| The Ambulatory Pediatric Association Fellowship in Pediatric Environmental Health: A 5-Year Assessment Philip J. Landrigan,1,2 Alan D. Woolf,3 Ben Gitterman,4 Bruce Lanphear,5 Joel Forman,1,2 Catherine Karr,6 Erin L. Moshier,1 James Godbold,1 and Ellen Crain7 1Department of Community and Preventive Medicine, and 2Department of Pediatrics, Mount Sinai School of Medicine, New York, New York, USA; 3Department of Pediatrics, Children's Hospital, Boston and Harvard Medical School, Boston, Massachusetts, USA; 4Department of Pediatrics, George Washington University School of Medicine, Washington, DC, USA; 5Department of General Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA; 6Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA; 7Department of Pediatrics (Emergency Medicine), Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA Abstract
Background: Evidence is mounting that environmental exposures contribute to causation of disease in children. Yet few pediatricians are trained to diagnose, treat, or prevent disease of environmental origin. Objectives: To develop a cadre of future leaders in pediatric environmental health (PEH) , the Ambulatory Pediatric Association (APA) launched a new 3-year fellowship in 2001—the world's first formal training program in PEH. Sites were established at Boston Children's Hospital, Mount Sinai School of Medicine, George Washington University, University of Cincinnati, and University of Washington. Fellows are trained in epidemiology, biostatistics, toxicology, risk assessment, and preventive medicine. They gain clinical experience in environmental pediatrics and mentored training in clinical research, policy development, and evidence-based advocacy. Thirteen fellows have graduated. Two sites have secured follow-on federal funding to enable them to continue PEH training. Discussion: To assess objectively the program's success in preparing fellows for leadership careers in PEH, we conducted a mailed survey in 2006 with follow-up in 2007. Conclusions: Fifteen (88%) of 17 fellows and graduates participated ; program directors provided information on the remaining two. Nine graduates are pursuing full-time academic careers, and two have leadership positions in governmental and environmental organizations. Ten have published one or more first-authored papers. Seven graduates are principal investigators on federal or foundation grants. The strongest predictors of academic success are remaining affiliated with the fellowship training site and devoting < 20% of fellowship time to clinical practice. Conclusion: The APA fellowship program is proving successful in preparing pediatricians for leadership careers in PEH. Key words: community pediatrics, environmental medicine, environmental pediatrics, fellowship training, medical education. Environ Health Perspect 115:1383–1387 (2007) . doi:10.1289/ehp.10015 available via http://dx.doi.org/ [Online 28 June 2007]
Address Correspondence to P.J. Landrigan, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1057, New York, NY 10029-6574, USA, Telephone: (212) 241-6173. Fax: (212) 996-0407. E-mail: phil.landrigan@mssm.edu The authors gratefully acknowledge the guidance of J.F. Steiner of the Division of General Internal Medicine, University of Colorado Health Sciences Center. This research was supported by The Mount Sinai Center for Children's Environmental Health and Disease Prevention Research (grants ES-09584 and EPA-R827039) ; the Mount Sinai Pediatric Environmental Health Specialty Unit (grant U50ATU300014) ; and the Ambulatory Pediatric Association Fellowship in Pediatric Environmental Health, which received core funding from the New York Community Trust and the Educational Foundation of America. The authors declare they have no competing financial interests. Received 19 December 2006 ; accepted 28 June 2007.
Addendum At the end of "Program Description," a new section, "Conclusion of funding," has been added.
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