Pediatrics
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2008-07-11T15:53:32Z
Goodnightmush
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Reverted edits by [[Special:Contributions/69.95.220.106|69.95.220.106]] to last version by 71.195.187.87 (using [[WP:HG|Huggle]])
{{otheruses4|the branch of medicine|the journal of the American Academy of Pediatrics|Pediatrics (journal)}}
[[Image:Newborn Examination 1967.jpg|thumb|Clinical Examination]]
'''Pediatrics''' (also spelled '''paediatrics''') is the branch of [[medicine]] that deals with the medical care of [[infant]]s, [[child]]ren, and [[adolescent]]s. The upper age limit ranges from age 14 to 18, depending on the country.
A [[physician|medical practitioner]] who specializes in this area is known as a ''pediatrician'' (also spelled ''paediatrician'').
The word ''pediatrics'' and its [[cognates]] mean ''healer of children''; they derive from two [[Ancient Greek|Greek]] words: [[wikt:παῖdh|παῖdh]] (''pais'' = child) and [[wikt:ἰατρός|ιατρός]] (''iatros'' = doctor or healer).
[[Image:Pediatric polysomnogram.jpg|thumb|240px|Pediatric [[polysomnography]] [[patient]]<br>[[Children's Hospital (Saint Louis)]], 2006]]
==Differences between adult and pediatric medicine==
Pediatrics differs from adult medicine in many respects. The obvious body size differences are paralleled by maturational changes. The smaller body of an [[infant]] or [[neonate]] is substantially different physiologically from that of an adult. Congenital defects, genetic variance, and developmental issues are of greater concern to pediatricians than they often are to adult physicians. Some may argue that pediatricians are not to be considered professional doctors. However, this claim is misplaced as pediatricians must undertake a course of study, training, and residency that is comparable and equivalent in every respect (other than specialization, of course) to that of a psychiatrist, surgeon, or any other specialization that doesn't require a fellowship.
Many [[genetic disorder|inherited diseases]] are more often treated by pediatricians than by adult physicians because only recently did the majority of these patients survive into adulthood. Well-known example are the [[thalassemia]]s, [[sickle cell anemia]] and [[cystic fibrosis]]. Issues revolving around infectious diseases and immunizations are also dealt with primarily by pediatricians.
Childhood is the period of greatest growth, development and maturation of the various organ systems in the body. Years of training and experience (above and beyond basic medical training) goes into recognizing the difference between normal variants and what is actually [[pathology|pathological]].
Treating a child is not like treating a miniature adult. A major difference between pediatrics and adult medicine is that children are minors and, in most [[jurisdiction]]s, cannot make decisions for themselves. The issues of [[guardianship]], privacy, legal responsibility and informed consent must always be considered in every pediatric procedure. In a sense, pediatricians often have to treat the parents and sometimes, the family, rather than just the child. Adolescents are in their own legal class, having rights to their own health care decisions in certain circumstances only, though this is in legal flux and varies by region.
==Training of pediatricians==
The training of pediatricians varies considerably across the world.{{main|Medical education|Physician}}
Like other medical practitioners, pediatricians begin their training with an entry-level medical education: a [[tertiary education|tertiary]]-level [[Course (education)|course]], undertaken at a [[medical school]] attached to a [[university]]. Such a course leads to a [[doctor of medicine|medical degree]].
Depending on jurisdiction and university, a medical degree course may be either undergraduate-entry or graduate-entry. The former commonly takes five or six years, and has been usual in the [[Commonwealth of Nations|Commonwealth]]. Entrants to graduate-entry courses (as in the USA), usually lasting four or five years, have previously completed a three- or four-year university degree, commonly but by no means always in sciences. Medical graduates hold a degree specific to the country and university in and from which they graduated. This degree qualifies that medical practitioner to become licensed or registered under the laws of that particular country, and sometimes of several countries, subject to requirements for "[[medical intern|internship]]" or "conditional registration".
Within the United States, the term [[physician]] also describes holders of the Doctor of [[Osteopathic medicine in the United States|Osteopathic medicine]] ([[D.O.]]) degree. However, outside the United States, osteopaths are not physicians who practice medicine. For further information on osteopathic medicine, see the entry on the comparison of [[Comparison of MD and DO in the United States|MD and DO in the US]].
