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Subspecialties / Pediatric Subspecialties Policies

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The American Board of Internal Medicine (ABIM) and the American Board of Pediatrics (ABP) have agreed that individuals who are graduates of combined training programs in internal medicine and general pediatrics may complete training in a subspecialty of each board in one year less than would be required of full training in both subspecialties. The one-year reduction in total training time is possible by double-counting a year of research or, for those beginning subspecialty training July 1, 2004, and thereafter, scholarly activity that is applicable to and supervised by both the internal medicine and pediatric subspecialty directors.

Individuals in combined subspecialty training are expected to meet the same clinical training requirements as those in standard internal medicine or pediatric subspecialty programs. A minimum of 12 (18 for gastroenterology and 24 for cardiovascular disease) months of clinical training are required for the internal medicine subspecialties. Although the clinical training requirements in pediatric subspecialties are not specifically delineated, it is understood that a minimum of one year of clinical training is required. Some subspecialties of pediatrics (including cardiology and gastroenterology) require more than one year of clinical training for a fellow to be able to attain the clinical competencies necessary to practice that subspecialty.

For most subspecialties (e.g., hematology, oncology, pulmonary, rheumatology) a proposal for combined training must include delineation of how longitudinal (continuity clinic) experience will be accomplished in both the pediatric and adult medicine subspecialty.

To apply for admission to the certifying examination in an adult subspecialty, the candidate must first be certified in internal medicine by ABIM. Likewise, to meet the requirements for application for a subspecialty certifying examination in pediatrics, an individual must first be certified in general pediatrics. In addition to successfully completing the required training, the program directors of both subspecialty programs must verify that the individual completed the necessary training and that he/she is recommended to take the certifying examination. The individual will also be required to provide to ABP evidence of meeting the meaningful accomplishment in research or, for those beginning subspecialty training July 1, 2004, and thereafter, the scholarly activity required of all pediatric subspecialty candidates.

A proposal for combined subspecialty training of an individual, which includes an outline of training in each specialty, should be submitted to each board for review. The proposal should be prospective, submitted either before training begins or in the first three to six months of fellowship training. The boards will not approve programs for combined training; rather, the boards will only consider training proposals for individuals in combined subspecialty training.