Introduction: Three pathways are available to students considering a pediatric emergency medicine(PEM) career: pediatric residency followed by PEM fellowship (Peds-PEM); emergency medicineresidency followed by PEM fellowship (EM-PEM); and combined EM and pediatrics residency(EM&Peds). Questions regarding differences between the training pathways are common amongmedical students. We present a comparative analysis of training pathways highlighting majorcurricular differences to aid in students’ understanding of these training options.

Methods: All currently credentialed training programs for each pathway with curricula publishedon their websites were included. We analyzed dedicated educational units (EU) core to all threepathways: emergency department (ED), pediatric-only ED, critical care, and research. Minimumrequirements for primary residencies were assumed for fellowship trainees.

Results: Of the 75 Peds-PEM, 34 EM-PEM, and 4 EM&Peds programs screened, 85% of Peds-PEM and EM-PEM and all EM&Peds program curricula were available for analysis. AveragePeds-PEM EUs were 20.4 EM, 20.1 pediatric-only EM, 5.8 critical care, and 9.0 research. AverageEM-PEM EUs were 33.2 EM, 18.3 pediatric-only EM, 6.5 critical care, and 3.3 research. AverageEM&Peds EUs were 26.1 EM, 8.0 pediatric-only EM, 10.0 critical care, and 0.3 research.

Conclusion: All three pathways exceed pediatric-focused training required for EM or pediatricresidency. Peds-PEM has the most research EUs, EM-PEM the most EM EUs, and EM&Pedsthe most critical care EUs. All prepare graduates for a pediatric emergency medicine career. Understanding the difference in emphasis between pathways can inform students to select the bestpathway for their own careers.