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With the commitment on the part of the American Osteopathic Association, the American Association of Colleges of Osteopathic Medicine, and the Accreditation Council for Graduate Medical Education to transition to a single graduate medical education accreditation system by 2020, a legitimate concern exists about the future of pediatric residency training that maintains an osteopathic focus. The authors describe a dually accredited pediatric residency program at one of the nation's largest children's hospitals, which may serve as a potential model of how to integrate a robust osteopathic-based education into a general pediatric residency program.

Uniformity in a teaching hospital's pediatric outpatient clinic is often inconsistent because of the varying numbers of housestaff involved in patient evaluation. We have developed a flow sheet that defines the appropriate standards of care to be delivered at the Doctors Hospital Pediatric Outpatient Clinic. This flow sheet encompasses a method of rapid assessment of growth, development, physical examination, immunization status, screening laboratory testing, and parental education. We have defined these parameters as the minimal evaluation to be completed at each preschool well-child visit.