Considering Fellowship Training

Following completion of general pediatrics residency, you may want to consider continuing your medical education with subspecialty training. 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.  

Advice When Considering A Pediatric Fellowship: 

• Invest time in learning more about the programs you are interested in. Ask attendings what a typical day/week looks like.   
• Try to encounter your subspecialty of interest in both clinic and inpatient settings. Do rotations in both, if possible.  
• Check out the full spectrum of practice opportunities that are available within your desired subspecialty (clinician, physician scientist, administrator, etc.).  
• To be successful, you’ll need to enjoy working with the “bread and butter” patients within the subspecialty. Whether it be feeder/growers in the NICU, asthmatics in pulmonology, or constipation in GI; they make up the bulk of your practice so it’s important to enjoy working with those patients. 
• Find out as much as you can about the environment of the fellowship program, but also the styles of practice at each institution. It can be challenging if providers have vastly different styles of care.  
• Really think about your career goals and how a fellowship can help obtain those goals. This will be important, not only for long-term career planning, but also vital when researching fellowship programs to make sure what they have to offer is in line with your individual career path. Do not be afraid to be upfront with what you want. It will only help you in the long run.   
• You should always think about why you're wanting to go into fellowship and then do as much as you can during residency to demonstrate your interest. This will help you have a stronger application. It’s ideal if you are able to network with attendings in your chosen field and seek their guidance and review of your application when the time comes. 
• If possible, speak to current fellows about the fellowship programs you are interested in. Each program will likely be different (even if they have the same core competencies), so it is nice to get an idea of what a specific fellowship is like. Also, think about what you want to get out of fellowship. Most fellowships give you some research/education time, so you have the time and chance to further develop those skills that you don't have time for in medical school and residency training. Be sure to take advantage of any opportunities that the fellowship institution will offer while you are there (certificates, extra degrees if offered, etc.). 

Applying to Fellowship Training 

Multiple fellowship matches representing more than 60 subspecialties are found in the National Resident Matching Program (NRMP) Specialties Matching Service® (SMS®). The SMS site describes each of pediatric subspecialty fellowships and links to various resources providing guidance on the application process. 

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. You can select from a variety of clinical focus options (eg, ambulatory, community, and/or hospitalist medicine).  

In 2020/2021 recommendations for processes related to recruitment to fellowship programs changed to consider the burdens of the COVID-19 pandemic and to improve equity in the admissions process. Programs are encouraged to conduct interviews virtually to reduce the burden of travel on the applicant. You can read more about these changes here.

Board Certification 

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 website. 

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* 

Other pathways: 

• Academic general pediatrics fellowship – Is a one-year option for those interested in an academic career. Information regarding academic general pediatrics is available from the Academic Pediatric Association. 
• Pediatric urgent care fellowship – A one-year pediatric urgent care fellowship is another option if you have an interest in acute care. Information is available from the Society of Pediatric Urgent Care. 
• National specialty boards – Include 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. 
• Surgery – To pursue pediatric surgery or other surgical disciplines, surgery residency is completed first, followed by additional training to specialize in the care of pediatric residents. 

AAP Sections and Councils 

AAP sections and councils are communities for members who share a pediatric subspecialty or surgical specialty. Sections and councils are a “homeroom” for pediatric medical subspecialists and surgical specialists for education, advocacy and career advancement. There are many networking and leadership opportunities for members within sections and councils.