The Strategic Planning Committee Report: The First Step in a Journey to Recognize Pediatric Hospital Medicine as a Distinct Discipline

Abstract

The field of pediatric hospital medicine (PHM) has experienced phenomenal growth over the past decade. Academic contributions by pediatric hospitalists include the creation of PHM core competencies,1 national collaborative PHM networks for both research (the Pediatric Research in Inpatient Settings network2) and quality improvement (the Value in Inpatient Pediatrics network3), a robust and well-attended annual scientific meeting,4 and an increasing number of divisions or sections of PHM in pediatric departments across the country. Many pediatricians are choosing to pursue careers in PHM,5,6 and several postgraduate training programs for PHM have emerged.7 Similar to other generalist pediatric fields,8-11 the question as to how best for PHM to evolve as a distinct discipline has arisen. Several training and/or certification options are feasible and have been examined by the pediatric hospitalists who constitute the Strategic Planning (STP) Committee. The objectives of this commentary are to (1) describe the work done to investigate these options to date, (2) provide a framework for evaluating them, and (3) describe next steps. This commentary will neither justify subspecialty status for PHM, which is currently still debated within the field, nor will it compare the development of PHM as a subspecialty with other generalist fields because such a comparison is premature.

Current Roles and Perceived Needs of Pediatric Hospital Medicine Fellowship Graduates

“…26 These are important considerations as program directors solidify fellowship goals in response to certification options. 27 This study has several limitations. Although the authors attempted to identify all PHM fellowship graduates before 2014, there is potential for sampling bias.…”

The History of Pediatric Hospital Medicine in the United States, 1996‐2019

“…In 2012, the STP shared the results of Strengths-Weaknesses-Opportunities-Threats analyses-but did not issue a recommendation. 17 The following year, a National PHM Leaders Conference was held to consider the various options. Participants concluded that the best path forward was to pursue subspecialty certification with a requirement for 2 years of fellowship (after a time-limited period for practice pathway eligibility).…”

Pediatric Hospital Medicine Role in the Comanagement of the Hospitalized Surgical Patient

“…While not yet accredited by the ACGME, fellowships are becoming more common and stronger in the training in research and clinical management they provide. 29 The new model of specialty tracking during residency also provides an opportunity for trainees interested in hospital medicine to obtain sub-specialized training, including peri-operative care. 29 Finally, with the increased prevalence of children with complex chronic conditions, 1,2 there is greater need for specific training to care for these children.…”

“…29 The new model of specialty tracking during residency also provides an opportunity for trainees interested in hospital medicine to obtain sub-specialized training, including peri-operative care. 29 Finally, with the increased prevalence of children with complex chronic conditions, 1,2 there is greater need for specific training to care for these children. Peri-operative management is an essential component of care of the complex child, since these children tend to have more technology than non-complex children.…”