The future of pediatric education (FOPE) II report summary and pediatric subspecialists.

Abstract

The Future of Pediatric Education (FOPE) II report summary1 is a thoughtful, prudent plan for the future of the education of general pediatricians. Yet, the summary takes a pessimistic view of the future for pediatric subspecialists (PSS) and has few useful recommendations to immediately improve the education of PSS. We believe that PSS provide the best care for children with complex and advanced disease. Physicians who care for these special children on a part-time basis, without equivalent specialty training , will not usually be able to provide the same service, as suggested by parents' lack of confidence in skill of generalists in managing chronic illness (FOPE II summary, page 187) FOPE II summary accurately documents the decreasing numbers of PSS and the subspecialty residents (FOPE II summary, pages 185–186) from 27% of pediatricians to 18% over the past decade. The report notes that “a shortage of subspecialists, therefore, has grave implications for the improvement of child health” (FOPE II summary, page 189). We believe that implementation of the FOPE II summary is more likely to exacerbate than ameliorate these problems. FOPE II supports PSS …