Pediatrics

Pediatrics

Pediatrics (or paediatrics) is the branch of medicine that deals with the medical care of infants, children, and adolescents. A medical practitioner who specializes in this area is known as a pediatrician or paediatrician. The word pediatrics and its cognates mean healer of children; they derive from two Greek words: παῖς (pais = child) and ἰατρός (iatros = doctor or healer).

In the United States, a pediatrician (US spelling) is often a primary care physician who specializes in children, whereas in the Commonwealth a paediatrician (British spelling) generally is a medical specialist not in primary general practice.

History

Pediatrics is a relatively new medical specialty, developing only in the mid-19th century. Abraham Jacobi (1830–1919) is known as the father of pediatrics because of his many contributions to the field. He was born in Germany, where he received his medical training, but later practiced in New York City.

Soranus of Ephesus in Greece in the 2nd century AD wrote the first known manuscript devoted to pediatrics. Rhazes (865–925) in Persia wrote a work entitled The Diseases of Children. The first printed book on pediatrics was in Italian (1472) – Bagallarder's Little Book on Disease in Children.

In the Western world, the first generally accepted pediatric hospital is the Hôpital des Enfants Malades (French: Hospital for Sick Children), which opened in Paris in June 1802 on the site of a previous orphanage. From its beginning, this famous hospital accepted patients up to the age of fifteen years, and it continues to this day as the pediatric division of the Necker-Enfants Malades Hospital, created in 1920 by merger with the physically contiguous Necker Hospital, founded in 1778.

This example was only gradually followed in other European countries. The Charité (a hospital founded in 1710) in Berlin established a separate Paediatric Pavilion in 1830, followed by similar institutions at Saint Petersburg in 1834, and at Vienna and Breslau (now Wrocław), both in 1837. The English-speaking world waited until 1852 for its first pediatric hospital, the Hospital for Sick Children, Great Ormond Street, some fifty years after the founding of its namesake in Paris. In the USA, the first similar institutions were the Children's Hospital of Philadelphia, which opened in 1855, and then Boston Children's Hospital (1869).

Training of pediatricians

The training of pediatricians varies considerably across the world. 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. 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 "internship" or "conditional registration". Pediatricians must undertake further training in their chosen field. This may take from four to eight 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 rather than universities, with varying degrees of government input, depending on jurisdiction.

Social role of pediatric specialists

Like other medical practitioners, 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.

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