April 29, 2026
3 min read
Key takeaways:
- Under the new model, fellows who “demonstrate readiness” can complete their training in 2 years.
- An optional third year will be available for “scholarship, research or advanced training.”
The American Board of Pediatrics has approved a shorter, 2-year training path for fellows entering practice within pediatric subspecialties, according to a statement from the organization.
The decision, approved by the ABP board of directors earlier this month, follows longstanding critiques from pediatric subspecialists that the current model, which requires them to complete 3 additional years of training after general pediatric training, places them at an immediate financial disadvantage. As Healio has previously reported, average salaries in pediatrics are far lower than adult specialties, and many young pediatric subspecialists exit their residency and fellowship burdened by hundreds of thousands of dollars in student loan debt.
“This [new] model has the potential to address longstanding barriers to entering pediatric subspecialties, including the length and cost of training,” Beth Jonas, MD, FACR, chair of the American College of Rheumatology Workforce Solutions Committee, said in a statement from the ACR. “By creating more flexible pathways, we hope to improve recruitment into pediatric rheumatology and strengthen the clinical workforce, ultimately improving access to care and reducing wait times for patients and families. We also see this as an important first step toward addressing broader workforce challenges.”
The new model, which the ABP said would come into effect for fellows entering training in July 2028 at the earliest, will offer two pathways for the organization’s 15 core subspecialties:
- Fellows who “demonstrate readiness for practice” will be allowed to complete their training in 2 years, in what the ABP calls a clinically oriented pathway.
- In the second pathway, programs can offer an optional third year for scholarship, research or advanced training.
Terry L. Moore, MD, FACP, FAAP, MACR, director of adult and pediatric rheumatology at St. Louis University Medical Center, in Missouri, told Healio these changes have been a long time coming.
“This is what we have been trying to obtain since 1992, when we were one of the 12 programs originally accredited to train pediatric rheumatologists,” he said. “This will provide a shortened fellowship for those fellows that are mainly clinically oriented or want to be clinical educators. Hopefully, this will be the nidus to help us reduce the pediatric rheumatology shortage.”
According to the ABP, the new dual-track model emphasizes “competency-based” approaches for pediatric subspecialty training, rather than focusing on a fixed time duration.
“Both pathways are grounded in the same competency-based expectations and assessment framework,” the ABP said in its statement. “This approach is intended to provide flexibility while maintaining consistent standards for readiness. The model is expected to apply across subspecialties and will be coordinated with the [Accreditation Council for Graduate Medical Education], with the earliest implementation anticipated for fellows entering training in July 2028.”
The ABP additionally announced the following key changes as part of the new model:
- Increased clinical time to 18 clinical educational blocks, meant to ensure sufficient opportunity to achieve readiness for practice within a 2-year training window;
- no required scholarly work product for certification or minimum scholarship time requirements; and
- a continued emphasis on education and assessment of scholarship through the Scholarship EPA.
The ABP additionally said it would move toward a “more comprehensive assessment system” in the new model. This would entail workplace-based assessments, or “micro-assessments,” which would be completed at or immediately following a clinical encounter. Also included would be “360-degree evaluations” from a range of team members, longitudinal tracking of EPA progress, and clinical competency committee review and attestation.
“This work represents a meaningful step forward in subspecialty training,” read the ABP statement. “It reflects an important evolution of competency-based training, one that emphasizes outcomes, readiness for practice, and flexibility based on demonstrated achievement.”
According to the ACR, which has “engaged in ongoing discussions with ABP leadership throughout this process,” the decision represents “an important step forward.”
“During this milestone year as we celebrate the 50th anniversary of pediatric rheumatology becoming a subspeciality, we are especially encouraged to see meaningful progress in training innovation,” Ekemini A. Ogbu, MD, MSc, chair of the ACR Committee on Pediatric Rheumatology, said in the group’s statement. “This achievement reflects years of collaboration and persistence among ACR members, partner organizations, and leaders across the pediatric community. We are proud of the role our committee and ACR leadership have played in advancing these efforts.”
Sources/Disclosures
Source:
Press Release
References:
Disclosures:
Jonas and Ogbu report no relevant financial disclosures.
Ask a clinical question and tap into Healio AI’s knowledge base.
- PubMed, enrolling/recruiting trials, guidelines
- Clinical Guidance, Healio CME, FDA news
- Healio’s exclusive daily news coverage of clinical data
<
Leave a Reply