
- Pediatric Emergency Medicine
- Pediatric Endocrinology
- Pediatric Gastroenterology
- Pediatric Hematology/Oncology
- Hospice and Palliative Medicine*
- Pediatric Hospital Medicine
- Pediatric Infectious Diseases
- Medical Toxicology*
- Neonatal-Perinatal Medicine
- Pediatric Nephrology
- Pediatric Pulmonology
- Pediatric Rheumatology
- Sleep Medicine*
- Sports Medicine*
- Pediatric Transplant Hepatology*
Academic general pediatrics fellowships are another option for those interested in an academic career.
These fellowships most often provide additional training in education, advocacy, and/or research skills, providing research opportunities in such areas as environmental health, quality improvement, outcomes, or care determinants. These fellows select from a variety of clinical focus options (eg, ambulatory, community, and/or hospitalist medicine).
Information regarding academic general pediatrics is available from the Academic Pediatric Association.
In addition, national specialty boards for anesthesiology, dermatology, emergency medicine, otolaryngology, pathology, physical medicine and rehabilitation, psychiatry and neurology, radiology, surgery, and urology offer certification for pediatric subspecialists in their respective disciplines.
Pediatric neurologists and psychiatrists may be certified in pediatrics/neurology or pediatrics/ psychiatry after completing 2 years of training in general pediatrics and meeting the training requirements of the American Board of Psychiatry and Neurology for certification in neurology or psychiatry with special qualification in child neurology or child psychiatry.
Surgeons in other disciplines (such as neurological surgery, ophthalmology, orthopedics, and plastic surgery) often complete additional training to specialize in care of pediatric patients.