When I learned I was the recipient of this year’s Joseph W. St Geme Jr Award, I was honored, to say the least, and for a while at a loss for written or spoken words, which for those who know me is highly unusual. It is humbling to be considered in the same category as previous awardees and as someone who exemplifies what Dr St Geme strove for in his own life as a leader, consensus builder, unifier, and collaborator. In thinking about receiving this award and how I might reflect on the values and attributes of Dr St Geme, I wondered what he might say about the world in which we live today.
Instead of consensus building, in 2014 we live in a world of silos, meaning more and more aspects of pediatrics are becoming stand-alone towers that seem unable to connect with one another. There are certainly the silos we are familiar with in medical education—undergraduate, graduate, and continuing medical education, and new ones like maintenance of certification—all hoping to join together, but each with their own curriculum, standards, and assessments.
Clinical care has also become increasingly more fragmented. Think of the many pediatric subspecialties that exist today, each with their own set of boards and requirements, and the new ones being developed, such as general academic pediatrics and hospitalist medicine, which are now striving to be recognized as separate board-certifiable fields when they had not until recently been considered as such.
In addition to clinical pediatrics, research has also become more siloed. Just how specialized has our field of pediatric research become? Just look at the program for this past year’s Pediatric Academic Societies (PAS) meeting, and it’s no longer a simple listing of papers and posters on neonatology. Instead you can select your area of interest …
Address correspondence to Lewis R. First, MD, UVM, Department of Pediatrics, Given Courtyard, S250, Burlington, VT 05405. E-mail: