Adolescent medicine

Adolescent medicine also known as adolescent and young adult medicine is a medical subspecialty that focuses on care of patients who are in the adolescent period of development. This period begins at puberty and lasts until growth has stopped,[1][2] at which time adulthood begins. Typically, patients in this age range will be in the last years of middle school up until college graduation (some doctors in this subspecialty treat young adults attending college at area clinics, in the subfield of college health). In developed nations, the psychosocial period of adolescence is extended both by an earlier start, as the onset of puberty begins earlier, and a later end, as patients require more years of education or training before they reach economic independence from their parents.[3]

For the journal, see Journal of Adolescent Health.
Adolescent Medicine Physician
Occupation
Names
  • Physician
Occupation type
Specialty
Activity sectors
Medicine
Description
Education required
Fields of
employment
Hospitals, Clinics
Related jobs

Medicine is often categorized most simply as pediatric and adult, with the pediatric category covering from infancy through both childhood and adolescence. However, such categorization is further divided in some contexts, such that adolescent medicine can be a more specific focus within pediatrics and geriatrics can be a more specific focus within adult medicine.

Issues with a high prevalence during adolescence are frequently addressed by providers. These include:

Gay, lesbian and bisexual young people

Adolescents who are gay, lesbian or bisexual tend to demonstrate more risky health behaviors and have worse health outcomes compared to heterosexual youth, including:[4]

  • Substance abuse
  • Suicidality
  • Eating disorders and body image
  • Sexual behaviors, including unintended pregnancy involvement (Contrary to assumptions, gay, bisexual or lesbian youth are more likely to report involvement in pregnancy compared to their heterosexual peers)[5]
  • Homelessness, which affects health and access to care

Chronic conditions

The rising dominance of chronic conditions over acute conditions, along with dramatic improvement in life expectancy, has made the management of such chronic conditions in adolescence of greater importance: Chronic conditions and adolescent development are mutually impactful.

Chronic conditions often cause delay in onset of puberty and temporary or permanent impediments to growth; conversely the growth and hormonal changes can destabilize treatment for the chronic condition. An increase in independence can lead to gaps in self-management, for example, in the decreased management of diabetes.[6]

Young peoples' access to health care

In addition, issues of medical ethics, particularly related to confidentiality and the right to consent for medical care, are pertinent to the practice of adolescent medicine.[7]

Marginalised young people’s access is affected by their ability to recognize and understand health issues; service knowledge and attitudes toward help seeking; structural barriers; professionals' knowledge, skills, attitudes; service environments and structures; ability to navigate the health system; youth participation; and technology opportunities.[8] Marginalised young people’s healthcare journeys can be supported by advocates that help them navigate the health system.[9]

The particular needs of young people when accessing healthcare have also led the WHO to publishing guidelines [10] for adolescent-friendly health care, in an effort to increase adolescents utilization of the healthcare system.

Training

Adolescent medicine providers are generally drawn from the specialties of pediatrics, internal medicine, med/peds or family medicine. The certifying boards for these different specialties have varying requirements for certification, though all require successful completion of a fellowship and a passing score on a certifying exam. The American Board of Pediatrics and the American Board of Internal Medicine require evidence of scholarly achievement by candidates for subspecialty certification, usually in the form of an original research study.

In the United States, subspecialty medical board certification in adolescent medicine is available through the specialty boards of American Board of Internal Medicine, the American Osteopathic Board of Neurology and Psychiatry, the American Board of Family Medicine, the American Osteopathic Board of Family Physicians, the American Board of Pediatrics, and the American Osteopathic Board of Pediatrics.[11]

List of adolescent health centers in the United States

Many subspecialists practice as part of general specialty clinics or practices, or in high school or college clinics. In addition, many major metropolitan areas have clinics that offer adolescent-specific care. A partial list includes:

San Antonio, Texas

Dallas, Texas

  • Adolescent and Young Adult Clinic at Children's Medical Center (Dallas)
  • Windhaven Adolescent Medicine Clinic at Texas Health Presbyterian Hospital (Plano)
  • Girls to Women Health and Wellness (North Dallas)
  • Young Men's Health and Wellness (North Dallas)

U.S. Air Force Academy, Colorado Spring, Colorado

Kansas City, Missouri

Indianapolis, Indiana

New York City, New York

Dayton, Ohio

Rochester, New York

Los Angeles, California

San Francisco area

Massachusetts[13]


Philadelphia, Pennsylvania

Columbus, Ohio

Seattle, Washington

Cincinnati, Ohio

Richmond, Virginia

Fayetteville, North Carolina

List of adolescent health centers in Australia

These hospitals offer adolescent-specific care:

Sydney

Melbourne

Relationship with college health
Main article: College health

In the United States, the subspecialty of college health is closely affiliated with adolescent medicine. Many adolescent medicine fellowships include rotations in college-based student health clinics and many adolescent medicine physicians work in college health clinics.[15][16]

Professional organizations

In addition to membership in the organizations for their various specialties, adolescent medicine providers often belong to The Society for Adolescent Health and Medicine and/or The North American Society for Pediatric and Adolescent Gynecology.

