ConceptsAdvanced Training in Pediatric Emergency Medicine in the United States, Canada, United Kingdom, and Australia: An International Comparison and Resources Guide
Introduction
Pediatric emergency medicine is a relatively new and rapidly evolving subspecialty in many countries. It was first formulated and developed as a subspecialty in the United States in the 1970s. Since then, the ideas and concepts of pediatric emergency medicine have been either exported to other countries or developed de novo locally. The purpose of this comparison and resource guide for postresidency pediatric emergency medicine training is (1) to allow pediatric emergency medicine training directors to appreciate the strengths and weaknesses of their own and other systems; and (2) for countries without or with less-developed formal pediatric emergency medicine training structures to review existing models as a basis for planning purposes in the development of pediatric emergency medicine training systems.
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Methods
Advanced training structures and national guidelines for pediatric emergency medicine training were systematically reviewed and compared across 4 countries, the United States, Canada, United Kingdom, and Australia. Although the countries included are diverse, all are English speaking (English and French in the case of Canada), highly developed, and highly industrialized, with low child mortality and a high life expectancy, and have, from a global perspective, high per capita expenditures for
Overview
The first pediatric emergency medicine fellowship training program began in 1981 at the Children's Hospital of Pennsylvania. As of 2003, 1,229 US physicians were board certified in pediatric emergency medicine.2 The subspecialty is regulated jointly by the American Board of Pediatrics (ABP) and the American Board of Emergency Medicine (ABEM). Presently, there are 48 accredited pediatric emergency medicine fellowships, 41 accredited through the ABP and 7 through ABEM. Thirty-four programs are
Overview
The Royal College of Physicians and Surgeons of Canada oversees all specialty training programs within Canada. These programs must be affiliated with a university-based faculty of medicine. The Royal College has just recently recognized pediatric emergency medicine as a subspecialty, under the category of accreditation without certification.5 Attending physician (senior staff specialist) positions in pediatric emergency medicine do not require accredited training in pediatric emergency medicine.
Overview
Pediatric emergency medicine in the United Kingdom has been developing as a subspecialty in recent years but has only in 2003 received official recognition by the Specialist Training Authority. The Specialist Training Authority is responsible for licensing all European doctors for specialist (consultant) practice, with a Certificate of Completion of Specialist Training. The Certificate of Completion of Specialist Training will be in either pediatrics or emergency medicine, but an interest in
Overview
Pediatric emergency medicine training is regulated by the Specialist Advisory Committee of the Royal Australasian College of Pediatrics (RACP). Eligibility for pediatric emergency medicine training requires completion of basic training and professional examinations in pediatrics. Pediatric emergency medicine training through the Australasian College for Emergency Medicine (ACEM) is not established but is to be implemented. At this time, employment in senior medical staff posts in pediatric
Discussion
There are a total of 48 US, 9 Canadian, 8 UK, and 8 Australian programs for advanced pediatric emergency medicine training recognized by national bodies. Access to officially recognized pediatric emergency medicine training in the United States and Canada is after completion of general pediatric or emergency medicine training, in the United Kingdom after basic pediatric or emergency medicine training, and in Australia only after basic pediatric training (although emergency medicine trainees are
References (8)
- World Health Organization Web site. Countries. Statistics. Available at: http://www.who.int/country. Accessed May 20,...
- American Board of Emergency Medicine Web site. Geographic distribution of diplomats by subspecialty certificate....
- Accreditation Council for Graduate Medical Education Web site. Available at: http://www.acgme.org/adspublic/. Accessed...
- American Board of Pediatrics Web site. Changes in training requirements for subspecialty certification. Available at:...
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Funding and support: The authors report this study did not receive any outside funding or support.
Reprints not available from the authors.