GOALS & OBJECTIVES
The key goal is to train pediatricians to play an active professional role in enhancing developmental, behavioral, and health outcomes for children, especially those at-risk due to poverty. The trainee will gain the competence to assume a role of leadership in promoting DBP in an academic setting, through excellence in teaching, research, clinical care, program development, and child advocacy. The eight key objectives of the fellowship training program are: 1. Training in clinical skills. 2. Training in research skills. 3. Training in teaching skills. 4. Training in the theoretical and evidence-based foundations of behavioral pediatrics. 5. Training in special issues of children and families living in poverty. 6. Training in individual and systemic advocacy for the needs of children. 7. Experience with administration and program development. 8. DBP training and support of other pediatricians and child professionals.

METHODOLOGY
1. Training in clinical skills results from supervised activities in a variety of BMC clinical sites, including two DBP Clinics (one for ages 0-6 years, the other ages 6-21 years), the Comprehensive Care Program (a primary care medical home for 160 children with significant developmental disabilities and/or complex medical problems), the Failure to Thrive Clinic, the Newborn Nursery, the inpatient wards, the Primary Care Clinic, selected clinics at the affiliated Neighborhood Health Centers, and selected community child care sites. 2. Training in research skills results from didactic seminars at Boston University School of Public Health and the Division of DBP at BMC and from mentorship from the interdisciplinary DBP-Research Consortium. With this support the fellow will conduct an independent research project and write a scholarly manuscript describing the results. 3. Training in teaching skills is accomplished by fellows’ practical teaching experience in teaching different types of audiences (including pediatric residents, parents, teachers, nurses, and pediatricians) in a variety of settings, both formal and informal. 4. Specialized training in behavioral-developmental issues of poor families results from the clinical experiences at BMC (an inner-city hospital), from focused seminars addressing issues of social class and ethnicity, and from independent readings. 5. Training in the theoretical foundations of behavioral pediatrics results from a formal Literature Seminar, through attendance at national behavioral pediatrics meetings, through literature reviews concerning about clinical cases, and through attendance at established continuing educational offerings. 6. Training advocacy for children is woven into the fabric of all clinical work at BMC and through BMC’s unique Family Advocacy Program (FAP) which offers ongoing advocacy projects and weekly meetings. 7. Experience with administration and program development occurs thorough graduated administrative responsibilities assumed by the fellows and mentorship around program development by faculty. 8. Training and support of other pediatricians and child professionals occurs by active participation of the staff of the Division of DBP in medical school lectures, clinical supervision, consultation and lectures, and ongoing continuing educational programs, such as the yearly two day conference, "Behavioral Pediatrics: Clinical Problems in Primary Care”. Our Division also has received a number of grants to create DBP teaching materials for national dissemination.

COORDINATION
The Division of DBP at BMC / BUSM enjoys a close collaborative relationship with many state and local agencies, including Mass Dept of Public Health (“BMC “care coordination” sponsors, Early Intervention programs), the Massachusetts Department of Social Services (our Family Development Center is funded by DSS), coordination with Boston Healthy Start (through referrals from the newborn Nursery and Comprehensive Care Program), consultation to the Boston Public Schools, and the Suffolk County District Attorney's Office. We enjoy a close working relationship with the MCHB sponsored Maternal-Child Health department at the Boston University School of Public Health, and Sargent College’s integrated occupational therapy initiative.

EVALUATION
The fellowship training program utilizes three modes of programmatic evaluation: 1) A Fellow's Log to keep track of the fellow's clinical and didactic experiences during the fellowship; 2) A Faculty Evaluation Form, which rates the fellows' skills and competence in achieving the fellowship goals; and 3) The academic productivity, teaching, and clinical achievements of the fellows, both during and after the fellowship.

ANNOTATION
The purpose of the DBP Fellowship Training Program at Boston Medical Center / Boston University School of Medicine (BMC/BUSM) is to train pediatricians to become academic and programmatic leaders in the field of Developmental-Behavioral Pediatrics (DBP), and to enhance the skills and competence of other pediatricians and child professionals to address the developmental and behavioral issues of children across disparate socio-economic strata and cultures. The methodology to achieve these goals includes a three year fellowship program with intensive training in clinical, research, teaching, advocacy and administrative skills, with a special focus on economically disadvantaged families, and educational and training programs for pediatricians, residents, medical students and other professionals. Evaluation will occur through careful documentation of the achievement of measurable project objectives.

KEYWORDS
Behavioral Pediatrics / Family Centered Health Care / Maternal and Child Health Bureau / Medical Home / Pediatricians / Professional Education in Behavioral Pediatrics / Professional Education in Chronic Illnesses and Disabilities / Professional Education in Cultural Sensitivity / Title V Programs / Urban Population