What is Pediatrics?

Pediatrics is the branch of medicine that deals with the medical care of infants, children, and adolescents, typically up to the age of 18. Pediatricians are medical doctors who specialize in the diagnosis, treatment, and prevention of diseases and disorders that affect children. (1)

Overview and Definition

Pediatrics is a branch of medicine that focuses on the medical care of infants, children, and adolescents, as well as their growth and development. Pediatricians are medical doctors who specialize in the diagnosis, treatment, and prevention of a wide range of medical conditions affecting children, from minor illnesses to serious diseases. They work closely with families to provide comprehensive healthcare services that meet the physical, emotional, and social needs of children. Pediatricians also play an important role in promoting health and disease prevention through regular check-ups, vaccinations, and health education. (2)

Education and Training

The education and training required for pediatricians vary significantly worldwide. The length and type of medical degree program depending on the jurisdiction and the university. Medical schools in some countries offer undergraduate-entry programs, which typically take five or six years to complete, while in others, graduate-entry programs are more common. These programs usually last four to five years and require a previous three- or four-year university degree, preferably in sciences.

After earning their medical degrees, graduates must obtain a license or registration in their country, which may also require an internship or conditional registration. To specialize in pediatrics, physicians must undergo additional training, which can take from four to eleven or more years, depending on the jurisdiction and the level of specialization desired.

In the United States, a medical school graduate interested in specializing in pediatrics must complete a three-year residency program consisting of outpatient, inpatient, and critical care rotations. Subspecialties within pediatrics, such as critical care, gastroenterology, neurology, infectious disease, hematology/oncology, rheumatology, pulmonology, child abuse, emergency medicine, endocrinology, neonatology, and others, require further training in the form of 3-year fellowships.

In some jurisdictions, pediatric specialization may begin before the completion of an entry-level degree, while in others, it may commence immediately following the completion of such training. In some cases, junior medical doctors must complete generalist training before undertaking pediatric or other specializations. Pediatric organizations, rather than universities, often oversee specialist training, which can vary depending on the jurisdiction. (3)

Practicing as a Pediatrician

Pediatricians are medical doctors who specialize in the healthcare of infants, children, adolescents, and young adults. They provide a wide range of services to ensure the health and well-being of their patients. They provide care from birth up to a child's 21st birthday or beyond. Pediatricians are responsible for preventing, detecting, and managing physical, behavioral, and developmental issues that affect children. While some work in general practice, others specialize in treating children with specific health conditions. 

They have a wide range of duties, including performing well-baby checkups, managing chronic medical conditions, and providing preventive care. In addition, pediatricians diagnose and treat illnesses, injuries, and diseases, conduct physical exams, and monitor a child's physical, emotional, and social development. They administer vaccines, prescribe medication, and offer health advice to parents. They also listen to parents' concerns and answer their questions and refer families to specialists if necessary. (4)

Procedures Performed

Pediatric procedures refer to the medical procedures that pediatricians perform to diagnose and treat illnesses, injuries and diseases that affect infants, children, adolescents, and young adults. Some of the common pediatric procedures include:

• Physical exams: Pediatricians conduct physical exams to assess a child's overall health, growth, and development.
• Immunizations: Pediatricians administer vaccines to prevent infectious diseases, such as measles, mumps, rubella, polio, and chickenpox.
• Laboratory tests: Pediatricians order laboratory tests, such as blood tests, urine tests, and stool tests, to diagnose various conditions, including infections, anemia, and allergies.
• X-rays and imaging tests: Pediatricians order X-rays and imaging tests, such as ultrasounds and CT scans, to diagnose and monitor conditions, such as bone fractures and tumors.
• Medication management: Pediatricians prescribe medications to treat various conditions, such as infections, asthma, and ADHD.
• Minor surgical procedures: Pediatricians may perform minor surgical procedures, such as removing a wart or repairing a laceration.
• Behavioral and mental health assessments: Pediatricians assess and treat mental health and behavioral issues, such as depression, anxiety, and ADHD.

According to ACGME requirements, pediatric residents are expected to possess the ability to proficiently execute various procedures commonly used in pediatric general practice, including providing a detailed explanation of each step involved in the procedure, recognizing the indications and contraindications, anticipating potential complications, effectively managing pain, providing post-procedure care, and interpreting relevant results. To demonstrate their procedural competency, residents are expected to perform the following procedures in the suggested settings:

• Bag-mask ventilation (NICU, PICU, wards, and simulation)
• Bladder catheterization (ED and NICU)
• Immunization administration (Continuity Clinic, Wake Clinic, and Cone Clinic)
• Abscess incision and drainage (ED)
• Lumbar puncture (ED, NICU, PICU, and wards)
• Neonatal endotracheal intubation (NICU)
• Peripheral intravenous catheter insertion (ED, NICU, PICU, wards, and simulation)
• Simple dislocation reduction (ED)
• Simple laceration repair (ED)
• Simple foreign body removal (ED and clinics)
• Temporary fracture splinting (ED)
• Umbilical catheter insertion (NICU and simulation)
• Venipuncture (ED, NICU, PICU, wards, and simulation)

Furthermore, residents must have a comprehensive understanding of the indications, contraindications, and potential complications for the following procedures and must receive training, either real or simulated, if these procedures are relevant to their future post-residency position.

• arterial line placement (PICU and simulation)
• arterial puncture (ED, PICU, and simulation)
• chest tube placement (ED, NICU, PICU, and simulation)
• circumcision (NBN)
• endotracheal intubation of non-neonates (Anesthesiology, PICU, and simulation)
• thoracentesis (simulation) (5)