Competency in neonatal endotracheal intubation: mission impossible?

The Accreditation Council for Graduate Medical Education Program Requirements (PRs) for Pediatrics require that residents be able to competently perform neonatal endotracheal intubation (NET). In this issue of Pediatrics, DeMeo et al defined competency as a 75% likelihood of intubation success; only a minority of residents (23%) were able to achieve competency during the study period. Four cumulative NET successes were needed to achieve competency; the median number of NET opportunities for their subjects, however, was 3 (range: 1–13).