Pediatricians must undertake further training in their chosen field. This may take from three to six or more years, depending on jurisdiction and the degree of specialization. The post-graduate training for a [[primary care]] physician, including primary care pediatricians, is generally not as lengthy as for a hospital-based [[medical specialist]].
In most jurisdictions, entry-level degrees are common to all branches of the medical profession, but in some jurisdictions, specialization in pediatrics may begin before completion of this degree. In some jurisdictions, pediatric training is begun immediately following completion of entry-level training. In other jurisdictions, junior medical doctors must undertake [[generalist]] (unstreamed) training for a number of years before commencing pediatric (or any other) [[specialization]]. Specialist training is often largely under the control of '''pediatric organizations''' (see below) rather than universities, with varying degrees of government input, depending on jurisdiction.
==''"Pediatrician"'' versus ''"Paediatrician"''==
There is a slight semantic difference associated with the difference in spelling. In the USA, a '''pediatrician''' (US spelling) is a [[specialty (medicine)|specialist]] physician who generally functions in a primary care setting for children. Like all [[physician]]s, they first receive a general medical degree (from a US medical school, typically [[Doctor of Medicine|MD]] or [[Doctor of Osteopathic Medicine|DO]]). Next, such '''pediatricians''' (US spelling) must complete an [[internship (medical)|internship]] and then a 3-year [[residency (medicine)|residency]] in pediatrics. A similar situation exists in Germany: a [[wikt:Kinderarzt|kinderarzt]] is commonly a primary care pediatrician.
In the [[United Kingdom|UK]] and the [[Commonwealth of Nations|Commonwealth]] (and also in much of the rest of the world), a '''paediatrician''' (British spelling) is also a [[specialty (medicine)|specialist]] physician for children, but generally ''not'' in primary care. He or she sees children who are either urgently taken to a hospital or who are referred by [[general practitioner]]s; the latter see the bulk of child patients in primary care. Such '''paediatricians''' (British spelling) generally first receive a general medical degree (in the [[United Kingdom|UK]] or [[Commonwealth of Nations|Commonwealth]], typically [[Bachelor of Medicine and Surgery| MB BS, MB BChir ''etc'']]). Afterwards (in the [[United Kingdom|UK]] or [[Commonwealth of Nations|Commonwealth]]), they complete at least 2 years general clinical training ("foundation training"), then 6 or more years additional training in pediatrics or its [[Subspecialty|subspecialties]]. A ''paediatrician'' in this sense could fairly be described as an [[internist]] who has subspecialized in infants & children.
==Subspecialists in pediatrics==
Specialist pediatricians may undergo further training in sub-specialties. Practising a subspecialty in pediatrics is similar in some respects to practising the relevant adult specialty, but a major difference is in the pattern of disease. Typically, diseases commonly seen in children are rare in adults (''eg'' [[bronchiolitis]], [[rotavirus]] infection), and those seen in adults are rare in children (''eg'' [[coronary artery disease]], [[deep vein thrombosis]]). Hence, pediatric [[cardiology|cardiologists]] deal with the heart conditions of children, particularly congenital heart defects, and pediatric [[oncology|oncologists]] most often treat types of cancer that are relatively common in children (''eg'' certain [[leukemia]]s, [[lymphoma]]s and [[sarcomas]]), but which are rarely seen in adults. Every subspecialty of adult medicine exists in pediatrics (with the obvious exception of [[geriatrics]]).
[[Adolescent medicine]] is a growing sub-specialty. The pattern of diseases in adolescents in part resembles that seen in older adults, and specialists or sub-specialists in adolescent medicine are also drawn from practitioners of [[internal medicine]] or [[family medicine]]. Another major sub-specialty, which is unique to pediatrics, is [[neonatology]]: the medical care of newborn babies.sf
== Pediatric organizations==
Most pediatricians are members of a national body. Examples are the [[American Academy of Pediatrics]], the [[Canadian Paediatric Society]], the [[Royal College Of Paediatrics and Child Health]], [[Norsk barnelegeforening]] (The Norwegian society of pediatricians) or the [[Indian Academy of Pediatrics]]. In Australia and New Zealand, paediatricians are fellows of the [[Royal Australasian College of Physicians]], which covers both nations and which has adult & paediatric sections. This was the situation in the UK until the late 1990s, where specialist paediatricians were Members or Fellows of either the [[Royal College of Physicians]] or of the fraternal colleges in Scotland. In 1996, British paediatricians were granted a royal charter to form their own college, the [[Royal College of Paediatrics and Child Health]].