Founded in 1987, the International Association for Adolescent Health (IAAH) is a multidisciplinary, non-government organization with a broad focus on youth health.[17]

Publications

See also

References
  1. Behavioral medicine : a guide for clinical practice. Feldman, Mitchell D.,, Christensen, John F. (Fourth ed.). New York. 2014-08-07. ISBN 9780071767705. OCLC 897078390.{{cite book}}: CS1 maint: location missing publisher (link) CS1 maint: others (link)
  2. Rieder S, Alderman EM, Cohen, MI (Feb 2011). "Adolescent Medicine: Emergence of a New Specialty". AMA Journal of Ethics. 7 (3). doi:10.1001/virtualmentor.2005.7.3.msoc1-0503. PMID 23249495. Retrieved 20 Sep 2020.
  3. "Child and Adolescent Health, Credo Encyclopedia". Retrieved October 27, 2013.
  4. Coker, TR; Austin, SB; Schuster, MA (2010). "The Health and Health Care of Lesbian, Gay, and Bisexual Adolescents". Annual Review of Public Health. 31: 457–477. doi:10.1146/annurev.publhealth.012809.103636. PMID 20070195.
  5. Saewyc, EM; Poon, CS; Homma, Y; et al. (2008). "Stigma management? The links between enacted stigma and teen pregnancy trends among gay, lesbian, and bisexual students in British Columbia". The Canadian Journal of Human Sexuality. University of Toronto Press. 17 (3): 123–139. ISSN 1188-4517. OCLC 53880937. PMC 2655734. PMID 19293941.
  6. Michaud, PA; Suris, JC; Viner, R (2007). The Adolescent with a Chronic Condition: Epidemiology, developmental issues and health care provision. Department of Child and Adolescent Health and Development. World Health Organization. ISBN 978-92-4-159570-4. Archived from the original (Discussion papers on adolescence) on 3 July 2022.
  7. "Adolescent Health Care, Confidentiality". American Academy of Family Physicians. Retrieved 24 Sep 2020.
  8. Robards, Fiona; Kang, Melissa; Usherwood, Tim; Sanci, Lena (2018). "How Marginalized Young People Access, Engage With, and Navigate Health-Care Systems in the Digital Age: Systematic Review". Journal of Adolescent Health. 62 (4): 365–381. doi:10.1016/j.jadohealth.2017.10.018. ISSN 1054-139X. LCCN 91642057. OCLC 807447214. PMID 29429819.
  9. Robards, Fiona; Kang, Melissa; Tolley, Kate; Hawke, Catherine; Sanci, Lena; Usherwood, Tim (2018). "Marginalised young people's healthcare journeys: Professionals' perspectives". Health Education Journal. Thousand Oaks, CA: Sage. 77 (6): 692–704. doi:10.1177/0017896917752965. eISSN 1748-8176. ISSN 0017-8969. LCCN 49052191. OCLC 300300198. S2CID 79580047.
  10. World Health Organization. (2009). Quality assessment guidebook: A guide to assessing health services for adolescent clients. https://apps.who.int/iris/handle/10665/44240
  11. "Specialties & Subspecialties". American Osteopathic Association. Archived from the original on 2015-08-13. Retrieved 25 September 2012.
  12. "Adolescent Medicine - Pediatrics - IU School of Medicine". iu.edu. Archived from the original on 26 March 2018. Retrieved 9 April 2018.
  13. "Adolescent health centers in Massachusetts".
  14. "Directory of school-based health centers".
  15. "Adolescent Medicine – Education & Training | The Children's Hospital at Montefiore". www.cham.org. Retrieved 2020-12-15.
  16. "Adolescent Medicine Fellowship". UPMC Children's Hospital of Pittsburgh. Retrieved 14 December 2020.
  17. "History". International Association for Adolescent Health. Retrieved 10 May 2020.

Further reading
  • Hergenroeder, Albert; Weimann, Constance (May 2018). Health Care Transition: Building A Program for Adolescents and Young Adults with Chronic Illness and Disability. Springer. doi:10.1007/978-3-319-72868-1. ISBN 978-3-319-72867-4. S2CID 19136208.
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