Ten years ago, a comprehensive series of articles was published in Pediatric Emergency Care detailing the state of pediatric emergency medicine (PEM) fellowship education. We intend to provide an update to the clinical elements of fellowship training, with a companion article to follow that will address the nonclinical domains. This article will summarize the core components of fellowship as mandated by the Accreditation Council for Graduate Medical Education (ACGME) and review significant changes and challenges to fellowship education that have occurred over the past decade. In light of upcoming modifications to fellowship education, including an increased focus on competency-based medical education and the addition of a 2-year, clinically oriented fellowship option, it is vital for stakeholders to be familiar with the core elements of PEM fellowship training as the curriculum is adapted to meet the needs of trainees and their patients.
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Kane et al. (2026) studied this question.
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