==Social role of pediatricians==
Like other physicians, pediatricians are traditionally considered to be members of a learned [[profession]], because of the extensive training requirements, and also because of the occupation's special ethical and legal duties.
Pediatricians commonly enjoy high [[social status]], often combined with expectations of a high and stable income and [[job security]]. However, medical practitioners in general often work long and inflexible hours, with shifts at unsociable times, and may earn less than other professionals whose education is of comparable length. [[Neonatology|Neonatologists]] or general pediatricians in hospital practice are often on call at unsociable times for [[perinatal]] problems in particular — such as for [[Caesarean section]] or other high risk [[childbirth|births]], and for the care of ill newborn infants.
The U.S. Bureau of Labor Statistics estimates that general pediatricians earned an average of $141,440 in 2006.
In August 2000, a paediatrician in [[Wales]] had her home and car vandalised by "[[vigilantes]]", believing "paediatrician" meant "[[paedophile]]".<ref>[http://www.guardian.co.uk/uk/2000/aug/30/childprotection.society Doctor driven out of home by vigilantes | UK news | The Guardian<!-- Bot generated title -->]</ref>
== See also ==
* [[Children's hospital]]
* [[Medical specialty]]
* [[Pediatric ophthalmology]]
* [[Pediatric endocrinology]]
* [[Child life specialist]]
==References==
{{reflist}}
==Further reading==
* [http://www.contemporarypediatrics.com/contpeds/ Contemporary Pediatrics] - a monthly magazine
* [http://clp.sagepub.com Clinical Pediatrics] - a peer-reviewed journal
==External links==
{{commons|Paediatrics|Pediatrics}}
{{Wikibooks|Pediatrics}}
{{wiktionary|Pediatrics}}
* [http://www.aap.org American Academy of Pediatrics]
* Royal College of Paediatrics website - [http://www.rcpch.ac.uk Homepage for the Royal College of Paediatrics and Child Health]
*[http://www.racp.edu.au/ Royal Australasian College of Physicians]
* [http://www.virtualpediatrichospital.org/patients/cqqa/index.shtml Pediatric Common Questions Quick Answers]
* GeneralPediatrics.com - [http://www.generalpediatrics.com The General Pediatrician's View of the Internet]
* [http://www.pedrad.info Pediatric Radiology] - the first international Pediatric Radiology platform for doctors and patients.
* PediatricEducation.org - [http://www.pediatriceducation.org A Pediatric Digital Library and Learning Collaboratory intended to serve as a source of continuing pediatric education]
* Virtual Pediatric Hospital - [http://www.virtualpediatrichospital.org A digital library of pediatric information]
* [http://www.pediatrics.org Pediatrics] Official Journal of the AAP
* [http://journals.aol.com/saharfarida/pir Summaries of articles published in Pediatrics in Review]
* [http://www.borninbradford.nhs.uk Born in Bradford - A UK-based birth cohort study]written by Amera Nicholice
* [http://pedbase.org/ The Pediatric Database]
* [http://www.atsdr.cdc.gov/HEC/CSEM/pediatric/ Case Studies in Environmental Medicine: Pediatric Environmental Health]
* [http://www.medstudy.com MedStudy Corporation] - produces quality study/review materials to prepare physicians for Pediatrics Board certification and recertification exams.
* [http://www.bmj.com/cgi/collection/paediatrics%3Aother Pediatric Collection by the BMJ] - Collection of Pediatric papers published in the British Medical Journal.
* [http://www.carrolltonpediatrics.com/news/ Carrollton Pediatrics Health News]
* [http://www.paediatrics.info Paediatrics.info] - Pediatric resource for medical students.
* [http://pediatricianonline.in Online Pediatrician] - Online pediatricians answer your child health related queries on a regular basis.
* [http://www.pediapals.com/ Pediapals.com] - Kid-friendly medical equipment
* [http://medicaldesign.com/special_report/pediatric_medical_design/ Pediatric Medical Design]
*[http://www.quickddd.com Dynamic Differential Diagnosis]
{{Medicine}}
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