EDITORIAL

Help is on the way

The applicant is a 31-year-old man who holds an MD degree and has spent the past two years in a postdoctoral fellowship. His research has focused on the molecular pathogenesis of cardiomyopathies associated with muscular dystrophy. He has described a method for preventing cardiomyopathy in genetic mouse models and has 11 published articles with more in preparation. I'm meeting with him because he is interested in a combined training program in genetics and pediatrics being offered at our institution. He's the father of two children, is friendly and enthusiastic, and has a good sense of humor. What impresses me most, however, is his persistence in wanting me to know that his laboratory research is secondary to his desire to acquire clinical skills that will ensure his becoming a superb pediatrician. He emphasizes that his laboratory efforts have all been inspired by one patient with muscular dystrophy—and he shows me a picture of that patient. His goal is to become a pediatrician who will know how to provide ongoing, complete care to patients like this one. He would also like to continue his laboratory work in the hope that he will one day help to prevent or cure such conditions in children.

Though among the most impressive applicants, this man is only one of many dedicated and determined future pediatricians who are applying to pediatric residency programs this year. The same day I interviewed this applicant I also met with a young woman who will graduate with both an MD and a PhD whose laboratory accomplishments rival his. She also wants to become the best pediatrician she can be. And then she wants to tackle autism.

Some observers have worried that because of a national environment favoring primary care many of the more scientifically minded college graduates were being drawn away from medical school and away from pediatrics. Department chairs have had a hard time filling faculty positions in many of the pediatric subspecialties, leading to concern about availability of clinical care for children with chronic conditions and about research and discovery that will benefit our patients. If the resident applicants we have seen so far are indicative of the pediatrics-bound medical students around the country, however, help is on the way.

This is good news. We have a lot to do. In just this one issue of Contemporary Pediatrics we offer an example of a successful effort to prevent disease (varicella vaccine) as well as discussions of two diseases about which there are still great mysteries (type 2 diabetes and asthma). To tackle problems such as these we will need investigators to uncover epidemiologic clues and approaches to prevention and treatment, and we'll need knowledgeable community pediatricians to implement solutions. Without both, we won't do the best job possible for children.

Julia A. McMillan, MD, Editor-in-chief of Contemporary Pediatrics, is Vice Chair, Pediatric Education, and Director, Residency Training, Johns Hopkins University School of Medicine, Baltimore.

 

Julia McMillan. Editorial: Help is on the way. Contemporary Pediatrics 2001;1:9.