Two Years or Three? Rethinking the Ideal PEM Training Timeline

Concerns about the pediatric subspecialty workforce and financial impacts of subspecialty training have prompted national conversations regarding the optimal duration of pediatric subspecialty training. It is unknown whether accrediting bodies will change duration of training, and if so, which data/influences/drivers will inform those decisions. This special feature, assembled by a national group of pediatric emergency medicine educational leaders, compares the current 3-year training model with a shortened 2-year training duration for pediatric emergency medicine fellows. We discuss the rationale and potential impacts of each of these models in regard to recruitment, clinical competency, scholarly activity, and career preparation for fellows in this subspecialty. A balanced look at aspects of each model can help guide the national conversation and serve as a starting point to explore experiences and perceptions of key stakeholders—trainees and program leadership—in an effort to better inform future decisions about subspecialty training.