Peds EM & board certification

[zinjanthropus]

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Hello-

I apologize if this is a ******ed question but I will ask anyway...

If you do a peds residency and then do a peds EM fellowship, do you sit for the same boards as those coming from an EM residency?

I've noticed that many Peds EM fellowships include a decent amount of training in Adult EM. Is it possible to work in an adult ER after completing a Peds fellowship?

At my institution the adult EM folks do cover the Peds ER at times - basically I'm wondering if you are qualified enough to do the reverse and what type of training would be appropriate if you wanted to spend some of your time in the Adult ER and some of your time in the peds ER.

 

[doctawife]

Hello-

I apologize if this is a ******ed question but I will ask anyway...

If you do a peds residency and then do a peds EM fellowship, do you sit for the same boards as those coming from an EM residency?

I've noticed that many Peds EM fellowships include a decent amount of training in Adult EM. Is it possible to work in an adult ER after completing a Peds fellowship?

At my institution the adult EM folks do cover the Peds ER at times - basically I'm wondering if you are qualified enough to do the reverse and what type of training would be appropriate if you wanted to spend some of your time in the Adult ER and some of your time in the peds ER.

Not a ******ed question at all. The answer to the first question is no - you sit for the peds boards and then the pedi EM boards. The amount of adult time in PEM isn't really enough for full proficiency. It is enough to know what to do with the 18 year olds that wander into the pedi EC with chest pain. So, no to the second question as well.

And in regards to your final observation, some of the adult EC people out in the community get basic peds care wrong. Big props to the adult EC types, they see things that so could not treat, and a lot of them are really good at emergency pediatrics. But then there are the others who haven't read the fever guidelines for 0-3 year old patients since Prevnar (the pneumococcal vaccine) came out. Or the ones that give ceftriaxone to a febrile child without doing any cultures. Or referring a patient to a tertiary care pedi hopsital for febrile seizures (which don't need treatment in most senarios).

Will sign off, call with questions (heh.)

 

[kungfufishing]

1. No

2. I hope not

3. If you want a mixture of adult and pediatric emergencies, seek an EM residency.

Separate adult and pediatric EDs are not all that common outside of academic centers. The "adult" EPs who occasionally cover the PedsED at your institution, assuming they are EM residency trained, already have formal training in dealing with pediatric emergencies. Remember that EM training is intended to yield proficiency in managing both adult and pediatric emergencies. This is not true of pediatric training.

 

[doctawife]

Remember that EM training is intended to yield proficiency in managing both adult and pediatric emergencies. This is not true of pediatric training.

True that. If someone had a MI in front of me in a fully stocked ER, I'd get some asprin and holler for help. I'm clueless. It's pathetic. 😳

 

[zinjanthropus]

thank you for the quick and thurough responses from both of you - it helps.

 

[Apollyon]

Umm...I think the two people who said that Peds and EM people that do Peds EM fellowships take different boards are wrong.

http://www.abem.org/public/portal/alias__Rainbow/lang__en-US/tabID__3357/DesktopDefault.aspx

People are credentialed and authorized by their respective boards (ABEM and ABP) to take the test, and the test is administered by ABP - but it's the same test, and the sub-board qualification is joint by ABEM and ABP.

 

[kungfufishing]

Umm...I think the two people who said that Peds and EM people that do Peds EM fellowships take different boards are wrong.

http://www.abem.org/public/portal/alias__Rainbow/lang__en-US/tabID__3357/DesktopDefault.aspx

People are credentialed and authorized by their respective boards (ABEM and ABP) to take the test, and the test is administered by ABP - but it's the same test, and the sub-board qualification is joint by ABEM and ABP.

Oops I didnt even realize what the actual question the OP asked was. I had somehow interpreted this as "if I do a pedsEM fellowship, can I sit for the EM boards?". Just a little EM centric.....

 

[paramed2premed]

If a variation on the OP's question would be indulged . . .

As an MS IV (hopefully) headed into EM, I am also considering a subsequent PEM fellowship. My question is, what kinds of jobs are PEM docs finding?

Of course, I am mostly interested in what the EM->PEM folks are doing.

I have heard a couple perspectives already, just wondering what SDN posters know.

 

[doctawife]

PEM is a (relatively) new field, so the job market is pretty good. The whole idea of children's hospitals is spreading to smaller cities (eg Austin), so new jobs are always popping up.

PS - I always knew that the PEM boards are the same regardless of whether or not the first residency was pedi or EM. But the first set of boards (after residency) differ between tracks. Either way, PEM requires six years of training, either 3/3 pedi/PEM or 4/2 EM/PEM (I think, anyway. EM is four years, right? Yikes, I'm forgetful and under informed!)

