We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
The Pediatric Forum |

Preparation for Pediatric Primary Care

Mary Ann Prendiville Rigas, MD
Arch Pediatr Adolesc Med. 1998;152(2):209-210. doi:.
Text Size: A A A
Published online


I am responding to the article by Camp et al1 published in the January 1997 ARCHIVES. I completed my internship (at Children's Hospital, Boston, Mass) and residency (at Children's Hospital of Philadelphia in Pennsylvania) in 1990 and have been involved in the primary care practice of pediatrics in rural north central Pennsylvania since then. The closest tertiary care medical center for children is approximately 3 hours away. As did many of the graduates surveyed in this study, I too felt inadequately prepared to handle issues in developmental and behavioral pediatrics, learning disabilities, and orthopedics early in my practice experience. However, I have found that the past 7 years have been a continuing learning experience for me; through reading, telephone consultation, referral of patients to specialists, working with the local school system, and simple experience—seeing several patients with the same presentation or clinical course—I have come to feel much more comfortable with many of these "new morbidity" areas. On the other hand, when I am occasionally called on to perform certain acute care skills that I felt very comfortable with on leaving residency (such as intubation of premature newborns, placement of umbilical lines, resuscitation of near-drowning or trauma victims), I am grateful that I did master these skills with a certain degree of proficiency. It seems important that we not shift the emphasis of residency training too far in the direction of the new morbidity areas, in which we can continue to gain proficiency during our practice careers, at the expense of the acute care fields of neonatology, emergency pediatrics, and critical care pediatrics, which we pediatricians who practice in remote areas will continue to need (but will be unable to gain extensive experience in) during the remainder of our careers.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Pretest Probabilities and Likelihood Ratios for Clinical Findings