Pediatric emergency medicine has grown to become the third most popular pediatric subspecialty choice, but experts say the reasons are unclear.
Since 1997, the year in which the American Board of Pediatrics (ABP) began tracking subspecialty fellows in all training programs, the number of fellows enrolled in pediatric emergency medicine (EM) programs has increased by 64%, from 197 fellows in the 1997–1998 training year to 323 fellows in the 2005–2006 year. Approximately 1,300 physicians are now certified in the subspeciality by the ABP.
The data, which provide a “supply-side” perspective only, were released by the ABP as part of a series on workforce trends.
Dr. Aaron Friedman, who chairs the American Academy of Pediatrics Committee on the Pediatric Workforce, said the increasing interest in emergency medicine is not surprising but, on the other hand, it is not well understood.
“This isn't just a pediatrics issue. Medical students are choosing this direction [of emergency medicine] more than they did 10 years ago, and there's speculation about why students are interested in it. Is it [about] lifestyle issues, for instance, or [being on] call? We really don't know,” said Dr. Friedman, of Brown University, Providence, R.I. “We also don't know whether going into a pediatrics residency and then going into an emergency medicine subspecialty was a choice these students made initially,” he said in an interview.
Research into general pediatrics has shown an increasing trend toward part-time work, according to the ABP report, but there “are no current data to indicate this is the case in pediatric emergency medicine.”
The percentage of women fellows is at a peak of about 56%, but overall the proportion of male to female physicians in pediatric EM has not changed drastically, wrote report authors Linda A. Althouse, Ph.D., and Dr. James A. Stockman III (J. Pediatr. 2006;149:600–2). Similarly, the percentage of fellows who are U.S. medical school graduates has remained “relatively steady,” above 80% since 1997.
It also is not clear what the demand is for pediatric EM physicians, Dr. Friedman said. The ABP report points out that six states do not currently have a practicing ABP-certified pediatric EM physician, and that more than half of the states have a pediatric EM physician-to-child ratio of at least 1:100,000 (see chart).
The ABP's new training data capture emergency medicine physicians as well as pediatricians. However, the report indicates that the pediatric emergency medicine certificate, which the ABP established in collaboration with the American Board of Emergency Medicine more than 15 years ago, is clearly more popular among pediatricians. Whereas the ABEM has thus far awarded approximately 170 certificates to emergency medicine physicians, the ABP has certified 1,300 physicians to date, the report says.
Overall, the ABP and ABEM use similar eligibility criteria, and candidates applying to either board are given the same exam. ABEM does require 2 years of fellowship while ABP requires 3 years to cover an ABP research requirement, said Lee Currin, manager of credentialing and examinations administration at the ABP.
Elsevier Global Medical News