Fo shizzle.

 

[Apollyon]

PEM is a (relatively) new field, so the job market is pretty good. The whole idea of children's hospitals is spreading to smaller cities (eg Austin), so new jobs are always popping up.

PS - I always knew that the PEM boards are the same regardless of whether or not the first residency was pedi or EM. But the first set of boards (after residency) differ between tracks. Either way, PEM requires six years of training, either 3/3 pedi/PEM or 4/2 EM/PEM (I think, anyway. EM is four years, right? Yikes, I'm forgetful and under informed!)

Fo shizzle.

No - and that is a bone of contention between peds and EM. Half the PEM programs that take graduates of both residencies are 2 years for EM and 3 years for peds.

>80% of EM programs are 3 years. The remainder are split between 1-4's and the (gradually disappearing) 2-4.

What do you mean by "But the first set of boards (after residency) differ between tracks." ? I thought it's the same exam - that's the way the web site depicts it for initial certification.

 

[doctawife]

What do you mean by "But the first set of boards (after residency) differ between tracks." ? I thought it's the same exam - that's the way the web site depicts it for initial certification.

I mean that I want to sit for the pediatrics boards, while the EM folks should sit for the EM boards. So that if I ever get bored with PEM, I can still be a garden variety pedi. PEM is a sub specialty. So regardless of how one gets there, one can either take EM or pedi boards.

 

[Apollyon]

I mean that I want to sit for the pediatrics boards, while the EM folks should sit for the EM boards. So that if I ever get bored with PEM, I can still be a garden variety pedi. PEM is a sub specialty. So regardless of how one gets there, one can either take EM or pedi boards.

Oh, I gotcha now - however, I thought you HAVE to be primarily boarded to get subspecialty boarded, don't you? Even if you take and pass the PEM boards, you can't actually GET the title/credential until you are board certified by your primary, right?

 

[deleted109597]

I was talking to the Peds EM guys at one program, and none of them were EM first. All of them said that Peds EM is typically academic, and EM guys actually take a pay cut to go into Peds EM. However, pediatricians get a raise, so that is why a majority of Peds EM started out as peds.
However, this was at one institution. YMMV

 

[BKN]

Oh, I gotcha now - however, I thought you HAVE to be primarily boarded to get subspecialty boarded, don't you? Even if you take and pass the PEM boards, you can't actually GET the title/credential until you are board certified by your primary, right?

A,

I believe it goes like this. You sit for a primary board certification. After that your primary board may issue a certificate of special qualifications after a fellowship and sub-board exam.

Thus nobody is "boarded" in Pedi EM or any other subspecialty, but it is common to refer to oneself that way.

I could be wrong on this one, but I don't think so. Even admitting uncertainty gives me nausea and piloerection.😉

 

[doctawife]

Thus nobody is "boarded" in Pedi EM or any other subspecialty, but it is common to refer to oneself that way.

One usually refers to folks that have passed the pedi EM boards as 'sub-boarded'. There is a regulatory group, recognized by the AMA, for pedi EM. So there are actual boarded members and related exams.

One of the few recognized, but not boarded, pedi specialty (that I know about) is general academic pedi, which is so the opposite of EM it's not even funny.

 

[Apollyon]

A,

I believe it goes like this. You sit for a primary board certification. After that your primary board may issue a certificate of special qualifications after a fellowship and sub-board exam.

Thus nobody is "boarded" in Pedi EM or any other subspecialty, but it is common to refer to oneself that way.

I could be wrong on this one, but I don't think so. Even admitting uncertainty gives me nausea and piloerection.😉

From ABEM, and, as doctawife said, it's a "sub-board". From what I can find, it's not a CAQ, like medical toxicology.

 

[BKN]

From ABEM, and, as doctawife said, it's a "sub-board". From what I can find, it's not a CAQ, like medical toxicology.

Actually the other 3 subspecialties (including med tox) are all described as having certfication exams and being subboards of ABEM plus others.

Actually I think that the CAQs were given by a single board, but I went to the ABS and the ABMS sites and couldn't find references to CAQs. The ped surgery and vascular surgery exams are described as certification exams but it doesn't say whether it awards a certificate or a sub-board certifcation.

Perhaps CAQs have been eliminated as terminology.

In any case, you must have primary board certifcation before you can achieve subspecialty certification - which is also issued by your board.

And I was wrong. Fourth time I've said it this year. Part of my 12 step.