Pediatric Emergency Medicine
What does a Pediatric Emergency Medicine (PEM) physician do?
What are the career opportunities?
What Board, if any, certifies a PEM program graduate?
What is the lifestyle of a PEM physician?
What is the compensation of a PEM physician?
How do I become a PEM physician?
Where do I find out about available programs?
When do I apply?
Why should I choose to become a PEM physician ?
PEM trained physicians may serve in a variety of capacities both clinical, advocacy, disaster medicine and policy development. The PEM physician is challenged to be responsible for the initial care of any child with a wide array of conditions from simple to highly complex. On any given day, a PEM physician may provide care for a child struck by an automobile, a patient with a metabolic disorder that is not responding to therapy, a child with an asthma attack, a victim of child abuse, a jaundiced newborn with a fever and a hypothermic child after a near-drowning episode, or a wide variety of behavioral conditions. In the clinical realm, they provide care for critically ill and injured children in an Emergency Department setting. In addition to knowledge that is obtained during their pediatric or emergency medicine residency training, PEM physicians have an increased fund of knowledge in areas such as advanced procedural skills such as advanced airway management, procedural sedation, critical care, and forensic pediatrics.
Beyond the clinical realm, PEM physicians may have multiple roles in the emergency department, hospital, healthcare system and community. These include contributing to the education of residents, medical or other health care students, paramedics or community members. PEM physicians may also become involved in hospital committees that examine the quality of pediatric emergency care or work with local, regional or national politicians to discuss specific issues of child health, including disaster planning. There are a variety of ways to champion the causes of children within PEM. Further information may be found at Society for Academic Emergency Medicine website
PEM physicians may work in either an academic or community emergency department, but roles outside of the clinical care are numerous. For clinical careers, the majority of opportunities exist in tertiary care children’s hospitals. However, PEM physicians may work in a hospital with an emergency medicine residency where their specific pediatric expertise is needed or in a community hospital that evaluates a significant number of children. Beyond clinical opportunities, there are openings within administration, research, education, simulation or injury prevention. The Future of Pediatric Education II PEM data is a descriptive survey of PEM practitioners, and may be accessed at AAP Future of PEM.
Both the American Board of Pediatrics and the American Board of Emergency Medicine certify graduates from their respective primary residencies. After passing primary residency boards, and meeting both the ACGME and specific fellowship requirements for board eligibility, a fellowship graduate will take a one-day written examination.
On average, PEM physicians spend 65% of their time in clinical care, with the balance being spent (in descending order) in administrative, teaching and research roles. Children have a tendency to be seen in the emergency department during hours when they are not in school, so PEM physician clinical time will be concentrated during afternoon, evenings, holidays and weekends. The number of shifts will vary significantly within facilities and between different facilities depending on other non-clinical roles the practitioner plays.
PEM physicians generally receive higher compensation then general pediatricians, and somewhat less then emergency physicians, depending on the type of practice.
Following successful completion of a residency in either Pediatrics or Emergency Medicine, applicants will complete an additional two years of fellowship (EM residency graduates) or three years (Pediatric residency graduates). Irrespective of the type of residency, selection of fellows is through the Pediatric Specialties Fall Match administered by the NRMP.
Information about programs is available through ERAS Fellowships, FREIDA and the ACGME (depending upon the residency, select either Emergency Medicine/Pediatric emergency medicine or Pediatrics/Pediatric emergency medicine). In addition, the Society for Academic Emergency Medicine has a listing of Pediatric Emergency Medicine fellowships on its website.
Applications are accepted beginning in mid-summer (11 months prior to matriculation) utilizing ERAS (for both types of residencies). Interviews generally begin in late summer through the fall, and match results are reported the first week of December. For match statistics, click here.
Combining the best of general Pediatrics with the best of the critical care specialties, Pediatric Emergency Medicine is a good fit for calm, curious physicians who enjoy both the intellectual and procedural challenge of resuscitations as well as the joy of interacting with minimally ill children during an exam. As one of the younger specialties within Pediatrics, and the first subspecialty within Emergency Medicine, there are areas of significant growth and the ongoing potential for significant, clinically relevant research that will significantly affect the care of children.
For more information about Pediatric Emergency Medicine, visit these websites:
Pediatric Emergency Medicine Database
American Academy of Pediatrics Committee on Pediatric Emergency Medicine
American Academy of Pediatrics Section on Emergency Medicine
American College of Emergency Physicians Pediatric Emergency Medicine Section
Society for Academic Emergency Medicine