The global pediatrician: is there such a person, or can there be?

All rights reserved. 10.1016/j.jpeds.2010.01.001 A s pediatricians, our concern for the health of children and youth starts with our individual encounters with patients and their families and extends to the community in which they live and the broader systems of society that influence their health. This concept of a pediatrician is captured in one of the ‘‘bibles’’ of our profession and in the words of Richard Behrman when he defines pediatrics as being ‘‘concerned with the health of infants, children, and adolescents, their growth and development, and their opportunity to achieve full potential as adults.’’ Health, growth and development, and opportunity as adults encompass the breadth and importance of our interests and responsibilities. Many institutions training our future pediatricians interpret this responsibility as not only encompassing the children in their community, but also expanding to a global concern for the health of children and youth. Indeed, many medical students and residents are encouraging faculty to pay more attention to global child health, and we are responding by creating more informal and formal opportunities for trainees to engage in global health issues. Our academic societies also have devoted more time to the issues of global child health and how we might more effectively contribute to this agenda, for example, the Federation of Pediatric Organizations, the International Pediatric Association (http://www.ipa-world. org), and the International Pediatric Academic Leaders Association (http://www.academicpediatrics.org). If we are to have training programs for this ‘‘global pediatrician,’’ what should the core elements of the curriculum look like? Can we begin to integrate these core elements into our training programs in a way that builds a common vision of the global pediatrician while also recognizing the distinct nature of practice in various communities? We might first define a global pediatrician as a pediatrician who understands the state of child health locally and globally and has the knowledge, skills, attitudes, and behaviors necessary to improve the lives of children individually and in the world community. The pediatrician will have the knowledge and skills to diagnose and treat the diseases and disorders of childhood, both those common globally and those unique to their region. In addition, either directly through individual effort or indirectly through the support of engaged professional organizations, the global pediatrician will gain through training and will sustain through professional development a knowledge base that includes the following elements.