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Am J Dis Child. 1986;140(7):615. doi:10.1001/archpedi.1986.02140210013002.
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Sir.—I was ready to go into practice. Having completed three years of pediatric residency training followed by a year of chief residency in a well-respected institution, then two years of fellowship training in general academic pediatrics at another fine institution, I felt prepared to handle whatever came my way. I completed the applications for hospital privileges in pediatrics at several hospitals, confident that there would be no question of my abilities as a pediatrician.

Then it came. A call from the medical staff secretary at one of the hospitals. "Dr Williams, this is Ms Smith of the medical staff office. We have been reviewing your request for hospital privileges and find that you have marked 'neonatal intubation,' 'exchange transfusion,' 'care of children on ventilators,' and 'arterial blood gases' on your form."

"Yes," I said, thinking back on the long hours and many nights I had spent in the neonatal


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