We applaud the Pediatric Hospital Medicine fellowship directors for their collaboration in the development of core competencies that can be applied to all pediatric hospitalist programs. We found wide variability in the structure and requirements of the programs and believe that the establishment of core competencies will likely be of benefit in bringing greater uniformity and structure to curricula in the training programs.
Regarding the findings of the survey undertaken by Dr. Manicone, we believe a few issues deserve clarification and may lead to different conclusions. First, Dr. Manicone asked program directors to try to determine which of the deidentified programs in our tables were most likely to be their own program. We are unable, as is he, to infer how many, if any, were able to guess correctly. If a program director guessed incorrectly, undoubtedly they would, by definition, feel their program was not represented accurately. Second, our study was conducted in early 2007, and his 2 years later. It is possible, even likely, that some of these programs have modified their training during that time period. This may be one reason a program director might believe the description of their program is inaccurate at this time. Third, Dr. Manicone notes that he was not the program director of the Children's National Medical Center at the time of the survey and was not interviewed by our research team. It is certainly possible that the program directors of several other medical centers